| Entity Name: | MJ DENTAL SERVICES, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jul 2009 (16 years ago) |
| Document Number: | P09000063759 |
| FEI/EIN Number | 270713347 |
| Address: | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL, 32757 |
| Mail Address: | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL, 32757 |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659677714 | 2011-02-07 | 2011-02-07 | 2230 WEST OLD HIGHWAY 441, MOUNT DORA, FL, 327573508, US | 2230 WEST OLD HIGHWAY 441, MOUNT DORA, FL, 327573508, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-383-2959 |
| Fax | 3527353355 |
Authorized person
| Name | DR. MITESH JIVAN |
| Role | PRESIDENT |
| Phone | 3523832959 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN18726 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN6360 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 124Q00000X - Dental Hygienist |
| License Number | DH5118 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 124Q00000X - Dental Hygienist |
| License Number | DH15460 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 124Q00000X - Dental Hygienist |
| License Number | DH5702 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 126800000X - Dental Assistant |
| License Number | 106953 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JIVAN MITESH | Agent | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| JIVAN MITESH | President | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| Jivan Nirali | Vice President | 2230 W Old US Hwy 441, Mount Dora, FL, 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-16 | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL 32757 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-14 | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-14 | 2230 W OLD HIGHWAY 441, MOUNT DORA, FL 32757 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-02-07 |
| ANNUAL REPORT | 2019-06-13 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-05-02 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
