| Entity Name: | TRAE PAPPAS DDS P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Oct 2020 (4 years ago) |
| Document Number: | P20000080562 |
| FEI/EIN Number | 85-3383194 |
| Address: | 5170 S FERDON BLVD, CRESTVIEW, FL, 32536, US |
| Mail Address: | 5170 S FERDON BLVD, CRESTVIEW, FL, 32536, US |
| ZIP code: | 32536 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336748946 | 2020-10-23 | 2020-10-23 | 5170 S FERDON BLVD, CRESTVIEW, FL, 325369258, US | 5170 S FERDON BLVD, CRESTVIEW, FL, 325369258, US | |||||||||||||
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| Phone | +1 850-689-2332 |
Authorized person
| Name | DR. TRAE HARBESON PAPPAS |
| Role | OWNER/PRESIDENT |
| Phone | 8506858461 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TRAE PAPPAS DDS P.A. 401(K) PLAN | 2023 | 853383194 | 2024-10-07 | TRAE PAPPAS DDS P.A. | 8 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-07 |
| Name of individual signing | TRAE PAPPAS DDS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8506892332 |
| Plan sponsor’s address | 5170 SOUTH FERDON BLVD., CRESTVIEW, FL, 32536 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-13 |
| Name of individual signing | TRAE PAPPAS DDS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8506892332 |
| Plan sponsor’s address | 5170 SOUTH FERDON BLVD., CRESTVIEW, FL, 32536 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-11 |
| Name of individual signing | TRAE PAPPAS DDS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PAPPAS TRAE H | Agent | 5170 S FERDON BLVD, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| PAPPAS TRAE H | President | 5170 S FERDON BLVD, CRESTVIEW, FL, 32536 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000011643 | FREEDOM DENTAL | ACTIVE | 2021-01-24 | 2026-12-31 | No data | 5170 S FERDON BLVD, CRESTVIEW, FL, 32536 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-16 | 5170 S FERDON BLVD, CRESTVIEW, FL 32536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-16 | 5170 S FERDON BLVD, CRESTVIEW, FL 32536 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-08 | 5170 S FERDON BLVD, CRESTVIEW, FL 32536 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-03-16 |
| Domestic Profit | 2020-10-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
