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  5. ELEY FAMILY DENTISTRY, P.A.

ELEY FAMILY DENTISTRY, P.A.

Company Details

Entity Name: ELEY FAMILY DENTISTRY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Nov 2013 (11 years ago)
Document Number: P13000095585
FEI/EIN Number 46-4217607
Address: 2301 W. Eau Gallie Blvd, MELBOURNE, FL, 32935, US
Mail Address: 2301 W. Eau Gallie Blvd, MELBOURNE, FL, 32935, US
ZIP code: 32935
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033539085 2014-04-17 2016-09-13 2301 W EAU GALLIE BLVD, SUITE #102, MELBOURNE, FL, 329353120, US 2301 W EAU GALLIE BLVD, SUITE #102, MELBOURNE, FL, 329353120, US

Contacts
Phone +1 321-622-8711
Fax 3216228712

Authorized person
Name DR. DANIEL WARREN ELEY
Role PRESIDENT
Phone 3216228711

Taxonomy
Taxonomy Code 122300000X - Dentist
License Number DN19369
State FL
Is Primary Yes
Taxonomy Code 1223P0221X - Pediatric Dentist
License Number DN22269
State GA
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELEY FAMILY DENTISTRY 401(K) PLAN 2023 464217607 2024-10-17 ELEY FAMILY DENTISTRY, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BOULEVARD, SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2024-10-17
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY 401(K) PLAN 2022 464217607 2023-05-24 ELEY FAMILY DENTISTRY, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BOULEVARD, SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2023-05-24
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-24
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2021 464217607 2022-04-29 ELEY FAMILY DENTISTRY, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2022-04-29
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2020 464217607 2021-05-05 ELEY FAMILY DENTISTRY, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2021-05-05
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2019 464217607 2020-03-27 ELEY FAMILY DENTISTRY, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2020-03-27
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2018 464217607 2019-03-20 ELEY FAMILY DENTISTRY, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2019-03-20
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2017 464217607 2018-04-24 ELEY FAMILY DENTISTRY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2018-04-24
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2016 464217607 2017-05-08 ELEY FAMILY DENTISTRY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2017-05-08
Name of individual signing DANIEL ELEY
Valid signature Filed with authorized/valid electronic signature
ELEY FAMILY DENTISTRY, 401K PLAN 2015 464217607 2016-07-27 ELEY FAMILY DENTISTRY, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 3216228711
Plan sponsor’s address 2301 W. EAU GALLIE BLVD., SUITE 102, MELBOURNE, FL, 32935

Agent

Name Role Address
ELEY EDMOND L Agent 1310 W. EAU GALLIE BOULEVARD, SUITE D, MELBOURNE, FL, 32935

Director

Name Role Address
ELEY DANIEL W Director 3733 STREAM DRIVE, MELBOURNE, FL, 32940

President

Name Role Address
ELEY DANIEL W President 3733 STREAM DRIVE, MELBOURNE, FL, 32940

Secretary

Name Role Address
ELEY DANIEL W Secretary 3733 STREAM DRIVE, MELBOURNE, FL, 32940

Treasurer

Name Role Address
ELEY DANIEL W Treasurer 3733 STREAM DRIVE, MELBOURNE, FL, 32940

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2015-02-12 2301 W. Eau Gallie Blvd, Suite #102, MELBOURNE, FL 32935 No data
CHANGE OF MAILING ADDRESS 2015-02-12 2301 W. Eau Gallie Blvd, Suite #102, MELBOURNE, FL 32935 No data
REGISTERED AGENT NAME CHANGED 2014-01-27 ELEY, EDMOND L No data

Documents

Name Date
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-01-29
ANNUAL REPORT 2022-01-28
ANNUAL REPORT 2021-01-20
ANNUAL REPORT 2020-01-19
ANNUAL REPORT 2019-04-06
ANNUAL REPORT 2018-01-13
ANNUAL REPORT 2017-01-06
ANNUAL REPORT 2016-01-19
ANNUAL REPORT 2015-02-12

Related by officers

ELEY DANIEL W

CALDERON ELEY PROPERTY HOLDINGS, LLC

ELEY EDMOND L

CARLTON DRIVE STABLES, INC. RIVER GROVE UTILITIES, INC. PRIME MERIDIAN COMMUNICATIONS, INC. HEIDEKRUGER WELL & PUMP SERVICES, INC. NEIGHBORS AGAINST CRIME, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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