{"entity":{"id":9450295,"state":"FL","state_id":"N16773","entity_name":"THE DENTISTS SELF INSURANCE TRUST, INC.","entity_type":"DOMNP","entity_type_normalized":"domestic_nonprofit","status":"I","filing_date":"1986-09-09","filing_year":1986,"business_age_years":40,"principal_address1":"3829 HOLLYWOOD BLVD.","principal_address2":"SUITE C","principal_city":"HOLLYWOOD","principal_state":"FL","principal_zip":"33021","principal_country":"","mail_address1":"3829 HOLLYWOOD BLVD.","mail_address2":"SUITE C","mail_city":"HOLLYWOOD","mail_state":"FL","mail_zip":"33021","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"592738514","jurisdiction":null,"county":null,"last_transaction_date":"10161998","report_year_1":"1997","report_date_1":"02181997","report_year_2":"1997","report_date_2":"02181997","report_year_3":"1996","report_date_3":"03221996","agent_name":"Ralph R. Madio","agent_type":"P","agent_address":"2514 HOLLYWOOD BLVD., SUITE 406","agent_city":"HOLLYWOOD","agent_state":"FL","agent_zip":"33021","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata3.txt","fetched_at":"2026-05-09 11:32:58","updated_at":"2026-05-09 11:32:58","last_accessed":null,"status_reason":null,"agent_name_raw":"MADIO               RALPH R."},"officers":[{"name":"Carl Dann","first_name":"Carl","last_name":"Dann","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"2200 E. ROBINSON ST.","city":"ORLANDO","state":"FL","zip":"","name_raw":"DANN, CARL"},{"name":"Peter M. Fallon","first_name":"Peter","last_name":"Fallon","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"129 30 NORTH A1A","city":"VERO BEACH","state":"FL","zip":"","name_raw":"FALLON, PETER M."},{"name":"Samuel M. Meline","first_name":"Samuel","last_name":"Meline","title":"Secretary, Director","title_roles":["Secretary","Director"],"title_code":"sd","is_registered_agent":false,"address":"4410 SHERIDAN STREET","city":"HOLLYWOOD","state":"FL","zip":"","name_raw":"MELINE, SAMUEL M."},{"name":"Jorge Mestre","first_name":"Jorge","last_name":"Mestre","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"8500 W FLAGLER ST #B201","city":"MIAMI","state":"FL","zip":"","name_raw":"MESTRE, JORGE"},{"name":"Theodore S. Schwartz","first_name":"Theodore","last_name":"Schwartz","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"815 S. UNIVERSITY DR.","city":"PLANTATION","state":"FL","zip":"","name_raw":"SCHWARTZ, THEODORE S."},{"name":"Jack H. Soutar","first_name":"Jack","last_name":"Soutar","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"660 N.E. 95 STREET","city":"MIAMI SHORES","state":"FL","zip":"","name_raw":"SOUTAR, JACK H."}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/N16773"}