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  5. SOUTHSHORE ORTHODONTICS PA

SOUTHSHORE ORTHODONTICS PA

Company Details

Entity Name: SOUTHSHORE ORTHODONTICS PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 13 Jun 2014 (11 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 19 Nov 2021 (3 years ago)
Document Number: P14000051939
FEI/EIN Number 47-1100536
Mail Address: 8903 Key West Island Way, Riverview, FL, 33578, US
Address: 13135 Kings Lake Dr, Gibsonton, FL, 33534, US
ZIP code: 33534
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1508255712 2015-01-12 2015-01-13 13135 KINGS LAKE DR # 103, GIBSONTON, FL, 335343960, US 13135 KINGS LAKE DR # 103, GIBSONTON, FL, 335343960, US

Contacts
Phone +1 813-815-0080

Authorized person
Name MATTHEW AHRENS
Role PRESIDENT
Phone 3528430783

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number 18985
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2023 471100536 2024-09-30 SOUTHSHORE ORTHODONTICS, PA 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534

Signature of
Role Plan administrator
Date 2024-09-30
Name of individual signing MATTHEW AHRENS
Valid signature Filed with authorized/valid electronic signature
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2022 471100536 2023-10-09 SOUTHSHORE ORTHODONTICS, PA 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534

Signature of
Role Plan administrator
Date 2023-10-09
Name of individual signing MATTHEW AHRENS
Valid signature Filed with authorized/valid electronic signature
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2021 471100536 2022-09-13 SOUTHSHORE ORTHODONTICS, PA 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2020 471100536 2021-05-19 SOUTHSHORE ORTHODONTICS, PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2019 471100536 2020-10-09 SOUTHSHORE ORTHODONTICS, PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2018 471100536 2019-09-16 SOUTHSHORE ORTHODONTICS, PA 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2017 471100536 2018-08-22 SOUTHSHORE ORTHODONTICS, PA 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 13135 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534
SOUTHSHORE ORTHODONTICS, PA PROFIT SHARING PLAN 2016 471100536 2017-10-12 SOUTHSHORE ORTHODONTICS, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 8138150800
Plan sponsor’s address 1315 KINGS LAKE DR., SUITE 103, GIBSONTON, FL, 33534

Agent

Name Role Address
AHRENS MATTHEW Agent 8903 Key West Island Way, Riverview, FL, 33578

Manager

Name Role Address
Ahrens Matthew Manager 8903 Key West Island Way, Riverview, FL, 33578

Events

Event Type Filed Date Value Description
REINSTATEMENT 2021-11-19 No data No data
CHANGE OF MAILING ADDRESS 2021-11-19 13135 Kings Lake Dr, 103, Gibsonton, FL 33534 No data
REGISTERED AGENT NAME CHANGED 2021-11-19 AHRENS, MATTHEW No data
REGISTERED AGENT ADDRESS CHANGED 2021-11-19 8903 Key West Island Way, Riverview, FL 33578 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 No data No data
CHANGE OF PRINCIPAL ADDRESS 2015-03-03 13135 Kings Lake Dr, 103, Gibsonton, FL 33534 No data

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-02-07
ANNUAL REPORT 2022-03-08
REINSTATEMENT 2021-11-19
ANNUAL REPORT 2020-07-18
ANNUAL REPORT 2019-02-22
ANNUAL REPORT 2018-05-01
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-03-03
ANNUAL REPORT 2015-03-03

Related by officers

Ahrens Matthew

MSC PROPERTIES LLC

AHRENS MATTHEW

MCILWAIN DENTAL SPECIALISTS, P.L.L.C. MATTHEW AHRENS, D.M.D., P.L.L.C. MCAW ENTERPRISES, LLC MCMS PROPERTIES LLC MSMR PROPERTIES LLC MCILWAIN FAMILY DENTISTRY CORP

Related by address

8903 Key West Island Way, Riverview, FL, 33578, US

MSC PROPERTIES LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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