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  5. LAKELAND PERIODONTICS, INC.

LAKELAND PERIODONTICS, INC.

Company Details

Entity Name: LAKELAND PERIODONTICS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 19 Jul 2001 (24 years ago)
Document Number: P01000071275
FEI/EIN Number 593737600
Address: 3003 S. FLORIDA AVE., STE 201, LAKELAND, FL, 33803
Mail Address: 3003 S. FLORIDA AVE., STE 201, LAKELAND, FL, 33803
ZIP code: 33803
County: Polk
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1508892225 2006-06-24 2020-08-22 3003 S FLORIDA AVE, SUITE 201, LAKELAND, FL, 338034050, US 3003 S FLORIDA AVE, SUITE 201, LAKELAND, FL, 338034050, US

Contacts
Phone +1 863-687-9227
Fax 8636872813

Authorized person
Name DONNA L TODD
Role INSURANCE COORDINATOR
Phone 8636879227

Taxonomy
Taxonomy Code 1223P0300X - Periodontist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2023 593737600 2024-09-05 LAKELAND PERIODONTICS, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. CASH BALANCE PLAN AND TRUST 2023 593737600 2024-09-05 LAKELAND PERIODONTICS, INC. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2022 593737600 2023-06-29 LAKELAND PERIODONTICS, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. CASH BALANCE PLAN AND TRUST 2022 593737600 2023-06-29 LAKELAND PERIODONTICS, INC. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. CASH BALANCE PLAN AND TRUST 2021 593737600 2022-06-09 LAKELAND PERIODONTICS, INC. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2021 593737600 2022-06-09 LAKELAND PERIODONTICS, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2020 593737600 2021-04-30 LAKELAND PERIODONTICS, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2019 593737600 2020-05-27 LAKELAND PERIODONTICS, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2018 593737600 2019-05-17 LAKELAND PERIODONTICS, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050
LAKELAND PERIODONTICS, INC. EMPLOYEES PROFIT SHARING PLAN AND TRUST 2017 593737600 2018-03-15 LAKELAND PERIODONTICS, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 8636879227
Plan sponsor’s address 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 338034050

Agent

Name Role Address
CAMPBELL DAVID A Agent 3003 S. FLORIDA AVE., LAKELAND, FL, 33803

Director

Name Role Address
CAMPBELL DAVID A Director 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 33803

President

Name Role Address
CAMPBELL DAVID A President 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 33803

Secretary

Name Role Address
CAMPBELL DAVID A Secretary 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 33803

Treasurer

Name Role Address
CAMPBELL DAVID A Treasurer 3003 S. FLORIDA AVE., STE. 201, LAKELAND, FL, 33803

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000059334 LAKELAND PERIODONTICS AND IMPLANT DENTISTRY ACTIVE 2017-05-30 2027-12-31 No data 232 N MASSACHUSETTS AVE, LAKELAND, FL, 33801--498

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2016-02-28 CAMPBELL, DAVID A No data
CHANGE OF PRINCIPAL ADDRESS 2012-04-26 3003 S. FLORIDA AVE., STE 201, LAKELAND, FL 33803 No data
CHANGE OF MAILING ADDRESS 2012-04-26 3003 S. FLORIDA AVE., STE 201, LAKELAND, FL 33803 No data
REGISTERED AGENT ADDRESS CHANGED 2012-04-26 3003 S. FLORIDA AVE., STE 201, LAKELAND, FL 33803 No data

Documents

Name Date
ANNUAL REPORT 2024-04-24
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-04-25
ANNUAL REPORT 2021-04-26
ANNUAL REPORT 2020-06-28
ANNUAL REPORT 2019-04-24
ANNUAL REPORT 2018-04-26
ANNUAL REPORT 2017-04-19
ANNUAL REPORT 2016-02-28
ANNUAL REPORT 2015-04-22

Related by officers

CAMPBELL DAVID A

DATA MANAGEMENT PROFESSIONALS, LLC FINE CUSTOM CABINETRY LLC PEACEBE AND THE HEARTWATCH, LLC 24/7 WHITE CAR TRANSPORTATION, INC. DAVID CAMPBELL CONCRETE,LLC SATISFACTION STONE INSTALLERS L.L.C. DA. CAMPBELL MANAGEMENT CONSULTING LLC. SMELL EZ LLC SOUTHERN GRADE, INC DRAINFIELD DESIGN AND DENSITY CORP.

Related by address

3003 S. FLORIDA AVE., STE 201, LAKELAND, FL, 33803

DAVID A. CAMPBELL, D.M.D., P.A.

3003 S. FLORIDA AVE., STE 201, LAKELAND, FL, 33803

DAVID A. CAMPBELL, D.M.D., P.A.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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