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DAVID F. RANDOLPH, D.M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: DAVID F. RANDOLPH, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Dec 2002 (23 years ago)
Document Number: P02000134177
FEI/EIN Number 364515831
Address: 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025
Mail Address: 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025
ZIP code: 32025
City: Lake City
County: Columbia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
RANDOLPH DAVID F President 1779 SW BARNETT WAY SUITE 101, LAKE CITY, FL, 32025
RANDOLPH DAVID F Director 1779 SW BARNETT WAY SUITE 101, LAKE CITY, FL, 32025
RANDOLPH DAVID FDr. Agent 1779 SW BARNETT WAY, LAKE CITY, FL, 32025

National Provider Identifier

NPI Number:
1528189446

Authorized Person:

Name:
DAVID F RANDOLPH
Role:
DENTIST
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fax:
3867552581

Form 5500 Series

Employer Identification Number (EIN):
364515831
Plan Year:
2024
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2024
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
10
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2019-02-15 RANDOLPH, DAVID F, Dr. -

Documents

Name Date
ANNUAL REPORT 2024-04-08
ANNUAL REPORT 2023-03-27
ANNUAL REPORT 2022-03-15
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-30
ANNUAL REPORT 2019-02-15
ANNUAL REPORT 2018-01-22
ANNUAL REPORT 2017-02-09
ANNUAL REPORT 2016-02-08
ANNUAL REPORT 2015-01-11

Paycheck Protection Program

Jobs Reported:
10
Initial Approval Amount:
$110,630
Date Approved:
2021-02-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$110,630
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$111,245.28
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $110,627
Utilities: $1

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Date of last update: 02 Aug 2025

Sources: Florida Department of State