| 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: | 3930 JOHNSON STREET, HOLLYWOOD, FL, 33021, US |
| Mail Address: | 1440 SW 125TH AVE, DAVIE, FL, 33325 |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114509171 | 2021-04-28 | 2023-09-25 | 3039 JOHNSON STREET, HOLLYWOOD, FL, 33021, US | 3039 JOHNSON STREET, HOLLYWOOD, FL, 33021, US | |||||||||||||||||
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| Phone | +1 954-399-8039 |
Authorized person
| Name | DR. EYAD SHEHADEH |
| Role | DIRECTOR |
| Phone | 9543998039 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FRANCO DIAZ ANDREA | Agent | 1440 SW 125 AVE, DAVIE, FL, 33325 |
| 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 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000133899 | HEALTHSTONE DENTAL | ACTIVE | 2021-10-05 | 2026-12-31 | No data | 1440 SW 125TH AVENUE, DAVIE, FL, 33325 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-07 | 3930 JOHNSON STREET, HOLLYWOOD, FL 33021 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-07 |
| Domestic Profit | 2021-03-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
