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  5. COSMETIC & COMPREHENSIVE DENTISTRY P.A.

COSMETIC & COMPREHENSIVE DENTISTRY P.A.

Company Details

Entity Name: COSMETIC & COMPREHENSIVE DENTISTRY P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 07 Nov 2007 (17 years ago)
Last Event: AMENDMENT
Event Date Filed: 01 Apr 2013 (12 years ago)
Document Number: P07000121673
FEI/EIN Number 261381520
Address: 4638 E. Lake Drive, Winter Springs, FL, 32708, US
Mail Address: 4638 E Lake Drive, Winter Springs, FL, 32708, US
ZIP code: 32708
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669622445 2008-09-29 2008-09-29 2828 CASA ALOMA WAY SUITE 700, WINTER PARK, FL, 327922270, US 2828 CASA ALOMA WAY SUITE 700, WINTER PARK, FL, 327922270, US

Contacts
Phone +1 407-678-4000
Fax 4076784001

Authorized person
Name DR. CARL DENNIS BILANCIONE
Role DOCTOR/OWNER
Phone 4076784000

Taxonomy
Taxonomy Code 122300000X - Dentist
License Number DN9154
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DR. BILANCIONE 401(K) SPECIAL PLAN 2017 261381520 2018-09-07 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4074357300
Plan sponsor’s address 4638 EAST LAKE DRIVE, WINTER SPRINGS, FL, 32708

Signature of
Role Plan administrator
Date 2018-09-07
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-07
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2016 261381520 2017-10-15 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Signature of
Role Plan administrator
Date 2017-10-15
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-15
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2015 261381520 2016-07-05 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Signature of
Role Plan administrator
Date 2016-07-05
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-05
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2014 261381520 2015-10-12 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-12
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2013 261381520 2014-07-23 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2012 261381520 2013-04-29 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Signature of
Role Plan administrator
Date 2013-04-29
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2011 261381520 2012-08-06 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Plan administrator’s name and address
Administrator’s EIN 261381520
Plan administrator’s name COSMETIC & COMPREHENSIVE DENTISTRY, P.A.
Plan administrator’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792
Administrator’s telephone number 4076784000

Signature of
Role Plan administrator
Date 2012-08-06
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-06
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2010 261381520 2011-09-12 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Plan administrator’s name and address
Administrator’s EIN 261381520
Plan administrator’s name COSMETIC & COMPREHENSIVE DENTISTRY, P.A.
Plan administrator’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792
Administrator’s telephone number 4076784000

Signature of
Role Plan administrator
Date 2011-09-12
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature
DR. BILANCIONE 401(K) SPECIAL PLAN 2009 261381520 2010-07-26 COSMETIC & COMPREHENSIVE DENTISTRY, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 4076784000
Plan sponsor’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792

Plan administrator’s name and address
Administrator’s EIN 261381520
Plan administrator’s name COSMETIC & COMPREHENSIVE DENTISTRY, P.A.
Plan administrator’s address 2828 CASA ALOMA WAY, SUITE 700, WINTER PARK, FL, 32792
Administrator’s telephone number 4076784000

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing CARL BILANCIONE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BILANCIONE CARL Agent 4638 E. Lake Drive, Winter Springs, FL, 32708

Director

Name Role Address
BILANCIONE CARL Director 4638 E. Lake Drive, Winter Springs, FL, 32708

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2018-03-12 4638 E. Lake Drive, Winter Springs, FL 32708 No data
CHANGE OF PRINCIPAL ADDRESS 2017-01-09 4638 E. Lake Drive, Winter Springs, FL 32708 No data
REGISTERED AGENT ADDRESS CHANGED 2017-01-09 4638 E. Lake Drive, Winter Springs, FL 32708 No data
AMENDMENT 2013-04-01 No data No data

Documents

Name Date
ANNUAL REPORT 2024-03-12
ANNUAL REPORT 2023-01-31
ANNUAL REPORT 2022-01-30
ANNUAL REPORT 2021-02-12
ANNUAL REPORT 2020-01-30
ANNUAL REPORT 2019-02-12
ANNUAL REPORT 2018-03-12
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-03-05
ANNUAL REPORT 2015-01-07

Related by officers

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Related by address

4638 E Lake Drive, Winter Springs, FL, 32708, US

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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