| Entity Name: | PALM SPRINGS FAMILY DENTISTRY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Feb 2004 (21 years ago) |
| Date of dissolution: | 03 Jan 2025 (a month ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 03 Jan 2025 (a month ago) |
| Document Number: | P04000031945 |
| FEI/EIN Number | 753148003 |
| Address: | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
| Mail Address: | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
| ZIP code: | 33461 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PALM SPRINGS FAMILY DENTISTRY PENSION PLAN | 2012 | 753148003 | 2013-10-01 | PALM SPRINGS FAMILY DENTISTRY P A | 14 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-10-01 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-10-01 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2005-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5612961010 |
| Plan sponsor’s address | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
Plan administrator’s name and address
| Administrator’s EIN | 753148003 |
| Plan administrator’s name | PALM SPRINGS FAMILY DENTISTRY P A |
| Plan administrator’s address | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
| Administrator’s telephone number | 5612961010 |
Signature of
| Role | Plan administrator |
| Date | 2012-09-25 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-09-25 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2005-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5612961010 |
| Plan sponsor’s address | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
Plan administrator’s name and address
| Administrator’s EIN | 753148003 |
| Plan administrator’s name | PALM SPRINGS FAMILY DENTISTRY P A |
| Plan administrator’s address | 3112 SOUTH CONGRESS AVENUE, SUITE B, PALM SPRINGS, FL, 33461 |
| Administrator’s telephone number | 5612961010 |
Signature of
| Role | Plan administrator |
| Date | 2011-09-07 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-09-07 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2005-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5612961010 |
| Plan sponsor’s address | 3112 SOUTH CONGRESS AVENUE, PALM SPRINGS, FL, 33461 |
Plan administrator’s name and address
| Administrator’s EIN | 753148003 |
| Plan administrator’s name | PALM SPRINGS FAMILY DENTISTRY, P.A. |
| Plan administrator’s address | 3112 SOUTH CONGRESS AVENUE, PALM SPRINGS, FL, 33461 |
| Administrator’s telephone number | 5612961010 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-13 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-09-13 |
| Name of individual signing | SREEDEVI SHANKARAIAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| palmsprings family dentistry | Agent | 3112 S. CONGRESS AVE, PALMSPRINGS, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| SHANKARAIAH SREEDEVI D | President | 3112 SOUTH CONGRESS AVENUE #B, PALM SPRINGS, FL, 33461 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2025-01-03 | No data | No data |
| REINSTATEMENT | 2018-10-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-10-24 | palmsprings family dentistry | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-03-30 | 3112 S. CONGRESS AVE, SUITE B, PALMSPRINGS, FL 33461 | No data |
| AMENDMENT AND NAME CHANGE | 2004-03-03 | PALM SPRINGS FAMILY DENTISTRY, P.A. | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2025-01-03 |
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-06-14 |
| REINSTATEMENT | 2018-10-24 |
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
