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  5. PEDIATRIC DENTISTRY ASSOCIATES, LLC

PEDIATRIC DENTISTRY ASSOCIATES, LLC

Company Details

Entity Name: PEDIATRIC DENTISTRY ASSOCIATES, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Forfeited
Date Formed: 23 Jun 2000
Business ALEI: 0654964
Annual report due: 31 Mar 2021
NAICS code: 621210 - Offices of Dentists
Business address: 991 STATE ST., NEW HAVEN, CT, 06510, United States
Mailing address: 991 STATE ST., NEW HAVEN, CT, United States, 06510
ZIP code: 06510
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: bryan@wileylegal.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2016 061442972 2017-08-03 PEDIATRIC DENTISTRY ASSOCIATES, LLC 17
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2017-08-03
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-03
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2016 061442972 2017-09-27 PEDIATRIC DENTISTRY ASSOCIATES, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2017-09-27
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2015 061442972 2016-09-20 PEDIATRIC DENTISTRY ASSOCIATES, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2016-09-20
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2014 061442972 2015-08-15 PEDIATRIC DENTISTRY ASSOCIATES, LLC 15
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2015-08-14
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2014 061442972 2016-09-20 PEDIATRIC DENTISTRY ASSOCIATES, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2016-09-20
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2013 061442972 2014-03-21 PEDIATRIC DENTISTRY ASSOCIATES, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2014-03-21
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2012 061442972 2013-09-13 PEDIATRIC DENTISTRY ASSOCIATES, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2011 061442972 2012-08-21 PEDIATRIC DENTISTRY ASSOCIATES, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Plan administrator’s name and address
Administrator’s EIN 061442972
Plan administrator’s name PEDIATRIC DENTISTRY ASSOCIATES, LLC
Plan administrator’s address 991 STATE STREET, NEW HAVEN, CT, 06511
Administrator’s telephone number 2037873669

Signature of
Role Plan administrator
Date 2012-08-20
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2010 061442972 2012-08-21 PEDIATRIC DENTISTRY ASSOCIATES, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Plan administrator’s name and address
Administrator’s EIN 061442972
Plan administrator’s name PEDIATRIC DENTISTRY ASSOCIATES, LLC
Plan administrator’s address 991 STATE STREET, NEW HAVEN, CT, 06511
Administrator’s telephone number 2037873669

Signature of
Role Plan administrator
Date 2012-08-20
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2010 061442972 2011-09-14 PEDIATRIC DENTISTRY ASSOCIATES, LLC 13
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 2037873669
Plan sponsor’s address 991 STATE STREET, NEW HAVEN, CT, 06511

Plan administrator’s name and address
Administrator’s EIN 061442972
Plan administrator’s name PEDIATRIC DENTISTRY ASSOCIATES, LLC
Plan administrator’s address 991 STATE STREET, NEW HAVEN, CT, 06511
Administrator’s telephone number 2037873669

Signature of
Role Plan administrator
Date 2011-09-13
Name of individual signing DOUGLAS KECK
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Residence address
COLIN KONG DMD Officer 991 STATE STREET, NEW HAVEN, CT, 06511, United States 7 ROSANNE LANE, PLAINVILLE, CT, 06062, United States

Agent

Name Role
WILEY ETTER DOYON, LLC Agent

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012469877 2023-11-28 No data Administrative Dissolution Certificate of Dissolution/Revocation No data
BF-0011947619 2023-08-28 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0006961969 2020-08-14 No data Annual Report Annual Report 2019
0006961971 2020-08-14 No data Annual Report Annual Report 2020
0006961965 2020-08-14 No data Annual Report Annual Report 2018
0006961857 2020-08-10 2020-08-10 Interim Notice Interim Notice No data
0006961859 2020-08-10 2020-08-10 Change of Agent Agent Change No data
0005860209 2017-06-07 No data Annual Report Annual Report 2017
0005725102 2016-12-27 No data Annual Report Annual Report 2015
0005725103 2016-12-27 No data Annual Report Annual Report 2016

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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