| Entity Name: | EGAO, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Jul 2024 (7 months ago) |
| Document Number: | L24000313089 |
| Address: | 10611 AVENTURA DR., JACKSONVILLE, FL 32256 |
| Mail Address: | 10611 AVENTURA DR., JACKSONVILLE, FL 32256 |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760214530 | 2024-08-19 | 2024-08-19 | 1550 RIVERSIDE AVE, JACKSONVILLE, FL, 322044161, US | 1550 RIVERSIDE AVE, JACKSONVILLE, FL, 322044161, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 518-466-4294 |
Authorized person
| Name | DR. JASMINE SHAKYA |
| Role | DENTIST/OWNER |
| Phone | 5184664294 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | No |
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | No |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Taxonomy Code | 1223P0106X - Oral and Maxillofacial Pathology Dentist |
| Is Primary | No |
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | No |
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SHAKYA, JASMINE | Agent | 10611 AVENTURA DR., JACKSONVILLE, FL 32256 |
| Name | Role | Address |
|---|---|---|
| SHAKYA, JASMINE | Authorized Member | 10611 AVENTURA DR., JACKSONVILLE, FL 32256 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000097324 | ALL SMILES ON RIVERSIDE | ACTIVE | 2024-08-15 | 2029-12-31 | No data | 1550 RIVERSIDE AVENUE, UNIT B, JACKSONVILLE, FL, 32204 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-07-15 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
