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  5. ANDREW DIETRICH, D.M.D., M.S., P.A.

ANDREW DIETRICH, D.M.D., M.S., P.A.

Company Details

Entity Name: ANDREW DIETRICH, D.M.D., M.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 30 Nov 2011 (13 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 30 Dec 2011 (13 years ago)
Document Number: P11000101938
FEI/EIN Number 453942274
Address: 330 E HIGHLAND DR, LAKELAND, FL, 33813, US
Mail Address: 330 E Highland Dr., LAKELAND, FL, 33813, US
ZIP code: 33813
County: Polk
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2019 453942274 2020-10-15 ANDREW DIETRICH, D.M.D., M.S., P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2018 453942274 2019-08-30 ANDREW DIETRICH, D.M.D., M.S., 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 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2017 453942274 2018-10-09 ANDREW DIETRICH, D.M.D., M.S., P.A. 15
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2017 453942274 2018-10-09 ANDREW DIETRICH, D.M.D., M.S., 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 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2017 453942274 2018-10-09 ANDREW DIETRICH, D.M.D., M.S., P.A. 15
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2016 453942274 2017-10-13 ANDREW DIETRICH, D.M.D., M.S., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2015 453942274 2016-10-13 ANDREW DIETRICH, D.M.D., M.S., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8636440430
Plan sponsor’s address 330 E. HIGHLAND DRIVE, LAKELAND, FL, 33813

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing ANDREW DIETRICH
Valid signature Filed with authorized/valid electronic signature
DIETRICH ORTHODONTIC GROUP 401(K) PLAN 2014 231864970 2016-05-04 ANDREW DIETRICH D.M.D., M.S., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 8638593581
Plan sponsor’s address 2417 CLEVELAND HEIGHTS BLVD, LAKELAND, FL, 338033114

Signature of
Role Plan administrator
Date 2016-05-04
Name of individual signing ANDREW DIETRICH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-04
Name of individual signing ANDREW DIETRICH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DIETRICH ANDREW Agent 330 E HIGHLAND DR, LAKELAND, FL, 33813

President

Name Role Address
DIETRICH ANDREW President 330 E Highland Dr., LAKELAND, FL, 33813

Secretary

Name Role Address
DIETRICH ANDREW Secretary 330 E Highland Dr., LAKELAND, FL, 33813

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000010279 HILLIARD & DIETRICH ORTHODONTICS EXPIRED 2012-01-30 2017-12-31 No data 330 E. HIGHLAND DR., LAKELAND, FL, 33813

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2015-04-17 330 E HIGHLAND DR, LAKELAND, FL 33813 No data
REGISTERED AGENT ADDRESS CHANGED 2015-04-17 330 E HIGHLAND DR, LAKELAND, FL 33813 No data
CHANGE OF PRINCIPAL ADDRESS 2013-01-26 330 E HIGHLAND DR, LAKELAND, FL 33813 No data
NAME CHANGE AMENDMENT 2011-12-30 ANDREW DIETRICH, D.M.D., M.S., P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-03-22
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-01-22
ANNUAL REPORT 2021-01-25
ANNUAL REPORT 2020-04-10
ANNUAL REPORT 2019-03-22
ANNUAL REPORT 2018-03-18
ANNUAL REPORT 2017-05-21
ANNUAL REPORT 2016-04-13
ANNUAL REPORT 2015-04-17

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Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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