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  5. PALM BEACH ENDODONTICS, P.A.

PALM BEACH ENDODONTICS, P.A. - Florida Company Profile

Company Details

Entity Name: PALM BEACH ENDODONTICS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

PALM BEACH ENDODONTICS, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 07 Aug 1998 (27 years ago)
Document Number: P98000069071
FEI/EIN Number 650862462

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 11211 PROSPERITY FARMS RD., B107, PALM BEACH GARDENS, FL, 33410
Mail Address: 11211 PROSPERITY FARMS RD., B107, PALM BEACH GARDENS, FL, 33410
ZIP code: 33410
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740431980 2008-10-07 2008-10-07 11211 PROSPERITY FARMS RD, SUITE B107, PALM BEACH GARDENS, FL, 334103446, US 11211 PROSPERITY FARMS RD, SUITE B107, PALM BEACH GARDENS, FL, 334103446, US

Contacts
Phone +1 561-630-8900
Fax 5616308909

Authorized person
Name DR. KENNETH W. BRADSHAW
Role PRESIDENT
Phone 5616308900

Taxonomy
Taxonomy Code 1223E0200X - Endodontist
License Number DN13872
State FL
Is Primary Yes
Taxonomy Code 1223E0200X - Endodontist
License Number DN16549
State FL
Is Primary No
Taxonomy Code 1223E0200X - Endodontist
License Number DN13841
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2023 650862462 2024-09-20 PALM BEACH ENDODONTICS, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2024-09-20
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-20
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2022 650862462 2023-10-11 PALM BEACH ENDODONTICS, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-11
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2021 650862462 2022-10-16 PALM BEACH ENDODONTICS, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2022-10-16
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-16
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2020 650862462 2021-07-19 PALM BEACH ENDODONTICS, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-19
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2019 650862462 2020-07-30 PALM BEACH ENDODONTICS, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2020-07-30
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-30
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2018 650862462 2019-08-23 PALM BEACH ENDODONTICS, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2019-08-23
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-23
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2017 650862462 2018-07-24 PALM BEACH ENDODONTICS, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2018-07-24
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-24
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ENDODONTICS, P.A. 401(K) PROFIT SHARING PLAN & TRUST 2016 650862462 2017-10-02 PALM BEACH ENDODONTICS, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5618334633
Plan sponsor’s address 11211 PROSPERITY FARMS ROAD, SUITE B107, PALM BEACH GARDENS, FL, 33410

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-02
Name of individual signing KENNETH BRADSHAW
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
BRADSHAW KENNETH W President 11211 PROSPERITY FARMS RD. , B107, PALM BEACH GARDENS, FL, 33410
BRADSHAW CHARLYN R Vice President 11211 PROSPERITY FARMS RD. , B107, PALM BEACH GARDENS, FL, 33410
BRADSHAW KENNETH J Agent 11211 PROSPERITY FARMS RD., PALM BEACH GARDENS, FL, 33410

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2005-07-01 11211 PROSPERITY FARMS RD., B107, PALM BEACH GARDENS, FL 33410 -
CHANGE OF MAILING ADDRESS 2005-07-01 11211 PROSPERITY FARMS RD., B107, PALM BEACH GARDENS, FL 33410 -
REGISTERED AGENT ADDRESS CHANGED 2005-07-01 11211 PROSPERITY FARMS RD., B107, PALM BEACH GARDENS, FL 33410 -

Documents

Name Date
ANNUAL REPORT 2024-01-28
ANNUAL REPORT 2023-01-21
ANNUAL REPORT 2022-01-29
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-18
ANNUAL REPORT 2019-04-07
ANNUAL REPORT 2018-01-14
ANNUAL REPORT 2017-04-16
ANNUAL REPORT 2016-02-19
ANNUAL REPORT 2015-01-11

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3706268407 2021-02-05 0455 PPS 11211 Prosperity Farms Rd Ste B107, Palm Beach Gardens, FL, 33410-3453
Loan Status Date 2022-03-10
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 195949.85
Loan Approval Amount (current) 195949.85
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17616
Servicing Lender Name Seacoast National Bank
Servicing Lender Address 815 Colorado Ave, STUART, FL, 34994-3053
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Palm Beach Gardens, PALM BEACH, FL, 33410-3453
Project Congressional District FL-21
Number of Employees 13
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 458637
Originating Lender Name Seacoast National Bank
Originating Lender Address Coral Gables, FL
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 197909.35
Forgiveness Paid Date 2022-02-07

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BRADSHAW CHARLYN R

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Companies related by address

No other companies in our directory share the same address as PALM BEACH ENDODONTICS, P.A.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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