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DENTISTS OF VISTA, PA - Florida Company Profile

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Company Details

Entity Name: DENTISTS OF VISTA, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Aug 2024 (a year ago)
Last Event: AMENDMENT
Event Date Filed: 08 Nov 2024 (10 months ago)
Document Number: P24000053539
FEI/EIN Number 99-4608689
Mail Address: 17000 RED HILL AVENUE, IRVINE, CA, 92614, US
Address: 7601 NARCOOSSEE RD, ORLANDO, FL, 32822, US
ZIP code: 32822
City: Orlando
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
NAM SUNG D.M.D. President 17000 RED HILL AVE, IRVINE, CA, 92614
PHAM MINH D.D.S. Secretary 17000 RED HILL AVE, IRVINE, CA, 92614
PHAM MINH D.D.S. Director 17000 RED HILL AVE, IRVINE, CA, 92614
BUTTON NICHOLAS D.D.S. Chief Executive Officer 17000 RED HILL AVE, IRVINE, CA, 92614
BUTTON NICHOLAS D.D.S. Director 17000 RED HILL AVE, IRVINE, CA, 92614
NAM SUNG MIN D.M.D. Director 17000 RED HILL AVE, IRVINE, CA, 92614
Ghazal Carolyn Director 17000 Red Hill Ave., Irvine, CA, 92614
- Agent -

National Provider Identifier

NPI Number:
1700613247
Certification Date:
2024-09-12

Authorized Person:

Name:
SUNG NAM
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000109867 DENTISTS OF VISTA ACTIVE 2024-09-04 2029-12-31 - 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614

Events

Event Type Filed Date Value Description
AMENDMENT 2024-11-08 - -

Documents

Name Date
Amendment 2024-11-08
Domestic Profit 2024-08-20

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Date of last update: 03 Aug 2025

Sources: Florida Department of State