| Entity Name: | BALMIR-THEVENIN & ASSOCIATES D.D.S., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Oct 1995 (29 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 03 Oct 2001 (23 years ago) |
| Document Number: | P95000076467 |
| FEI/EIN Number | 650613602 |
| Address: | 10621 N. KENDALL DRIVE, 102, MIAMI, FL, 33176 |
| Mail Address: | 10621 N. KENDALL DRIVE, 102, MIAMI, FL, 33176 |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639403868 | 2009-09-21 | 2009-09-21 | 10621 N KENDALL DR, SUITE # 102, MIAMI, FL, 331768708, US | 10621 N KENDALL DR, SUITE # 102, MIAMI, FL, 331768708, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-271-0510 |
| Fax | 3052713532 |
Authorized person
| Name | DR. JOELLE MARIE BALMIR-THEVENIN |
| Role | DENTIST/OWNER |
| Phone | 3052710510 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN0013260 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | BC1102336 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 071317100 |
| State | FL |
| Issuer | NPI |
| Number | 1972618361 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THEVENIN JOELLE Dr. | Agent | 10621 N. KENDALL DR., MIAMI, FL, 33176 |
| Name | Role | Address |
|---|---|---|
| BALMIR THEVENIN JOELLE | Director | 10621 N. KENDALL DR., MIAMI, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2014-05-01 | THEVENIN, JOELLE, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-04-29 | 10621 N. KENDALL DRIVE, 102, MIAMI, FL 33176 | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-29 | 10621 N. KENDALL DRIVE, 102, MIAMI, FL 33176 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-04-29 | 10621 N. KENDALL DR., 102, MIAMI, FL 33176 | No data |
| NAME CHANGE AMENDMENT | 2001-10-03 | BALMIR-THEVENIN & ASSOCIATES D.D.S., P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-16 |
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-25 |
| ANNUAL REPORT | 2020-02-24 |
| ANNUAL REPORT | 2019-03-13 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
