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ERIC S. BURGESS, D.M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: ERIC S. BURGESS, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 21 May 1998 (27 years ago)
Document Number: P98000046545
FEI/EIN Number 593515299
Mail Address: 16220 North Scottsdale Road, Suite 400, Scottsdale, AZ, 85254, US
Address: 180 Library Blvd., Suite 101, Ponte Vedra Beach, FL, 32082, US
ZIP code: 32082
City: Ponte Vedra Beach
County: St. Johns
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
Burgess Eric SD.M.D. President 180 Library Blvd., Ponte Vedra Beach, FL, 32082

National Provider Identifier

NPI Number:
1619797461
Certification Date:
2024-10-16

Authorized Person:

Name:
BELLA ZARITSKY
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000129941 BURGESS CENTER FOR COSMETIC DENTISTRY ACTIVE 2021-09-28 2026-12-31 - 108 LIBRARY BLVD., SUITE 101, PONTE VEDRA BEACH, FL, 32082

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-04-17 180 Library Blvd., Suite 101, Ponte Vedra Beach, FL 32082 -
REGISTERED AGENT NAME CHANGED 2024-03-04 C T CORPORATION SYSTEM -
REGISTERED AGENT ADDRESS CHANGED 2024-03-04 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 -
CHANGE OF PRINCIPAL ADDRESS 2019-02-17 180 Library Blvd., Suite 101, Ponte Vedra Beach, FL 32082 -

Documents

Name Date
ANNUAL REPORT 2024-04-17
Reg. Agent Change 2024-03-04
ANNUAL REPORT 2023-01-29
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-01-15
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-17
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-29

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$107,510
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$107,510
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$108,608.66
Servicing Lender:
Celtic Bank Corporation
Use of Proceeds:
Payroll: $107,510
Jobs Reported:
8
Initial Approval Amount:
$107,510
Date Approved:
2021-01-25
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$107,510
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$108,180.34
Servicing Lender:
Celtic Bank Corporation
Use of Proceeds:
Payroll: $107,510

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Date of last update: 02 Aug 2025

Sources: Florida Department of State