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PARK DENTAL ASSOCIATES, PLLC

Company Details

Name: PARK DENTAL ASSOCIATES, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 26 Mar 2007 (18 years ago) (Companies founded in March 2007)
Entity Number: 3494457
ZIP code: 14618 (Companies in Monroe, 14618)
County: Monroe
Place of Formation: New York
Address: 880 WESTFALL ROAD, SUITE C, ROCHESTER, NY, United States, 14618

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PARK DENTAL ASSOCIATES PLLC 401(K) PROFIT SHARING PLAN & TRUST 2020 208714126 2021-04-05 PARK DENTAL ASSOCIATES PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD - SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2021-04-05
Name of individual signing EDWARD ROJAS
PARK DENTAL ASSOCIATES PLLC 401(K) PROFIT SHARING PLAN & TRUST 2019 208714126 2020-05-27 PARK DENTAL ASSOCIATES PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD - SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2020-05-27
Name of individual signing EDWARD ROJAS
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2017 208714126 2018-07-23 PARK DENTAL ASSOCIATES PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 146182611

Signature of
Role Plan administrator
Date 2018-07-23
Name of individual signing THOMAS J. MILLER DDS
Role Employer/plan sponsor
Date 2018-07-23
Name of individual signing THOMAS MILLER
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2016 208714126 2017-05-15 PARK DENTAL ASSOCIATES PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 146182611

Signature of
Role Plan administrator
Date 2017-05-03
Name of individual signing THOMAS J. MILLER DDS
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2015 208714126 2016-07-05 PARK DENTAL ASSOCIATES PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 146182611

Signature of
Role Plan administrator
Date 2016-07-05
Name of individual signing THOMAS J. MILLER DDS
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2014 208714126 2015-04-28 PARK DENTAL ASSOCIATES PLLC 11
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2015-04-28
Name of individual signing THOMAS J. MILLER DDS
Role Employer/plan sponsor
Date 2015-04-28
Name of individual signing THOMAS J. MILLER
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2014 208714126 2015-10-06 PARK DENTAL ASSOCIATES PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing THOMAS J. MILLER
Role Employer/plan sponsor
Date 2015-10-06
Name of individual signing THOMAS J. MILLER
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2013 208714126 2014-10-08 PARK DENTAL ASSOCIATES PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing THOMAS J. MILLER DDS
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2012 208714126 2013-07-24 PARK DENTAL ASSOCIATES PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2013-07-24
Name of individual signing THOMAS J. MILLER
PARK DENTAL ASSOCIATES PLLC 401K PLAN 2011 208714126 2012-04-30 PARK DENTAL ASSOCIATES PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 5854734320
Plan sponsor’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618

Plan administrator’s name and address
Administrator’s EIN 208714126
Plan administrator’s name PARK DENTAL ASSOCIATES PLLC
Plan administrator’s address 880 WESTFALL ROAD SUITE C, ROCHESTER, NY, 14618
Administrator’s telephone number 5854734320

Signature of
Role Plan administrator
Date 2012-04-30
Name of individual signing KEPTJM040770
Role Employer/plan sponsor
Date 2012-04-30
Name of individual signing KEPTJM040770

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 880 WESTFALL ROAD, SUITE C, ROCHESTER, NY, United States, 14618

Filings

Filing Number Date Filed Type Effective Date
190425060011 2019-04-25 BIENNIAL STATEMENT 2019-03-01
150303007232 2015-03-03 BIENNIAL STATEMENT 2015-03-01
130312006492 2013-03-12 BIENNIAL STATEMENT 2013-03-01
110329003184 2011-03-29 BIENNIAL STATEMENT 2011-03-01
090304002164 2009-03-04 BIENNIAL STATEMENT 2009-03-01
070910000311 2007-09-10 CERTIFICATE OF PUBLICATION 2007-09-10
070326000335 2007-03-26 ARTICLES OF ORGANIZATION 2007-03-26

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Date of last update: 09 Nov 2024

Sources: New York Secretary of State

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