| Entity Name: | DENTISTS OF DAVENPORT, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Dec 2023 (a year ago) |
| Document Number: | P23000084233 |
| FEI/EIN Number | 93-4777495 |
| Mail Address: | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Address: | 2122 TRIGLIA WAY, DAVENPORT, FL 33896 |
| ZIP code: | 33896 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073381521 | 2023-12-14 | 2023-12-14 | PO BOX 920050, DALLAS, TX, 753920050, US | 2122 TRIGLIA WAY, DAVENPORT, FL, 33896, US | |||||||||||||||
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| Phone | +1 863-812-4570 |
| Fax | 8638124219 |
Authorized person
| Name | OMEIR TARIQ ANSARI |
| Role | OWNER |
| Phone | 8638124570 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Pham, Minh B. | Director | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Ansari, Omeir | Director | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Button, Nicholas R. | Director | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Ansari, Omeir | President | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Button, Nicholas R. | Secretary | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Name | Role | Address |
|---|---|---|
| Pham, Minh B. | Treasurer | 17000 RED HILL AVE, IRVINE, CA 92614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000151973 | DENTISTS OF DAVENPORT | ACTIVE | 2023-12-14 | 2028-12-31 | No data | 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| Domestic Profit | 2023-12-06 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
