Search icon

SPA DENTAL, P.C.

Company Details

Name: SPA DENTAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 25 Nov 1996 (28 years ago)
Entity Number: 2087061
ZIP code: 12020
County: Saratoga
Place of Formation: New York
Principal Address: 68 MILTON AVE., BALLSTON SPA, NY, United States, 12020
Address: 68 MILTON AVE, BALLSTON SPA, NY, United States, 12020

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN 2020 141798157 2021-10-13 SPA DENTAL, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN 2019 141798157 2020-10-07 SPA DENTAL, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN 2018 141798157 2019-07-30 SPA DENTAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN 2017 141798157 2018-09-28 SPA DENTAL, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN 2016 141798157 2017-10-10 SPA DENTAL, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2014 141798157 2015-07-14 SPA DENTAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2013 141798157 2014-08-11 SPA DENTAL, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2012 141798157 2013-05-15 SPA DENTAL, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020

Signature of

Role Plan administrator
Date 2013-05-15
Name of individual signing JAMES HANSEN, DMD
Role Employer/plan sponsor
Date 2013-05-15
Name of individual signing JAMES HANSEN, DMD
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2011 141798157 2012-05-11 SPA DENTAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020

Plan administrator’s name and address

Administrator’s EIN 141798157
Plan administrator’s name SPA DENTAL, P.C.
Plan administrator’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
Administrator’s telephone number 5188851791

Signature of

Role Plan administrator
Date 2012-05-10
Name of individual signing SUSAN HANSEN
Role Employer/plan sponsor
Date 2012-05-10
Name of individual signing SUSAN HANSEN
SPA DENTAL, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2010 141798157 2011-06-02 SPA DENTAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621210
Sponsor’s telephone number 5188851791
Plan sponsor’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020

Plan administrator’s name and address

Administrator’s EIN 141798157
Plan administrator’s name SPA DENTAL, P.C.
Plan administrator’s address 68 MILTON AVENUE, BALLSTON SPA, NY, 12020
Administrator’s telephone number 5188851791

Signature of

Role Plan administrator
Date 2011-06-01
Name of individual signing JAMES T. HANSEN DMD
Role Employer/plan sponsor
Date 2011-06-01
Name of individual signing JAMES T. HANSEN DMD

Chief Executive Officer

Name Role Address
DR. JAMES T. HANSEN Chief Executive Officer 68 MILTON AVE., BALLSTON SPA, NY, United States, 12020

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 68 MILTON AVE, BALLSTON SPA, NY, United States, 12020

History

Start date End date Type Value
1998-11-02 2010-11-10 Address 68 MILTON AVE., BALLSTON SPA, NY, 12020, 1405, USA (Type of address: Chief Executive Officer)
1998-11-02 2010-11-10 Address 68 MILTON AVE., BALLSTON SPA, NY, 12020, 1405, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
181102006411 2018-11-02 BIENNIAL STATEMENT 2018-11-01
161103006221 2016-11-03 BIENNIAL STATEMENT 2016-11-01
141107007021 2014-11-07 BIENNIAL STATEMENT 2014-11-01
121123002368 2012-11-23 BIENNIAL STATEMENT 2012-11-01
101110003018 2010-11-10 BIENNIAL STATEMENT 2010-11-01
081104002821 2008-11-04 BIENNIAL STATEMENT 2008-11-01
061026002920 2006-10-26 BIENNIAL STATEMENT 2006-11-01
050105002696 2005-01-05 BIENNIAL STATEMENT 2004-11-01
021030002290 2002-10-30 BIENNIAL STATEMENT 2002-11-01
001115002599 2000-11-15 BIENNIAL STATEMENT 2000-11-01

Date of last update: 13 Nov 2024

Sources: New York Secretary of State