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  5. DONALD B. EDWARDS, D.D.S., P.A.

DONALD B. EDWARDS, D.D.S., P.A.

Company Details

Entity Name: DONALD B. EDWARDS, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 27 Apr 1990 (35 years ago)
Date of dissolution: 22 Sep 2017 (7 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2017 (7 years ago)
Document Number: L69273
FEI/EIN Number 59-3019784
Address: 6885 1st St SW, VERO BEACH, FL 32968
Mail Address: 6885 1st St SW, VERO BEACH, FL 32968
ZIP code: 32968
County: Indian River
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215246467 2010-10-05 2013-09-16 927 37TH PL, SUITE C2, VERO BEACH, FL, 329604873, US 927 37TH PL, SUITE C2, VERO BEACH, FL, 32960, US

Contacts
Phone +1 772-567-3500
Fax 7725678627

Authorized person
Name DONALD EDWARDS
Role DR.
Phone 7725673500

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number DN7683
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE
Number 63582
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DONALD B. EDWARDS, D.D.S., P.A. PROFIT SHARING TRUST 2012 593019784 2013-01-15 DONALD B. EDWARDS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Signature of
Role Plan administrator
Date 2013-01-15
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-01-15
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
DONALD B. EDWARDS, D.D.S., P.A. PROFIT SHARING TRUST 2012 593019784 2013-01-15 DONALD B. EDWARDS, D.D.S., P.A. 7
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Signature of
Role Plan administrator
Date 2013-01-15
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-01-15
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
DONALD B. EDWARDS, D.D.S., P.A. PROFIT SHARING TRUST 2011 593019784 2012-03-02 DONALD B. EDWARDS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 593019784
Plan administrator’s name DONALD B. EDWARDS, D.D.S., P.A.
Plan administrator’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960
Administrator’s telephone number 7725673500

Signature of
Role Plan administrator
Date 2012-03-02
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-02
Name of individual signing DONALD B. EDWARDS
Valid signature Filed with authorized/valid electronic signature
DONALD B. EDWARDS, D.D.S., P.A. PROFIT SHARING TRUST 2010 593019784 2011-09-02 DONALD B. EDWARDS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 593019784
Plan administrator’s name DONALD B. EDWARDS, D.D.S., P.A.
Plan administrator’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960
Administrator’s telephone number 7725673500

Signature of
Role Plan administrator
Date 2011-09-02
Name of individual signing DONALD EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-02
Name of individual signing DONALD EDWARDS
Valid signature Filed with authorized/valid electronic signature
DONALD B. EDWARDS, DDS PA RETIREMENT TRUST 2009 593019784 2010-08-24 DONALD B. EDWARDS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 593019784
Plan administrator’s name DONALD B. EDWARDS, D.D.S., P.A.
Plan administrator’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960
Administrator’s telephone number 7725673500

Signature of
Role Plan administrator
Date 2010-08-24
Name of individual signing DONALD EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-24
Name of individual signing DONALD EDWARDS
Valid signature Filed with authorized/valid electronic signature
DONALD B. EDWARDS, D.D.S., P.A. PROFIT SHARING TRUST 2009 593019784 2010-08-12 DONALD B. EDWARDS, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 7725673500
Plan sponsor’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 593019784
Plan administrator’s name DONALD B. EDWARDS, D.D.S., P.A.
Plan administrator’s address 777 37TH STREET, SUITE B101, VERO BEACH, FL, 32960
Administrator’s telephone number 7725673500

Signature of
Role Plan administrator
Date 2010-08-12
Name of individual signing DR DONALD B EDWARDS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-12
Name of individual signing DR DONALD B EDWARDS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
EDWARDS, DONALD B., D.D.S., P.A. Agent 6885 1st SW, VERO BEACH, FL 32968

Director

Name Role Address
EDWARDS, Cindy Director 6885 1st St SW, VERO BEACH, FL 32968

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data
REGISTERED AGENT ADDRESS CHANGED 2016-01-13 6885 1st SW, VERO BEACH, FL 32968 No data
CHANGE OF PRINCIPAL ADDRESS 2015-04-22 6885 1st St SW, VERO BEACH, FL 32968 No data
CHANGE OF MAILING ADDRESS 2015-04-22 6885 1st St SW, VERO BEACH, FL 32968 No data

Documents

Name Date
ANNUAL REPORT 2016-01-13
ANNUAL REPORT 2015-04-22
ANNUAL REPORT 2014-04-14
ANNUAL REPORT 2013-04-04
ANNUAL REPORT 2012-04-10
ANNUAL REPORT 2011-04-06
ANNUAL REPORT 2010-03-24
ANNUAL REPORT 2009-03-20
ANNUAL REPORT 2008-03-26
ANNUAL REPORT 2007-01-19

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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