| Entity Name: | ANDREW DACUNHA, DMD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Apr 2019 (6 years ago) |
| Document Number: | P19000031337 |
| FEI/EIN Number | 83-4442203 |
| Address: | 4508 Patricia Ann Ct, Orlando, FL 32839 |
| Mail Address: | 4508 Patricia Ann Ct, Orlando, FL 32839 |
| ZIP code: | 32839 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831731009 | 2019-10-09 | 2022-03-22 | 71 DOCTORS VILLAGE DR STE 303, SAINT JOHNS, FL, 322592406, US | 71 DOCTORS VILLAGE DR STE 303, SAINT JOHNS, FL, 322592406, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 904-417-7400 |
| Fax | 9046029995 |
Authorized person
| Name | DR. ANDREW ALLEN DACUNHA |
| Role | PRESIDENT |
| Phone | 9044177400 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOHNS SMILE CARE 401(K) PLAN | 2023 | 834442203 | 2024-06-30 | ANDREW DACUNHA, DMD, PA | 4 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-06-30 |
| Name of individual signing | DR. ANDREW DACUNHA |
| 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 |
| Plan sponsor’s address | 71 DOCTORS VILLAGE DRIVE, SUITE 303, SAINT JOHNS, FL, 32259 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-11 |
| Name of individual signing | ANDREW DACUNHA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DACUNHA, ANDREW A, DMD | Agent | 71 DOCTORS VILLAGE DR STE 303, SAINT JOHNS, FL 32259 |
| Name | Role | Address |
|---|---|---|
| DACUNHA, ANDREW A, DMD | President | 71 Doctors Village Dr, Suite 303 St. Johns, FL 32259 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000118608 | ST. JOHNS SMILE CARE | EXPIRED | 2019-11-03 | 2024-12-31 | No data | 71 DOCTORS VILLAGE DR., SUITE 303, ST. JOHNS, FL, 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-16 | 4508 Patricia Ann Ct, Orlando, FL 32839 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-16 | 4508 Patricia Ann Ct, Orlando, FL 32839 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-02 | 71 DOCTORS VILLAGE DR STE 303, SAINT JOHNS, FL 32259 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-16 |
| Reg. Agent Change | 2019-10-02 |
| Domestic Profit | 2019-04-08 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
