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LADY LAKE SMILES DENTISTRY, PA - Florida Company Profile

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Company Details

Entity Name: LADY LAKE SMILES DENTISTRY, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 06 May 2016 (9 years ago)
Document Number: P16000039642
FEI/EIN Number 81-2569715
Mail Address: 17000 RED HILL AVE, IRVINE, CA, 92614, US
Address: 870 N. US Hwy. 27, Lady Lake, FL, 32159, US
ZIP code: 32159
City: Lady Lake
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Quesada Garcia Alejandro M President 17000 RED HILL AVE, IRVINE, CA, 92614
Nam Sung M Secretary 17000 RED HILL AVE, IRVINE, CA, 92614
Pham Minh B Chief Financial Officer 17000 RED HILL AVE, IRVINE, CA, 92614
Quesada Garcia Alejandro M Director 17000 RED HILL AVE, IRVINE, CA, 92614
Pham Minh B Director 17000 RED HILL AVE, IRVINE, CA, 92614
Nam Sung M Director 17000 RED HILL AVE, IRVINE, CA, 92614
- Agent -

National Provider Identifier

NPI Number:
1982052262

Authorized Person:

Name:
DR. KATIE L MCCANN
Role:
OWNER DENTIST
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
9494741495
Fax:
3524320752

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000070806 LADY LAKE SMILES DENTISTRY ACTIVE 2016-07-18 2026-12-31 - 17000 RED HILL AVENUE, ATTENTION: RAELEA APOLITO, IRVINE, CA, 92614

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-06-13 115 N. CALHOUN ST., STE 4, TALLAHASSEE, FL 32301 -
CHANGE OF PRINCIPAL ADDRESS 2021-04-09 870 N. US Hwy. 27, Suite A, Lady Lake, FL 32159 -
CHANGE OF MAILING ADDRESS 2021-04-09 870 N. US Hwy. 27, Suite A, Lady Lake, FL 32159 -
REGISTERED AGENT NAME CHANGED 2018-04-26 COGENCY GLOBAL INC. -

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-17
ANNUAL REPORT 2022-03-21
Reg. Agent Change 2021-09-02
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-04-18
Reg. Agent Change 2018-08-01
ANNUAL REPORT 2018-04-26
ANNUAL REPORT 2017-03-24

USAspending Awards / Financial Assistance

Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
65717.00
Total Face Value Of Loan:
65717.00
Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
65717.00
Total Face Value Of Loan:
65717.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$65,717
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$65,717
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$62,847.49
Servicing Lender:
BMO Bank National Association
Use of Proceeds:
Payroll: $65,717

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Date of last update: 01 Aug 2025

Sources: Florida Department of State