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  5. BRAD FULKERSON, DMD, MSD, LLC

BRAD FULKERSON, DMD, MSD, LLC

Company Details

Name: BRAD FULKERSON, DMD, MSD, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 15 Mar 2005 (20 years ago)
Organization Date: 15 Mar 2005 (20 years ago)
Last Annual Report: 23 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0608330
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42420
City: Henderson
Primary County: Henderson County
Principal Office: 700 BARRETT BOULEVARD, HENDERSON, KY 42420
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2022 202499499 2023-06-11 BRAD FULKERSON, DMD, MSD, LLC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2023-06-11
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2021 202499499 2022-06-14 BRAD FULKERSON, DMD, MSD, LLC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2022-06-14
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2020 202499499 2021-03-31 BRAD FULKERSON, DMD, MSD, LLC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2021-03-31
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2019 202499499 2020-04-03 BRAD FULKERSON, DMD, MSD, LLC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2020-04-03
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2018 202499499 2019-05-11 BRAD FULKERSON, DMD, MSD, LLC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2019-05-11
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2017 202499499 2018-04-15 BRAD FULKERSON, DMD, MSD, LLC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2018-04-15
Name of individual signing BRAD T. FULKERSON
Valid signature Filed with authorized/valid electronic signature
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2016 202499499 2017-07-24 BRAD FULKERSON, DMD, MSD, LLC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419
BRAD FULKERSON, DMD, MSD, LLC CASH BALANCE PLAN 2016 202499499 2017-09-29 BRAD FULKERSON, DMD, MSD, LLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRET BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419
BRAD FULKERSON, DMD, MSD, LLC CASH BALANCE PLAN 2015 202499499 2016-05-31 BRAD FULKERSON, DMD, MSD, LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRET BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419
BRAD FULKERSON, DMD 401(K) PROFIT SHARING PLAN 2015 202499499 2016-07-11 BRAD FULKERSON, DMD, MSD, LLC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address 700 BARRETT BOULEVARD, SUITE A, P.O. BOX 276, HENDERSON, KY, 42419
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/03/28/20150328080945P040151404631001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2015-03-28
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/29/20140129163246P030189852275001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2014-01-29
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/03/10/20130310104756P040125829123001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Signature of
Role Plan administrator
Date 2013-03-10
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/02/11/20120211071805P040010259303001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Plan administrator’s name and address
Administrator’s EIN 202499499
Plan administrator’s name BRAD FULKERSON, DMD, MSD, LLC
Plan administrator’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419
Administrator’s telephone number 2708275522

Signature of
Role Plan administrator
Date 2012-02-11
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/26/20110126140812P040020611809001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Plan administrator’s name and address
Administrator’s EIN 202499499
Plan administrator’s name BRAD FULKERSON, DMD, MSD, LLC
Plan administrator’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419
Administrator’s telephone number 2708275522

Signature of
Role Plan administrator
Date 2011-01-26
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/05/10/20100510200834P030248554705001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2708275522
Plan sponsor’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419

Plan administrator’s name and address
Administrator’s EIN 202499499
Plan administrator’s name BRAD FULKERSON, DMD, MSD, LLC
Plan administrator’s address P.O. BOX 276, 700 A BARRET BLVD., HENDERSON, KY, 42419
Administrator’s telephone number 2708275522

Signature of
Role Plan administrator
Date 2010-05-10
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-05-10
Name of individual signing BRAD FULKERSON
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
BRAD FULKERSON Registered Agent

Member

Name Role
BRAD T FULKERSON Member

Organizer

Name Role
BRAD FULKERSON Organizer

Filings

Name File Date
Annual Report 2025-02-23
Annual Report 2024-03-23
Annual Report 2023-03-22
Annual Report 2022-04-13
Annual Report 2021-02-11
Annual Report 2020-02-14
Annual Report 2019-04-25
Annual Report 2018-04-15
Annual Report 2017-05-14
Annual Report 2016-03-21

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6303038309 2021-01-26 0457 PPS 700 Barrett Blvd Ste A, Henderson, KY, 42420-7526
Loan Status Date 2021-11-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 130687.5
Loan Approval Amount (current) 130687.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 21641
Servicing Lender Name Old National Bank
Servicing Lender Address One Main St, EVANSVILLE, IN, 47708-1449
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Henderson, HENDERSON, KY, 42420-7526
Project Congressional District KY-01
Number of Employees 14
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 21641
Originating Lender Name Old National Bank
Originating Lender Address EVANSVILLE, IN
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 131539.65
Forgiveness Paid Date 2021-09-24
3156597105 2020-04-11 0457 PPP 700 A Barret Blvd, HENDERSON, KY, 42420-7526
Loan Status Date 2020-12-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 118700
Loan Approval Amount (current) 118700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 21641
Servicing Lender Name Old National Bank
Servicing Lender Address One Main St, EVANSVILLE, IN, 47708-1449
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address HENDERSON, HENDERSON, KY, 42420-7526
Project Congressional District KY-01
Number of Employees 13
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 21641
Originating Lender Name Old National Bank
Originating Lender Address EVANSVILLE, IN
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 119314.64
Forgiveness Paid Date 2020-11-03

Related by officers

BRAD FULKERSON

SFD PROPERTY, LLC BK RENTAL, LLC EAR PROPERTY, LLC Cardinal Crossing, LLC

BRAD T FULKERSON

BARRETT PROFESSIONAL CENTER, LLC

Related by address

700 BARRETT BOULEVARD, HENDERSON, KY 42420

SFD PROPERTY, LLC BK RENTAL, LLC EAR PROPERTY, LLC

Sources: Kentucky Secretary of State

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