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  5. SIMON DENTISTRY LLC

SIMON DENTISTRY LLC

Company Details

Name: SIMON DENTISTRY LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 29 Nov 2006 (18 years ago)
Organization Date: 29 Nov 2006 (18 years ago)
Last Annual Report: 17 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0651822
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42104
City: Bowling Green
Primary County: Warren County
Principal Office: 625 THREE SPRINGS ROAD, BOWLING GREEN, KY 42104
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SIMON DENTISTRY 401(K) PLAN 2023 208087688 2024-01-23 SIMON DENTISTRY 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2022 208087688 2023-04-19 SIMON DENTISTRY 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2021 208087688 2022-06-07 SIMON DENTISTRY 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2020 208087688 2021-07-22 SIMON DENTISTRY 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2019 208087688 2020-06-30 SIMON DENTISTRY 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2018 208087688 2019-06-25 SIMON DENTISTRY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2017 208087688 2018-07-25 SIMON DENTISTRY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2016 208087688 2017-09-29 SIMON DENTISTRY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2015 208087688 2016-05-04 SIMON DENTISTRY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104
SIMON DENTISTRY 401(K) PLAN 2014 208087688 2015-04-14 SIMON DENTISTRY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2707825115
Plan sponsor’s address 625 THREE SPRINGS RD., BOWLING GREEN, KY, 42104

Signature of
Role Plan administrator
Date 2015-04-14
Name of individual signing DANIEL J. SIMON
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
DANIEL SIMON Registered Agent

Member

Name Role
Justin Puckett Member
Daniel J Simon Member

Organizer

Name Role
DANIEL SIMON Organizer

Filings

Name File Date
Annual Report 2025-02-17
Annual Report 2024-03-08
Annual Report 2023-03-21
Annual Report 2022-03-07
Annual Report 2021-02-25
Annual Report 2020-03-02
Annual Report 2019-03-28
Annual Report 2018-03-29
Annual Report 2017-03-06
Annual Report 2016-02-23

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1657537206 2020-04-15 0457 PPP 625 Three Springs Rd, Bowling Green, KY, 42104-7528
Loan Status Date 2021-01-04
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 182875
Loan Approval Amount (current) 182875
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27159
Servicing Lender Name First Southern National Bank
Servicing Lender Address 27, Public Sq, Lancaster, KY, 40444
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Bowling Green, WARREN, KY, 42104-7528
Project Congressional District KY-02
Number of Employees 16
NAICS code 621210
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 27159
Originating Lender Name First Southern National Bank
Originating Lender Address Lancaster, KY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 184087.49
Forgiveness Paid Date 2020-12-23
3213808307 2021-01-21 0457 PPS 625 Three Springs Rd, Bowling Green, KY, 42104-7528
Loan Status Date 2021-08-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 182875.6
Loan Approval Amount (current) 182875.6
Undisbursed Amount 0
Franchise Name -
Lender Location ID 124751
Servicing Lender Name American Bank & Trust Company, Inc.
Servicing Lender Address 1302 Scottsville, BOWLING GREEN, KY, 42102
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Bowling Green, WARREN, KY, 42104-7528
Project Congressional District KY-02
Number of Employees 16
NAICS code 621210
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 124751
Originating Lender Name American Bank & Trust Company, Inc.
Originating Lender Address BOWLING GREEN, KY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 183683.3
Forgiveness Paid Date 2021-07-14

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Sources: Kentucky Secretary of State

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