| Entity Name: | JENNIFER GARCIA, DDS, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Sep 2016 (8 years ago) |
| Document Number: | P16000073776 |
| FEI/EIN Number | 81-3807506 |
| Address: | 5745 NW 100th Terrace, CORAL SPRINGS, FL, 33076, US |
| Mail Address: | 5745 NW 100Th Terrace, CORAL SPRINGS, FL, 33076, US |
| ZIP code: | 33076 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609398684 | 2017-07-12 | 2022-07-21 | 3501 NW 84TH AVE, SUNRISE, FL, 333516607, US | 3501 NW 84TH AVE, SUNRISE, FL, 333516607, US | |||||||||||||||||||||||
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| Phone | +1 954-741-2323 |
Authorized person
| Name | JENNIFER GARCIA |
| Role | PRESIDENT |
| Phone | 9547412323 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN21347 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 015260900 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JENNIFER GARCIA DDS PA 401(K) PLAN | 2023 | 813807506 | 2024-07-03 | JENNIFER GARCIA DDS PA | 9 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-03 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GARCIA JENNIFER | Agent | 5745 NW 100th Terrace, CORAL SPRINGS, FL, 33065 |
| Name | Role | Address |
|---|---|---|
| GARCIA JENNIFER | President | 5745 NW 100th Terrace, CORAL SPRINGS, FL, 33076 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-24 | 5745 NW 100th Terrace, CORAL SPRINGS, FL 33076 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-24 | 5745 NW 100th Terrace, CORAL SPRINGS, FL 33076 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-24 | 5745 NW 100th Terrace, CORAL SPRINGS, FL 33065 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-04-19 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-02-28 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-30 |
| Domestic Profit | 2016-09-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
