| Entity Name: | BEULAH ROAD DENTAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Feb 2023 (2 years ago) |
| Document Number: | L23000051558 |
| FEI/EIN Number | 92-2146445 |
| Address: | 8716 Beulah Road, Pensacola, FL, 32526, US |
| Mail Address: | 8716 Beulah Road, Pensacola, FL, 32526, US |
| ZIP code: | 32526 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922704329 | 2023-02-07 | 2023-02-07 | 8716 BEULAH RD, PENSACOLA, FL, 325265326, US | 8716 BEULAH RD, PENSACOLA, FL, 325265326, US | |||||||||||||
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| Phone | +1 850-706-5688 |
Authorized person
| Name | DR. ETHAN SADOWSKI |
| Role | OWNER DENTIST |
| Phone | 8507065688 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BEULAH ROAD DENTAL 401K | 2023 | 922146445 | 2024-07-04 | BEULAH ROAD DENTAL PLLC | 10 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-04 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ETHAN SADOWSKI | Agent | 8716 Beulah Road, Pensacola, FL, 32526 |
| Name | Role | Address |
|---|---|---|
| ETHAN SADOWSKI | Manager | 1310 E. MALLORY ST., PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-23 | 8716 Beulah Road, Pensacola, FL 32526 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-23 | 8716 Beulah Road, Pensacola, FL 32526 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-23 | 8716 Beulah Road, Pensacola, FL 32526 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| Florida Limited Liability | 2023-02-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
