| Entity Name: | JACKSONVILLE DENTAL SPECIALISTS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
JACKSONVILLE DENTAL SPECIALISTS, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 25 Jul 2023 (2 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 25 Jul 2023 (2 years ago) |
| Document Number: | L23000378442 |
| FEI/EIN Number |
80-0895301
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 11512 LAKE MEAD AVENUE, SUITE 532, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 11512 LAKE MEAD AVENUE, SUITE 532, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568915387 | 2016-07-28 | 2016-07-28 | 11512 LAKE MEAD AVE, STE. 532, JACKSONVILLE, FL, 322569680, US | 11512 LAKE MEAD AVE, STE. 532, JACKSONVILLE, FL, 322569680, US | |||||||||||||||||||||||||||
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| Phone | +1 904-460-4201 |
| Fax | 9046833914 |
Authorized person
| Name | LYDIA CUEVAS |
| Role | PRACTICE COORDINATOR |
| Phone | 9046834781 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| License Number | DN16648 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1223P0700X - Prosthodontist |
| License Number | DN18280 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JACKSONVILLE DENTAL SPECIALISTS 401(K) PROFIT SHARING PLAN | 2023 | 800895301 | 2024-07-29 | JACKSONVILLE DENTAL SPECIALISTS | 9 | |||||||||||||
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| JACKSONVILLE DENTAL SPECIALISTS 401(K) PROFIT SHARING PLAN | 2022 | 800895301 | 2023-07-17 | JACKSONVILLE DENTAL SPECIALISTS | 8 | |||||||||||||
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| JACKSONVILLE DENTAL SPECIALISTS 401(K) PROFIT SHARING PLAN | 2021 | 800895301 | 2022-07-26 | JACKSONVILLE DENTAL SPECIALISTS | 8 | |||||||||||||
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| JACKSONVILLE DENTAL SPECIALISTS 401(K) PROFIT SHARING PLAN | 2020 | 800895301 | 2021-10-05 | JACKSONVILLE DENTAL SPECIALISTS | 7 | |||||||||||||
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| JACKSONVILLE DENTAL SPECIALISTS 401(K) PROFIT SHARING PLAN | 2019 | 800895301 | 2020-07-29 | JACKSONVILLE DENTAL SPECIALISTS | 7 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| AGILA RICHARD E | Manager | 11512 LAKE MEAD AVENUE, SUITE 532, JACKSONVILLE, FL, 32256 |
| NAWROCKI MATTHEW | Manager | 11512 LAKE MEAD AVENUE, SUITE 532, JACKSONVILLE, FL, 32256 |
| NAWROCKI MATTHEW | Agent | 11512 LAKE MEAD AVENUE, SUITE 532, JACKSONVILLE, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2023-07-25 | - | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS. CONVERSION NUMBER 100000243251 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| Florida Limited Liability | 2023-07-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7560937710 | 2020-05-01 | 0491 | PPP | 11512 LAKE MEAD AVE, JACKSONVILLE, FL, 32256-9733 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State
