| Entity Name: | DAVENPORT MODERN DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
DAVENPORT MODERN DENTISTRY, PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 02 Oct 2019 (6 years ago) |
| Document Number: | P19000074195 |
| FEI/EIN Number |
84-3251943
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 17000 RED HILL AVENUE, ATTN: LEGAL DEPARTMENT, IRVINE, CA, 92614, US |
| Address: | 43522 US HWY 27 N, DAVENPORT, FL, 33837, US |
| ZIP code: | 33837 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568005999 | 2019-10-17 | 2022-06-14 | PO BOX 920050, DALLAS, TX, 753920050, US | 1159 POSNER BLVD, DAVENPORT, FL, 338373664, US | |||||||||||||
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| Phone | +1 863-777-9890 |
Authorized person
| Name | DR. MINH B PHAM |
| Role | OWNER/DDS |
| Phone | 8637779890 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Pham Minh B | President | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| Pham Minh B | Chief Financial Officer | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| Button Nicholas R | Director | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| Pham Minh B | Director | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| Ansari Omeir B | Director | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| COGENCY GLOBAL INC. | Agent | - |
| Button Nicholas R | Secretary | 17000 RED HILL AVENUE, IRVINE, CA, 92614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000109124 | DAVENPORT MODERN DENTISTRY | ACTIVE | 2019-10-07 | 2029-12-31 | - | 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-12-27 | 43522 US HWY 27 N, DAVENPORT, FL 33837 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-13 | 115 N. CALHOUN ST., STE 4, TALLAHASSEE, FL 32301 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-25 | 43552 US HWY 27 N, DAVENPORT, FL 33837 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-03-16 |
| Reg. Agent Change | 2021-12-06 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-04-07 |
| Domestic Profit | 2019-10-02 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7641577101 | 2020-04-14 | 0455 | PPP | 1159 Posner Blvd., DAVENPORT, FL, 33837 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
