| Entity Name: | WEST PINES MODERN DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 28 Mar 2017 (8 years ago) |
| Document Number: | P17000027993 |
| FEI/EIN Number | 82-1089818 |
| Mail Address: | ATTN: LEGAL DEPT., 17000 RED HILL AVENUE, IRVINE, CA 92614 |
| Address: | 18312 Pines Blvd, Pembroke Pines, FL 33029 |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134654064 | 2017-04-28 | 2017-04-28 | 17000 RED HILL AVE, IRVINE, CA, 926145626, US | 18312 PINES BLVD, PEMBROKE PINES, FL, 330291412, US | |||||||||||||||||
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| Phone | +1 714-845-8890 |
| Phone | +1 786-204-0713 |
| Fax | 7862040714 |
Authorized person
| Name | KATIE MCCANN |
| Role | OWNER |
| Phone | 7862040713 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Pham, Minh B. | President | ATTN:, LEGAL DEPT. 17000 RED HILL AVENUE IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Gonzales, Nathaniel S. | Secretary | ATTN:, LEGAL DEPT. 17000 RED HILL AVENUE IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Pham, Minh B. | Chief Financial Officer | ATTN:, LEGAL DEPT. 17000 RED HILL AVENUE IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Gonzales, Nathaniel S. | Director | ATTN:, LEGAL DEPT. 17000 RED HILL AVENUE IRVINE, CA 92614 |
| Pham, Minh B. | Director | ATTN:, LEGAL DEPT. 17000 RED HILL AVENUE IRVINE, CA 92614 |
| Ghazal, Carolyn | Director | 17000 Red Hill Ave., Irvine, CA 92614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000117851 | WEST PINES MODERN DENTISTRY | ACTIVE | 2017-10-25 | 2027-12-31 | 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 | 2019-04-30 | 18312 Pines Blvd, Pembroke Pines, FL 33029 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-03-23 |
| Reg. Agent Change | 2021-09-02 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-05-12 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-26 |
| Domestic Profit | 2017-03-28 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
