| Entity Name: | HOMESTEAD MODERN DENTISTRY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Nov 2019 (5 years ago) |
| Document Number: | P19000088510 |
| FEI/EIN Number | 84-3871037 |
| Mail Address: | 17000 RED HILL AVENUE, IRVINE, CA, 92614, US |
| Address: | 805 N HOMESTEAD BLVD, HOMESTEAD, FL, 33030, US |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235777855 | 2019-12-13 | 2022-05-11 | PO BOX 920050, DALLAS, TX, 753920050, US | 805 N HOMESTEAD BLVD, HOMESTEAD, FL, 330305024, US | |||||||||||||
|
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| Phone | +1 786-410-6656 |
Authorized person
| Name | DR. CYNTHIA BUSTILLO |
| Role | OWNER |
| Phone | 7864106656 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Bustillo Cynthia | President | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Pham Minh B | Secretary | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Miranda Nicol | Chief Financial Officer | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Name | Role | Address |
|---|---|---|
| Bustillo Cynthia | Director | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Miranda Nicol | Director | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Pham Minh | Director | 17000 RED HILL AVE, IRVINE, CA, 92614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000000329 | HOMESTEAD MODERN DENTISTRY | ACTIVE | 2020-01-02 | 2025-12-31 | 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 | 2022-03-18 | 805 N HOMESTEAD BLVD, HOMESTEAD, FL 33030 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-18 | 805 N HOMESTEAD BLVD, HOMESTEAD, FL 33030 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-03-18 |
| Reg. Agent Change | 2022-01-05 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-04-13 |
| Domestic Profit | 2019-11-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
