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  5. ALACHUA FAMILY DENTISTRY, P.A.

ALACHUA FAMILY DENTISTRY, P.A.

Company Details

Entity Name: ALACHUA FAMILY DENTISTRY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 08 Aug 2007 (17 years ago)
Document Number: P07000089340
FEI/EIN Number 870811809
Address: 14690 NW 151ST BLVD, SUITE 20, ALACHUA, FL, 32615
Mail Address: 14690 NW 151ST BLVD, SUITE 20, ALACHUA, FL, 32615
ZIP code: 32615
County: Alachua
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2023 870811809 2024-10-14 ALACHUA FAMILY DENTISTRY, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2022 870811809 2023-08-09 ALACHUA FAMILY DENTISTRY, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2023-08-09
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2021 870811809 2022-08-22 ALACHUA FAMILY DENTISTRY, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2022-08-22
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2020 870811809 2021-09-22 ALACHUA FAMILY DENTISTRY, P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2021-09-22
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2019 870811809 2020-09-09 ALACHUA FAMILY DENTISTRY, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2020-09-09
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2018 870811809 2019-09-13 ALACHUA FAMILY DENTISTRY, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2019-09-13
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2017 870811809 2018-10-15 ALACHUA FAMILY DENTISTRY, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2016 870811809 2017-10-18 ALACHUA FAMILY DENTISTRY, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2017-10-18
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2015 870811809 2016-09-12 ALACHUA FAMILY DENTISTRY, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2016-09-12
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature
ALACHUA FAMILY DENTISTRY, P.A. RETIREMENT SAVINGS PLAN 2014 870811809 2015-09-11 ALACHUA FAMILY DENTISTRY, P.A. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 3864621771
Plan sponsor’s address 14690 NW 151 BLVD, SUITE 20, ALACHUA, FL, 32615

Signature of
Role Plan administrator
Date 2015-09-11
Name of individual signing SHANE GOSLINGA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GOSLINGA CODY S Agent 337 SW 128 Terrace, NEWBERRY, FL, 32669

Secretary

Name Role Address
GOSLINGA SHANE N Secretary 740 SW 135 WAY, NEWBERRY, FL, 32669

Director

Name Role Address
GOSLINGA SHANE N Director 740 SW 135 WAY, NEWBERRY, FL, 32669
GOSLINGA CODY S Director 337 SW 128 TERRACE, NEWBERRY, FL, 32669

President

Name Role Address
GOSLINGA CODY S President 337 SW 128 TERRACE, NEWBERRY, FL, 32669

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2015-01-12 337 SW 128 Terrace, NEWBERRY, FL 32669 No data
CHANGE OF PRINCIPAL ADDRESS 2008-04-21 14690 NW 151ST BLVD, SUITE 20, ALACHUA, FL 32615 No data
CHANGE OF MAILING ADDRESS 2008-04-21 14690 NW 151ST BLVD, SUITE 20, ALACHUA, FL 32615 No data

Documents

Name Date
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-01-30
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-01-21
ANNUAL REPORT 2019-01-28
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-04-19
ANNUAL REPORT 2016-01-21
ANNUAL REPORT 2015-01-12

Related by officers

GOSLINGA SHANE N

PARK AVENUE DENTAL, P.A. SGBC LLC 912 OFFICE CONDOMINIUM ASSOCIATION, INC.

GOSLINGA CODY S

PARK AVENUE DENTAL, P.A.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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