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DENTISTS OF MELBOURNE, PA - Florida Company Profile

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Company Details

Entity Name: DENTISTS OF MELBOURNE, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 11 Jan 2018 (8 years ago)
Document Number: P18000003516
FEI/EIN Number 82-4030927
Mail Address: 17000 RED HILL AVE, IRVINE, CA, 92614
Address: 6455 N WICKHAM RD, MELBOURNE, FL, 32940, US
ZIP code: 32940
City: Melbourne
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
Pham Minh B President ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614
Nam Sung M Secretary ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614
Pham Minh B Chief Financial Officer ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614
Nam Sung M Director ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614
Pham Minh B Director ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614
Ghazal Carolyn B Director 17000 Red Hill Ave., Irvine, CA, 92614

National Provider Identifier

NPI Number:
1871006742

Authorized Person:

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

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000057693 DENTISTS OF MELBOURNE ACTIVE 2018-05-10 2028-12-31 - 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 2021-04-09 6455 N WICKHAM RD, Suite 103, MELBOURNE, FL 32940 -

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-17
ANNUAL REPORT 2022-03-21
Reg. Agent Change 2021-12-06
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-05-12
ANNUAL REPORT 2019-04-30
Domestic Profit 2018-01-11

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:
41887.00
Total Face Value Of Loan:
41887.00
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:
41887.00
Total Face Value Of Loan:
41887.00

Paycheck Protection Program

Jobs Reported:
3
Initial Approval Amount:
$41,887
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$41,887
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$8,607.23
Servicing Lender:
BMO Bank National Association
Use of Proceeds:
Payroll: $41,887

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Date of last update: 02 Aug 2025

Sources: Florida Department of State