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  5. GERALD W. BIRD, D.D.S., P.A.

GERALD W. BIRD, D.D.S., P.A.

Company Details

Entity Name: GERALD W. BIRD, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 29 Dec 1994 (30 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 27 Oct 2008 (16 years ago)
Document Number: P94000093942
FEI/EIN Number 59-3284820
Address: 96 WILLARD ST., SUITE 105, COCOA, FL 32922
Mail Address: 96 WILLARD ST., SUITE 105, COCOA, FL 32922
ZIP code: 32922
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578793675 2009-07-23 2009-07-23 96 WILLARD ST, SUITE 105, COCOA, FL, 329228008, US 96 WILLARD ST, SUITE 105, COCOA, FL, 329228008, US

Contacts
Phone +1 321-631-7000
Fax 3216315135

Authorized person
Name DR. GERALD W. BIRD
Role PRESIDENT
Phone 3216317000

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 10251
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2022 593284820 2023-04-06 GERALD W. BIRD, D.D.S, P.A 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2022 593284820 2023-07-06 GERALD W. BIRD, D.D.S, P.A 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2021 593284820 2022-06-29 GERALD W. BIRD, D.D.S, P.A 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2020 593284820 2021-11-02 GERALD W. BIRD, D.D.S, P.A 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2020 593284820 2021-10-06 GERALD W. BIRD, D.D.S, P.A 9
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2019 593284820 2020-09-21 GERALD W. BIRD, D.D.S, P.A 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2018 593284820 2019-10-07 GERALD W. BIRD, D.D.S, P.A 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2017 593284820 2018-10-04 GERALD W. BIRD, D.D.S, P.A 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2016 593284820 2017-12-14 GERALD W. BIRD, D.D.S, P.A 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922
GERALD W. BIRD, D.D.S, P.A PROFIT SHARING PLAN AND TRUST 2015 593284820 2016-10-12 GERALD W. BIRD, D.D.S, P.A 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3216317000
Plan sponsor’s address 96 WILLARD STREET, SUITE 105, COCOA, FL, 32922

Agent

Name Role Address
Johnson, Jay A, Dr. Agent 96 WILLARD ST., SUITE 105, COCOA, FL 32922

PTDC

Name Role Address
Johnson, Jay A, Dr. PTDC 96 WILLARD ST., SUITE 105 COCOA, FL 32922

Secretary

Name Role Address
VOORHEES, SHELLEY V Secretary 96 WILLARD STREET, SUITE 105, COCOA, FL 32922

Vice President

Name Role Address
JOHNSON, Jill D, Dr. Vice President 96 WILLARD ST., SUITE 105 COCOA, FL 32922

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-12-18 Johnson, Jay A, Dr. No data
CHANGE OF PRINCIPAL ADDRESS 2010-01-08 96 WILLARD ST., SUITE 105, COCOA, FL 32922 No data
CHANGE OF MAILING ADDRESS 2010-01-08 96 WILLARD ST., SUITE 105, COCOA, FL 32922 No data
CANCEL ADM DISS/REV 2008-10-27 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2008-09-26 No data No data
CANCEL ADM DISS/REV 2007-05-15 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2006-09-15 No data No data
REINSTATEMENT 2000-01-03 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1999-09-24 No data No data
REINSTATEMENT 1998-05-11 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-12
AMENDED ANNUAL REPORT 2023-12-18
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-01-22

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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