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  5. PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C.

PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C.

Company Details

Entity Name: PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Forfeited
Date Formed: 11 Oct 1973
Business ALEI: 0012876
Business address: 10 MOTT AVENUE, NORWALK, CT, 06850, United States
Mailing address: 10 MOTT AVE, NORWALK, CT, United States, 06850
ZIP code: 06850
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: dsgottlieb1940@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2021 060900962 2022-10-13 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 7
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2020 060900962 2021-10-15 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 7
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2019 060900962 2020-07-05 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 7
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2020-07-05
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-05
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2018 060900962 2019-11-13 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2019-11-13
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-11-13
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2018 060900962 2019-10-15 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 6
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-15
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES' 401(K) PLAN 2017 060900962 2018-09-19 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 6
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2018-09-19
Name of individual signing DAVID GOTTLIEB, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-19
Name of individual signing DAVID GOTTLIEB, PRESIDENT
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES 401-K PLAN 2016 060900962 2017-10-09 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 7
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2017-10-03
Name of individual signing DAVID GOTTLIEB
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES 401-K PLAN 2015 060900962 2016-10-17 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing DAVID GOTTLIEB
Valid signature Filed with authorized/valid electronic signature
PERIODONTOLOGY ASSOCIATES OF NORWALK PC EMPLOYEES 401-K PLAN 2014 060900962 2015-10-15 PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 2038531120
Plan sponsor’s address 10 MOTT AVENUE, NORWALK, CT, 068503320

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing DAVID GOTTLIEB
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address E-Mail Residence address
DAVID S GOTTLIEB Agent 10 MOTT AVE, NORWALK, CT, 06850, United States dsgottlieb1940@gmail.com 135 HILLANDALE RD, WESTPORT, CT, 06880, United States

Officer

Name Role Business address Residence address
DAVID GOTTLIEB Officer 10 MOTT AVE., NORWALK, CT, 06850, United States 276 NORTH AVE., WESTPORT, CT, United States
ARLENE GOTTLIEB Officer 10 MOTT AVE., NORWALK, CT, 06850, United States 276 NORTH AVE., WESTPORT, CT, United States

History

Type Old value New value Date of change
Name change DAVID S. GOTTLIEB, D.M.D., AND ROBERT C. FAZIO, D.M.D., P.C. PERIODONTOLOGY ASSOCIATES OF NORWALK, P.C. 1978-11-13
Name change DAVID S. GOTTLIEB, D.M.D., P.C. DAVID S. GOTTLIEB, D.M.D., AND ROBERT C. FAZIO, D.M.D., P.C. 1977-10-06

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012039515 2023-10-31 No data Administrative Dissolution Certificate of Dissolution/Revocation No data
BF-0011903266 2023-07-27 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0006639079 2019-09-07 No data Annual Report Annual Report 2019
0006267876 2018-10-29 No data Annual Report Annual Report 2018
0006267874 2018-10-29 No data Annual Report Annual Report 2017
0005763898 2017-02-07 No data Annual Report Annual Report 2015
0005763899 2017-02-07 No data Annual Report Annual Report 2016
0005763897 2017-02-07 No data Annual Report Annual Report 2014
0004947809 2013-09-23 No data Annual Report Annual Report 2013
0004719123 2012-09-18 No data Annual Report Annual Report 2012

Related by officers

DAVID GOTTLIEB

SHADY LANE, LLC 851 LAKE AVENUE, LLC 270 OVERLOOK DRIVE, LLC GOOSETOWN ENTERPRISES, INC. GOOSETOWN NETWORK SERVICES LLC THE REPEATER NETWORK, LLC THE REPEATER NETWORK, LLC NOBLE BRIDGE GROUP, LLC

Related by address

10 MOTT AVENUE, NORWALK, CT, 06850, United States

OYSTER, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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