| Entity Name: | DORGIS DENTAL, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Feb 2018 (7 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 16 Jul 2018 (7 years ago) |
| Document Number: | P18000015913 |
| FEI/EIN Number | 824572195 |
| Address: | 2830 SW 117TH AVENUE, DAVIE, FL, 33330, US |
| Mail Address: | 2830 SW 117TH AVENUE, DAVIE, FL, 33330, US |
| ZIP code: | 33330 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417450404 | 2018-03-15 | 2018-07-19 | 18652 NW 67TH AVE, HIALEAH, FL, 330152406, US | 18652 NW 67TH AVE, HIALEAH, FL, 33015, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 305-474-0400 |
| Fax | 3054740094 |
Authorized person
| Name | DORGIS GARCIA LOPEZ |
| Role | PRESIDENT |
| Phone | 3054740400 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| License Number | DN20258 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DORGIS DENTAL, P.A. 401(K) PLAN | 2023 | 824572195 | 2024-05-03 | DORGIS DENTAL, P.A. | 4 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-03 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3054740400 |
| Plan sponsor’s address | 18652 NW 67TH AVE, HIALEAH, FL, 33015 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| SAS PRINZIVALLI, CPA PA | Agent |
| Name | Role | Address |
|---|---|---|
| GARCIA LOPEZ DORGIS | President | 2830 SW 117TH AVENUE, DAVIE, FL, 33330 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000074505 | KINDLY DENTAL | ACTIVE | 2018-07-06 | 2028-12-31 | No data | 18652 NW 67TH AVE, MIAMI, FL, 33015 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-07-11 | 2830 SW 117TH AVENUE, DAVIE, FL 33330 | No data |
| CHANGE OF MAILING ADDRESS | 2024-07-11 | 2830 SW 117TH AVENUE, DAVIE, FL 33330 | No data |
| NAME CHANGE AMENDMENT | 2018-07-16 | DORGIS DENTAL, P.A. | No data |
| NAME CHANGE AMENDMENT | 2018-02-27 | NEW SMILES DENTAL, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-06-23 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-03-25 |
| ANNUAL REPORT | 2019-03-27 |
| Name Change | 2018-07-16 |
| Name Change | 2018-02-27 |
| Domestic Profit | 2018-02-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
