| Entity Name: | PORT ORANGE MODERN DENTISTRY, PA. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Jul 2018 (7 years ago) |
| Document Number: | P18000066036 |
| FEI/EIN Number | 83-1670256 |
| Mail Address: | 17000 RED HILL AVE, IRVINE, CA, 92614, US |
| Address: | 1765 DUNLAWTON AVE, PORT ORANGE, FL, 32129, US |
| ZIP code: | 32129 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982179818 | 2018-10-08 | 2022-08-25 | PO BOX 920050, DALLAS, TX, 753920050, US | 1765 DUNLAWTON AVE., SUITE 103, PORT ORANGE, FL, 32129, US | |||||||||||||||||||
|
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| Phone | +1 714-845-8890 |
| Fax | 3039520892 |
| Phone | +1 386-259-3905 |
| Fax | 3862593905 |
Authorized person
| Name | DR. MINH B PHAM |
| Role | OWNER/GP |
| Phone | 3862593905 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Nam Sung M | Secretary | ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Pham Minh B | Chief Financial Officer | ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Nam Sung M | Director | ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Pham Minh B | Director | ATTN:LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Ghazal Carolyn M | Director | 17000 Red Hill Ave., Irvine, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Song Benjamin | President | 17000 Red Hill Ave., Irvine, CA, 92614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000131190 | PORT ORANGE MODERN DENTISTRY | ACTIVE | 2018-12-11 | 2028-12-31 | No data | 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, 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 | 2022-05-20 | 1765 DUNLAWTON AVE, STE 103, PORT ORANGE, FL 32129 | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-20 | 1765 DUNLAWTON AVE, STE 103, PORT ORANGE, FL 32129 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-05-20 | COGENCY GLOBAL INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-17 |
| Reg. Agent Change | 2022-05-20 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-04-23 |
| ANNUAL REPORT | 2019-04-30 |
| Domestic Profit | 2018-07-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
