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  5. JOHN LAZZARA, DDS, PA

JOHN LAZZARA, DDS, PA

Company Details

Entity Name: JOHN LAZZARA, DDS, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 19 Jul 2007 (18 years ago)
Document Number: P07000082183
FEI/EIN Number 260575310
Address: 436 Jacksonville Drive, JACKSONVILLE BEACH, FL, 32250, US
Mail Address: 436 Jacksonville Drive, JACKSONVILLE BEACH, FL, 32250, US
ZIP code: 32250
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245429604 2007-10-22 2007-10-22 4184 3RD ST S, JACKSONVILLE BEACH, FL, 322505833, US 4184 3RD ST S, JACKSONVILLE BEACH, FL, 322505833, US

Contacts
Phone +1 904-270-8750
Fax 9042708755

Authorized person
Name DR. JOHN LAZZARA
Role PRESIDENT
Phone 9048062238

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number DN 18064
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHN LAZZARA DDS PA CASH BALANCE PLAN 2023 260575310 2024-09-24 JOHN LAZZARA DDS PA 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2024-09-24
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-24
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401(K) PROFIT SHARING PLAN & TRUST 2023 260575310 2024-04-03 JOHN LAZZARA DDS PA 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2024-04-03
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401(K) PROFIT SHARING PLAN & TRUST 2022 260575310 2023-05-24 JOHN LAZZARA DDS PA 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2023-05-24
Name of individual signing JENNIFER LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA CASH BALANCE PLAN 2022 260575310 2023-11-21 JOHN LAZZARA DDS PA 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2023-11-21
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-11-21
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA CASH BALANCE PLAN 2021 260575310 2022-10-11 JOHN LAZZARA DDS PA 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-11
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401(K) PROFIT SHARING PLAN & TRUST 2021 260575310 2022-05-25 JOHN LAZZARA DDS PA 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing JENNIFER LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401(K) PROFIT SHARING PLAN & TRUST 2020 260575310 2021-05-24 JOHN LAZZARA DDS PA 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2021-05-24
Name of individual signing JENNIFER LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA CASH BALANCE PLAN 2020 260575310 2021-09-16 JOHN LAZZARA DDS PA 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2021-09-15
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-15
Name of individual signing JOHN LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401(K) PROFIT SHARING PLAN & TRUST 2019 260575310 2020-04-21 JOHN LAZZARA DDS PA 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2020-04-21
Name of individual signing JENNIFER LAZZARA
Valid signature Filed with authorized/valid electronic signature
JOHN LAZZARA DDS PA 401 K PROFIT SHARING PLAN TRUST 2018 260575310 2019-04-04 JOHN LAZZARA DDS PA 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-02-15
Business code 621210
Sponsor’s telephone number 9042106429
Plan sponsor’s address 436 JACKSONVILLE DR, JACKSONVILLE BEACH, FL, 322503812

Signature of
Role Plan administrator
Date 2019-04-04
Name of individual signing JENNIFER LAZZARA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
FT CORPORATE SERVICES, LLC Agent

President

Name Role Address
LAZZARA JOHN President 436 Jacksonville Drive, JACKSONVILLE BEACH, FL, 32250

Secretary

Name Role Address
LAZZARA JOHN Secretary 436 Jacksonville Drive, JACKSONVILLE BEACH, FL, 32250

Treasurer

Name Role Address
LAZZARA JOHN Treasurer 436 Jacksonville Drive, JACKSONVILLE BEACH, FL, 32250

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000024370 LAZZARA ORTHODONTICS ACTIVE 2019-02-19 2029-12-31 No data 436 JACKSONVILLE DRIVE, JACKSONVILLE BEACH, FL, 32250
G12000066060 LAZZARA ORTHODONTICS EXPIRED 2012-07-02 2017-12-31 No data 4184 S. THIRD STREET, JACKSONVILLE BEACH, FL, 32250

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-02-19 FT Corporate Services, LLC No data
REGISTERED AGENT ADDRESS CHANGED 2024-02-19 500 Riverside Avenue, Suite 700, JACKSONVILLE, FL 32202 No data
CHANGE OF PRINCIPAL ADDRESS 2013-01-26 436 Jacksonville Drive, JACKSONVILLE BEACH, FL 32250 No data
CHANGE OF MAILING ADDRESS 2013-01-26 436 Jacksonville Drive, JACKSONVILLE BEACH, FL 32250 No data

Documents

Name Date
ANNUAL REPORT 2024-02-19
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-02-06
ANNUAL REPORT 2018-01-09
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-20
ANNUAL REPORT 2015-01-12

Related by officers

LAZZARA JOHN

PARISH PROPERTIES, L.L.C. STROBERG LLC LEARNERS PERMIT LLC LAZZARA NOCATEE, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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