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PRIMARY DENTAL PARTNERS PA - Florida Company Profile

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Company Details

Entity Name: PRIMARY DENTAL PARTNERS PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 16 Mar 2021 (4 years ago)
Document Number: P21000026208
FEI/EIN Number 86-2838433
Address: 3039 JOHNSON STREET, HOLLYWOOD, FL, 33021, US
Mail Address: 1440 SW 125TH AVE, DAVIE, FL, 33325
ZIP code: 33021
City: Hollywood
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HERNANDEZ RIVERA RICARDO N Director 1440 SW 125TH AVE, DAVIE, FL, 33325
SHEHADEH EYAD Director 10610 NW 6TH ST, PLANTATION, FL, 33324
FRANCO DIAZ ANDREA Agent 1440 SW 125 AVE, DAVIE, FL, 33325

National Provider Identifier

NPI Number:
1114509171
Certification Date:
2023-01-24

Authorized Person:

Name:
DR. EYAD SHEHADEH
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
No
Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000133899 HEALTHSTONE DENTAL ACTIVE 2021-10-05 2026-12-31 - 1440 SW 125TH AVENUE, DAVIE, FL, 33325

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-02-07 3039 JOHNSON STREET, HOLLYWOOD, FL 33021 -
CHANGE OF PRINCIPAL ADDRESS 2022-04-07 3930 JOHNSON STREET, HOLLYWOOD, FL 33021 -

Documents

Name Date
ANNUAL REPORT 2025-02-07
ANNUAL REPORT 2024-01-22
ANNUAL REPORT 2023-04-11
ANNUAL REPORT 2022-04-07
Domestic Profit 2021-03-16

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Date of last update: 03 Aug 2025

Sources: Florida Department of State