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DENTISTS OF BOCA VILLAGE, PA - Florida Company Profile

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Company Details

Entity Name: DENTISTS OF BOCA VILLAGE, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 08 Mar 2022 (3 years ago)
Document Number: P22000017880
FEI/EIN Number 88-1137804
Address: 21200 ST ANDREWS BLVD UNITS 11 & 12, BOCA RATON, FL, 33433
Mail Address: 17000 RED HILL AVE, IRVINE, CA, 92614
ZIP code: 33433
City: Boca Raton
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Pham Minh B President 17000 RED HILL AVE, IRVINE, CA, 92614
Azadi Anthony A Secretary 17000 RED HILL AVE, IRVINE, CA, 92614
Pham Minh B Chief Financial Officer 17000 RED HILL AVE, IRVINE, CA, 92614
Pham Minh B Director 17000 RED HILL AVE, IRVINE, CA, 92614
Azadi Anthony A Director 17000 RED HILL AVE, IRVINE, CA, 92614
Tolmie Christopher B Director 17000 RED HILL AVE, IRVINE, CA, 92614
- Agent -

National Provider Identifier

NPI Number:
1073261699
Certification Date:
2022-03-14

Authorized Person:

Name:
MINH B PHAM
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
3039520892
Fax:
5615848162

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000143193 DENTISTS OF BOCA VILLAGE ACTIVE 2022-11-17 2027-12-31 - 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614
G22000034067 DENTISTS OF BOCA VILLAGE ACTIVE 2022-03-11 2027-12-31 - 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-06-13 115 N. CALHOUN ST., STE 4, TALLAHASSEE, FL 32301 -

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-04-17
Domestic Profit 2022-03-08

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Date of last update: 01 Aug 2025

Sources: Florida Department of State