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  5. KIMBERLY A. DETTORI, D.D.S., M.S., P.A.

KIMBERLY A. DETTORI, D.D.S., M.S., P.A.

Company Details

Entity Name: KIMBERLY A. DETTORI, D.D.S., M.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 09 Aug 1994 (31 years ago)
Document Number: P94000058521
FEI/EIN Number 65-0509846
Mail Address: 910 SE Riverside Dr, STUART, FL 34994
Address: 903 SE. OCEAN BLVD., Suite 1, STUART, FL 34994
ZIP code: 34994
County: Martin
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1821024522 2006-06-24 2016-03-18 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 349942475, US 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 349942475, US

Contacts
Phone +1 772-221-3700
Fax 7722219107

Authorized person
Name DR. KIMBERLY A DETTORI
Role DENTIST/OWNER
Phone 7722213700

Taxonomy
Taxonomy Code 1223E0200X - Endodontist
License Number DN12143
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KIMBERLY A. DETTORI, D.D.S., P.A. DEFINED BENEFIT PLAN 2023 650509846 2024-05-10 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., M.S., P.A RETIREMENT TRUST 2023 650509846 2024-05-10 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., M.S., P.A RETIREMENT TRUST 2022 650509846 2023-07-19 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., P.A. DEFINED BENEFIT PLAN 2022 650509846 2023-07-26 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., P.A. DEFINED BENEFIT PLAN 2021 650509846 2022-07-08 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., M.S., P.A RETIREMENT TRUST 2021 650509846 2022-06-09 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., P.A. DEFINED BENEFIT PLAN 2020 650509846 2021-06-03 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., M.S., P.A RETIREMENT TRUST 2020 650509846 2021-06-03 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., P.A. DEFINED BENEFIT PLAN 2019 650509846 2020-07-08 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994
KIMBERLY A. DETTORI, D.D.S., M.S., P.A RETIREMENT TRUST 2019 650509846 2020-06-24 KIMBERLY A. DETTORI, D.D.S., M.S., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 621210
Sponsor’s telephone number 7722213700
Plan sponsor’s address 903 SE OCEAN BLVD, SUITE 1, STUART, FL, 34994

Agent

Name Role Address
DETTORI, KIMBERLY A Agent 910 SE Riverside Dr, STUART, FL 34994

Director

Name Role Address
DETTORI, KIMBERLY A, DDS Director 910 SE Riverside Dr, STUART, FL 34994

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2025-01-02 903 SE. OCEAN BLVD., Suite 1, STUART, FL 34994 No data
REGISTERED AGENT ADDRESS CHANGED 2025-01-02 910 SE Riverside Dr, STUART, FL 34994 No data
CHANGE OF PRINCIPAL ADDRESS 2013-01-22 903 SE. OCEAN BLVD., Suite 1, STUART, FL 34994 No data
REGISTERED AGENT NAME CHANGED 2004-01-12 DETTORI, KIMBERLY A No data

Documents

Name Date
ANNUAL REPORT 2025-01-02
ANNUAL REPORT 2024-01-30
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-07
ANNUAL REPORT 2020-01-14
ANNUAL REPORT 2019-02-09
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-01-14
ANNUAL REPORT 2016-01-24

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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