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ALTAMONTE SPRINGS DENTAL GROUP, PA - Florida Company Profile

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Company Details

Entity Name: ALTAMONTE SPRINGS DENTAL GROUP, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 09 May 2023 (2 years ago)
Document Number: P23000036559
FEI/EIN Number 93-1709751
Address: 1001 N STATE RD 434 STE 1010, ALTAMONTE SPRINGS, FL, 32714, US
Mail Address: 17000 Red Hill Ave., IRVINE, CA, 92614, US
ZIP code: 32714
City: Altamonte Springs
County: Seminole
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Pham Minh B President 17000 Red Hill Ave., IRVINE, CA, 92614
Nam Sung Secretary 17000 Red Hill Ave., IRVINE, CA, 92614
Pham Minh B Treasurer 17000 Red Hill Ave., IRVINE, CA, 92614
Pham Minh B Director 17000 Red Hill Ave., IRVINE, CA, 92614
Nam Sung Director 17000 Red Hill Ave., IRVINE, CA, 92614
Hameedi Imran B Director 17000 Red Hill Ave., IRVINE, CA, 92614
- Agent -

National Provider Identifier

NPI Number:
1942994488
Certification Date:
2023-06-07

Authorized Person:

Name:
MINH PHAM
Role:
OWNER/DDS
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fax:
4075456616

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000091349 ALTAMONTE SPRINGS DENTAL GROUP ACTIVE 2023-08-04 2028-12-31 - 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPT., RAELEA APOLITO, IRVINE, CA, 92614

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-04-17 1001 N STATE RD 434 STE 1010, ALTAMONTE SPRINGS, FL 32714 -

Documents

Name Date
ANNUAL REPORT 2024-04-17
Domestic Profit 2023-05-09

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Date of last update: 03 Aug 2025

Sources: Florida Department of State