| 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 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982052262 | 2016-05-27 | 2016-05-27 | 17000 RED HILL AVE, IRVINE, CA, 926145626, US | 870 N US HIGHWAY 27, A, LADY LAKE, FL, 321593107, US | |||||||||||||||||||
|
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| Phone | +1 714-845-8890 |
| Fax | 9494741495 |
| Phone | +1 352-282-4785 |
| Fax | 3524320752 |
Authorized person
| Name | DR. KATIE L MCCANN |
| Role | OWNER DENTIST |
| Phone | 3522824785 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Quesada Garcia Alejandro M | President | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Nam Sung M | Secretary | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Pham Minh B | Chief Financial Officer | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| 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 |
| 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 | No data | 17000 RED HILL AVENUE, ATTENTION: RAELEA APOLITO, IRVINE, CA, 92614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-13 | 115 N. CALHOUN ST., STE 4, TALLAHASSEE, FL 32301 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-09 | 870 N. US Hwy. 27, Suite A, Lady Lake, FL 32159 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-09 | 870 N. US Hwy. 27, Suite A, Lady Lake, FL 32159 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-26 | COGENCY GLOBAL INC. | No data |
| 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 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
