| Entity Name: | IDEAL DENTAL SOUTH JACKSONVILLE PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Jun 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Jan 2024 (a year ago) |
| Document Number: | L22000256433 |
| FEI/EIN Number | 88-2812702 |
| Mail Address: | 12750 Merit Dr. Suite 1100, Dallas, TX, 75251, US |
| Address: | 5700 BEACH BOULEVARD, JACKSONVILLE, FL, 32207 |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255067179 | 2022-07-25 | 2023-10-04 | PO BOX 840925, DALLAS, TX, 752840925, US | 5753 BEACH BOULEVARD, UNIT #4, JACKSONVILLE, FL, 32207, US | |||||||||||||||||
|
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| Phone | +1 972-361-0600 |
| Phone | +1 904-441-1642 |
| Fax | 9048773037 |
Authorized person
| Name | MATTHEW DOAN |
| Role | OWNER |
| Phone | 9723318079 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| COUSSA, DMD JOSHUA J | Authorized Member | 5700 BEACH BOULEVARD, JACKSONVILLE, FL, 32207 |
| DOAN, DDS MATTHEW | Authorized Member | 5700 BEACH BOULEVARD, JACKSONVILLE, FL, 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-01-29 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-29 | 5700 BEACH BOULEVARD, JACKSONVILLE, FL 32207 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-29 | C T CORPORATION SYSTEM | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-01-29 |
| Florida Limited Liability | 2022-06-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
