| Entity Name: | LAKEWOOD DENTAL EXCELLENCE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 18 Jan 2022 (3 years ago) |
| Document Number: | P22000006247 |
| FEI/EIN Number | 87-4745763 |
| Mail Address: | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Address: | 5255 OFFICE PARK BLVD, SUITE 112, BRADENTON, FL 34203 |
| ZIP code: | 34203 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295483956 | 2022-03-12 | 2022-03-12 | 5255 OFFICE PARK BLVD STE 112, BRADENTON, FL, 342033443, US | 5255 OFFICE PARK BLVD STE 112, BRADENTON, FL, 342033443, US | |||||||||||||||
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| Phone | +1 941-739-7770 |
| Fax | 9417397770 |
Authorized person
| Name | RICHARD M KERNAGIS |
| Role | PRESIDENT |
| Phone | 9417397770 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KERNAGIS, RICHARD M | Agent | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Name | Role | Address |
|---|---|---|
| KERNAGIS, RICHARD M | President | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Name | Role | Address |
|---|---|---|
| KERNAGIS, RICHARD M | Secretary | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Name | Role | Address |
|---|---|---|
| KERNAGIS, RICHARD M | Treasurer | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Name | Role | Address |
|---|---|---|
| KERNAGIS, JENNIFER | Vice President | 4307 WEST JETTON AVENUE, TAMPA, FL 33629 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000046156 | YOUR TIME DENTAL URGENT CARE | ACTIVE | 2023-04-11 | 2028-12-31 | No data | 13145 KINGS LAKE DRIVE SUITE 105, GIBSONTON, FL, 33534 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-25 |
| Domestic Profit | 2022-01-18 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
