| Entity Name: | MULBERRY DENTAL CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 May 1998 (27 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 05 Oct 2005 (19 years ago) |
| Document Number: | P98000044878 |
| FEI/EIN Number | 593419655 |
| Address: | 105 N. CHURCH AVE., MULBERRY, FL, 33860 |
| Mail Address: | 105 N. CHURCH AVE., MULBERRY, FL, 33860 |
| ZIP code: | 33860 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972675809 | 2006-11-15 | 2020-08-22 | 105 N CHURCH AVE, MULBERRY, FL, 338602413, US | 105 N CHURCH AVE, MULBERRY, FL, 338602413, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-869-8888 |
| Fax | 8638698880 |
Authorized person
| Name | DR. FARIBA SHAFII |
| Role | OWNER |
| Phone | 8638698888 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN13663 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DR. SHAFII'S LICENSE # |
| Number | DN13663 |
| State | FL |
| Issuer | DR. FARZANEH'S LICENSE # |
| Number | DN 13817 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAFII FARIBA D | Agent | 105 N. CHURCH AVE., MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| SHAFII FARIBA | President | 105 N. CHUCH AVE., MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| Farzaneh Masoud KDr. | Vice Chairman | 105 N. CHURCH AVE., MULBERRY, FL, 33860 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2005-10-05 | SHAFII, FARIBA D.D.S. | No data |
| CANCEL ADM DISS/REV | 2005-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-02-09 | 105 N. CHURCH AVE., MULBERRY, FL 33860 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2001-02-09 | 105 N. CHURCH AVE., MULBERRY, FL 33860 | No data |
| CHANGE OF MAILING ADDRESS | 2001-02-09 | 105 N. CHURCH AVE., MULBERRY, FL 33860 | No data |
| NAME CHANGE AMENDMENT | 1998-07-02 | MULBERRY DENTAL CARE, INC. | No data |
| NAME CHANGE AMENDMENT | 1998-06-04 | SHAFII ENTERPRISES, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-13 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-01-03 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-03-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
