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FAMILY DENTIST OF PALM BEACH, INC. - Florida Company Profile

Company Details

Entity Name: FAMILY DENTIST OF PALM BEACH, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

FAMILY DENTIST OF PALM BEACH, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.

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: 20 Dec 2002 (22 years ago)
Document Number: P02000133247
FEI/EIN Number 510437993

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 11903 SOUTHERN BLVD, 116, ROYAL PALM BEACH, FL, 33411, US
Mail Address: 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
ZIP code: 33411
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1699913111 2009-01-22 2009-01-22 11903 SOUTHERN BLVD, STE 116, ROYAL PALM BEACH, FL, 334117644, US 11903 SOUTHERN BLVD, STE 116, ROYAL PALM BEACH, FL, 334117644, US

Contacts

Phone +1 561-795-7668

Authorized person

Name DR. SUNITHA SIRIVOLU
Role PRESIDENT
Phone 5617957668

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DN15871
State FL
Is Primary Yes
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DN12943
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY DENTIST OF PALM BEACH INC 401(K) PLAN 2023 510437993 2024-07-09 FAMILY DENTIST OF PALM BEACH INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5612360707
Plan sponsor’s address 11903 SOUTHERN BOULEVARD, SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2024-07-09
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-09
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC 401(K) PLAN 2022 510437993 2023-06-16 FAMILY DENTIST OF PALM BEACH INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5612360707
Plan sponsor’s address 11903 SOUTHERN BOULEVARD, SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2023-06-16
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC 401(K) PLAN 2021 510437993 2022-06-10 FAMILY DENTIST OF PALM BEACH INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5612360707
Plan sponsor’s address 11903 SOUTHERN BOULEVARD, SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2022-06-10
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC 401(K) PLAN 2020 510437993 2021-06-11 FAMILY DENTIST OF PALM BEACH INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5612360707
Plan sponsor’s address 11903 SOUTHERN BOULEVARD, SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2021-06-11
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2019 510437993 2020-06-23 FAMILY DENTIST OF PALM BEACH INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2020-06-23
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2018 510437993 2019-06-13 FAMILY DENTIST OF PALM BEACH INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2019-06-13
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2017 510437993 2018-06-29 FAMILY DENTIST OF PALM BEACH INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2018-06-29
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2016 510437993 2017-06-16 FAMILY DENTIST OF PALM BEACH INC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2017-06-16
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2015 510437993 2016-07-11 FAMILY DENTIST OF PALM BEACH INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2016-07-11
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
FAMILY DENTIST OF PALM BEACH INC PROFIT SHARING PLAN 2014 510437993 2015-07-21 FAMILY DENTIST OF PALM BEACH INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5617957668
Plan sponsor’s address 11903 SOUTHERN BLVD SUITE 116, ROYAL PALM BEACH, FL, 33411

Signature of

Role Plan administrator
Date 2015-07-21
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-21
Name of individual signing NARENDRA SIRIVOLU
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
SIRIVOLU NARENDRA Vice President 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
SIRIVOLU NARENDRA Secretary 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
SIRIVOLU NARENDRA Director 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
SIRIVOLU SUNITHA President 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
SIRIVOLU SUNITHA Treasurer 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
SIRIVOLU SUNITHA Director 4489 MARINERS COVE DR., WELLINGTON, FL, 33449
Sirivolu Kapil S Mr 4489 mariners cove dr, wellington, FL, 33449
SIRIVOLU SUNITHA Agent 11903 SOUTHERN BLVD, ROYAL PALM BEACH, FL, 33411

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2012-04-15 11903 SOUTHERN BLVD, 116, ROYAL PALM BEACH, FL 33411 -
REGISTERED AGENT NAME CHANGED 2012-04-15 SIRIVOLU, SUNITHA -
CHANGE OF MAILING ADDRESS 2010-04-15 11903 SOUTHERN BLVD, 116, ROYAL PALM BEACH, FL 33411 -
REGISTERED AGENT ADDRESS CHANGED 2004-03-22 11903 SOUTHERN BLVD, 116, ROYAL PALM BEACH, FL 33411 -

Documents

Name Date
ANNUAL REPORT 2024-04-12
ANNUAL REPORT 2023-04-07
ANNUAL REPORT 2022-04-10
ANNUAL REPORT 2021-04-25
ANNUAL REPORT 2020-03-26
ANNUAL REPORT 2019-06-12
ANNUAL REPORT 2018-04-22
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-04-19
ANNUAL REPORT 2015-04-11

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1099778503 2021-02-18 0455 PPS 11903 Southern Blvd Ste 116, Royal Palm Beach, FL, 33411-7644
Loan Status Date 2022-01-20
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 128653
Loan Approval Amount (current) 128653
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Royal Palm Beach, PALM BEACH, FL, 33411-7644
Project Congressional District FL-20
Number of Employees 15
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 129710.42
Forgiveness Paid Date 2021-12-16
6630427701 2020-05-01 0455 PPP 11903 SOUTHERN BLVD STE 116, ROYAL PALM BEACH, FL, 33411-7644
Loan Status Date 2021-01-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 181657
Loan Approval Amount (current) 181657
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address ROYAL PALM BEACH, PALM BEACH, FL, 33411-7644
Project Congressional District FL-20
Number of Employees 19
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 182811.64
Forgiveness Paid Date 2020-12-23

Date of last update: 02 Mar 2025

Sources: Florida Department of State