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  5. CENTRAL FLORIDA SMILES, INC.

CENTRAL FLORIDA SMILES, INC.

Company Details

Entity Name: CENTRAL FLORIDA SMILES, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 05 Aug 2010 (15 years ago)
Date of dissolution: 26 Apr 2018 (7 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 26 Apr 2018 (7 years ago)
Document Number: P10000065114
FEI/EIN Number 273226904
Address: 2855 W. SR 434, SUITE 1011, LONGWOOD, FL, 32779
Mail Address: 2855 W. SR 434, SUITE 1011, LONGWOOD, FL, 32779
ZIP code: 32779
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1265644348 2007-05-03 2023-03-07 2855 W SR 434, SUITE 1011, LONGWOOD, FL, 32779, US 2855 W SR 434, SUITE 1011, LONGWOOD, FL, 32779, US

Contacts
Phone +1 407-862-1870
Fax 4076827004

Authorized person
Name DR. NICHOLAS JOHN SAVASTANO JR.
Role PRESIDENT OWNER
Phone 4078621870

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number 6776
State FL
Is Primary No
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number 15487
State FL
Is Primary Yes

Other Provider Identifiers
Issuer DELTA DENTAL PROVIDER#
Number 9006776
State FL
Issuer BCBS PROVIDER#
Number 86838
State FL
Issuer UNITED CONCORDIA PROVIDER
Number 1953103
State FL
Issuer UNITED CONCORDIA #
Number 553680
State FL
Issuer TAX ID #
Number 592036601
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2016 273226904 2017-06-12 CENTRAL FLORIDA SMILES, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2017-06-12
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2015 273226904 2016-06-03 CENTRAL FLORIDA SMILES, INC. 20
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2016-06-02
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2014 273226904 2015-07-20 CENTRAL FLORIDA SMILES, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2013 273226904 2014-07-07 CENTRAL FLORIDA SMILES, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2012 273226904 2013-09-26 CENTRAL FLORIDA SMILES, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2013-09-26
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature
CENTRAL FLORIDA SMILES, INC. 401(K) PLAN 2012 273226904 2013-09-18 CENTRAL FLORIDA SMILES, INC. 17
Three-digit plan number (PN) 001
Effective date of plan 1980-11-01
Business code 621210
Sponsor’s telephone number 4078050068
Plan sponsor’s address 550 RINEHART RD, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2013-09-18
Name of individual signing BARBARA PARISI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SAVASTANO NICK DR. Agent 550 RINEHART ROAD, LAKE MARY, FL, 32746

President

Name Role Address
SAVASTANO NICK President 2855 W. HWY 434, SUITE 1011, LONGWOOD, FL, 32779
SAVASTANO JENNIFER M President 2855 W. HWY 434, SUITE 1011, LONGWOOD, FL, 32779

Manager

Name Role Address
SAVASTANO JENNIFER M Manager 2855 W. HWY 434, SUITE 1011, LONGWOOD, FL, 32779

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000106851 SAVASTANO & DUNN ORTHODONTICS EXPIRED 2016-09-29 2021-12-31 No data 2855 W. SR 434, SUITE 1011, LONGWOOD, FL, 32779
G10000085961 SAVASTANO & DUNN ORTHODONTICS EXPIRED 2010-09-20 2015-12-31 No data 2855 W. SR 434 SUITE 1011, LONGWOOD, FL, 32779

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2018-04-26 No data No data
AMENDMENT 2015-02-19 No data No data
REGISTERED AGENT NAME CHANGED 2015-02-19 SAVASTANO, NICK, DR. No data
REGISTERED AGENT ADDRESS CHANGED 2015-02-19 550 RINEHART ROAD, LAKE MARY, FL 32746 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2018-04-26
ANNUAL REPORT 2017-02-21
ANNUAL REPORT 2016-01-21
Amendment 2015-02-19
ANNUAL REPORT 2015-02-02
ANNUAL REPORT 2014-01-15
ANNUAL REPORT 2013-02-04
ANNUAL REPORT 2012-01-30
ANNUAL REPORT 2011-01-17
Domestic Profit 2010-08-05

Related by officers

SAVASTANO NICK

THE SMILE STORE-HOLDING COMPANY, LLC

SAVASTANO JENNIFER M

HORSEPOWER WORX LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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