| Entity Name: | VINELAND MODERN DENTISTRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Jan 2022 (3 years ago) |
| Document Number: | L22000038483 |
| FEI/EIN Number | 87-4583800 |
| Address: | 6001 VINELAND RD, SUITE 119, ORLANDO, FL, 32819, US |
| Mail Address: | 11063 MOBBERLEY CIRCLE, ORLANDO, FL, 32832, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285371393 | 2022-05-19 | 2022-05-19 | 6001 VINELAND RD STE 119, ORLANDO, FL, 328197829, US | 6001 VINELAND RD STE 119, ORLANDO, FL, 328197829, US | |||||||||||||
|
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| Phone | +1 407-352-6001 |
Authorized person
| Name | JESSICA VAUGHN |
| Role | OFFICE MANAGER |
| Phone | 4073526001 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MONTIJO IVAN | Agent | 11063 MOBBERLEY CIRCLE, ORLANDO, FL, 32832 |
| Name | Role | Address |
|---|---|---|
| MONTIJO IVAN | Manager | 11063 MOBBERLEY CIRCLE, ORLANDO, FL, 32832 |
| Name | Role | Address |
|---|---|---|
| JADUN IBRAHIM | Authorized Member | 13011 STODDART AVE., ORLANDO, FL, 32827 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-02-08 |
| Florida Limited Liability | 2022-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
