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REGENCY MODERN DENTISTRY, PA - Florida Company Profile

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Company Details

Entity Name: REGENCY MODERN DENTISTRY, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 10 Apr 2025 (5 months ago)
Document Number: P25000021168
Mail Address: 17000 RED HILL AVENUE, IRVINE, CA, 92614, US
Address: 9406 ATLANTIC BLVD, STE #1, JACKSONVILLE, FL, 32225, US
ZIP code: 32225
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Role
Agent

National Provider Identifier

NPI Number:
1477446078
Certification Date:
2025-06-02

Authorized Person:

Name:
MINH PHAM
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
G25000081355 REGENCY MODERN DENTISTRY ACTIVE 2025-06-26 2030-12-31 - 17000 RED HILL AVENUE, ATTENTION: LEGAL DEPARTMENT, IRVINE, CA, 92614

Events

Event Type Filed Date Value Description
AMENDMENT 2025-07-14 - -

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Date of last update: 03 Aug 2025

Sources: Florida Department of State