| Entity Name: | JEFFRY D. BARNES, D.M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Apr 1996 (29 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Nov 2014 (10 years ago) |
| Document Number: | P96000038328 |
| FEI/EIN Number | 593392030 |
| Address: | 320 AVE K SE, SUITE 1, WINTER HAVEN, FL, 33880, US |
| Mail Address: | 320 AVE K SE, SUITE 1, WINTER HAVEN, FL, 33880, US |
| ZIP code: | 33880 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFRY D. BARNES, DMD, P.A. 401(K) PROFIT SHARING PLAN AND TRUST | 2013 | 593392030 | 2014-09-19 | JEFFRY D. BARNES, D.M.D., P.A. | 12 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2014-09-19 |
| Name of individual signing | JEFFRY D. BARNES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1997-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8632935099 |
| Plan sponsor’s address | 320 AVENUE K, SE, SUITE 1, WINTER HAVEN, FL, 338804148 |
Signature of
| Role | Plan administrator |
| Date | 2013-09-25 |
| Name of individual signing | JEFFRY D. BARNES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BARNES JEFFRY DD.M.D. | Agent | 320 AVENUE K SE, WINTER HAVEN, FL, 33880 |
| Name | Role | Address |
|---|---|---|
| BARNES JEFFRY DD.M.D. | Director | 320 AVENUE K SE, SUITE 1, WINTER HAVEN, FL, 33880 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000072472 | POLK PERIODONTICS DENTAL IMPLANT CENTER | ACTIVE | 2012-07-20 | 2027-12-31 | No data | 320 AVENUE K S.E., SUITE 1, WINTER HAVEN, FL, 33880 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2014-11-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-21 | 320 AVENUE K SE, SUITE 1, WINTER HAVEN, FL 33880 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-22 | 320 AVE K SE, SUITE 1, WINTER HAVEN, FL 33880 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-22 | 320 AVE K SE, SUITE 1, WINTER HAVEN, FL 33880 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-03-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7016887105 | 2020-04-14 | 0455 | PPP | 320 Avenue K SE Suite 1, WINTER HAVEN, FL, 33880 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
