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CLERMONT SMILES DENTISTRY, PA - Florida Company Profile

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Company Details

Entity Name: CLERMONT SMILES DENTISTRY, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 23 Aug 2016 (9 years ago)
Document Number: P16000069807
FEI/EIN Number 81-3799409
Mail Address: ATTN: LEGAL DEPT., 17000 RED HILL AVENUE, IRVINE, CA, 92614
Address: 900 Hooks Street, Clermont, FL, 34711, US
ZIP code: 34711
City: Clermont
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
Pham Minh B Chief Financial Officer ATTN: LEGAL DEPT., IRVINE, CA, 92614
Nam Sung M Secretary ATTN: LEGAL DEPT., IRVINE, CA, 92614
Nam Sung M Director ATTN: LEGAL DEPT., IRVINE, CA, 92614
Pham Minh B Director ATTN: LEGAL DEPT., IRVINE, CA, 92614
Vu Nga T President ATTN: LEGAL DEPT., IRVINE, CA, 92614
Vu Nga T Director 17000 Red Hill Ave., IRVINE, CA, 92614

National Provider Identifier

NPI Number:
1174071500

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:
3528774379

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000108730 CLERMONT SMILES DENTISTRY ACTIVE 2016-10-04 2026-12-31 - 17000 RED HILL AVENUE, ATTENTION LEGAL DEPARTMENT, 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 2019-04-30 900 Hooks Street, Suite 100, Clermont, FL 34711 -
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 2022-01-05
Reg. Agent Change 2021-09-02
ANNUAL REPORT 2021-04-14
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-04-30
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:
80690.00
Total Face Value Of Loan:
80690.00
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:
80690.00
Total Face Value Of Loan:
80690.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$80,690
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$80,690
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$69,231.58
Servicing Lender:
BMO Bank National Association
Use of Proceeds:
Payroll: $80,690

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Date of last update: 03 Aug 2025

Sources: Florida Department of State