Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Fayette
    4. ›
  4. 40502
    5. ›
  5. ANDREW G. COUCH, DMD, PLLC

ANDREW G. COUCH, DMD, PLLC

Company Details

Name: ANDREW G. COUCH, DMD, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 09 Aug 2012 (12 years ago)
Organization Date: 09 Aug 2012 (12 years ago)
Last Annual Report: 23 Feb 2024 (a year ago)
Managed By: Members
Organization Number: 0835515
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40502
Primary County: Fayette
Principal Office: 1081 DOVE RUN RD, SUITE 101, SUITE 101, LEXINGTON, KY 40502
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANDREW G COUCH DMD 401(K) PLAN 2023 460751970 2024-06-06 ANDREW G COUCH DMD PLLC 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502
RETIREMENT INCOME SECURITY PLAN-ANDREW COUCH, DMD 2022 460751970 2023-07-24 ANDREW G COUCH DMD PLLC 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
ANDREW G COUCH DMD PLLC CBS BENEFIT PLAN 2022 460751970 2023-12-27 ANDREW G COUCH DMD PLLC 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-04-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
ANDREW G COUCH DMD PLLC CBS BENEFIT PLAN 2021 460751970 2022-12-29 ANDREW G COUCH DMD PLLC 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-04-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
ANDREW G COUCH DMD PLLC CBS BENEFIT PLAN 2021 460751970 2022-12-29 ANDREW G COUCH DMD PLLC 6
Three-digit plan number (PN) 501
Effective date of plan 2021-04-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-ANDREW COUCH, DMD 2021 460751970 2022-07-26 ANDREW G COUCH DMD PLLC 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
ANDREW G COUCH DMD PLLC CBS BENEFIT PLAN 2020 460751970 2021-12-14 ANDREW G COUCH DMD PLLC 6
Three-digit plan number (PN) 501
Effective date of plan 2021-04-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2021-12-14
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
ANDREW G COUCH DMD PLLC CBS BENEFIT PLAN 2020 460751970 2021-12-14 ANDREW G COUCH DMD PLLC 6
Three-digit plan number (PN) 501
Effective date of plan 2021-04-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN RD, STE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2021-12-14
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-ANDREW COUCH, DMD 2020 460751970 2021-07-22 ANDREW G COUCH DMD PLLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-ANDREW COUCH, DMD 2019 460751970 2020-07-24 ANDREW G COUCH DMD PLLC 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2020-07-24
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/07/22/20190722170319P030260698125001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2019-07-22
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/27/20180727125923P040041701215001.pdf
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 8592668890
Plan sponsor’s address 1081 DOVE RUN ROAD, SUITE 101, LEXINGTON, KY, 40502

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing SPENCER BARCLAY
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
ANDREW G. COUCH Registered Agent

Member

Name Role
Andrew Gordon Couch Member

Organizer

Name Role
ANDREW G. COUCH Organizer

Filings

Name File Date
Annual Report 2024-02-23
Annual Report 2023-03-22
Annual Report 2022-03-14
Annual Report 2021-02-10
Annual Report 2020-02-19
Annual Report 2019-05-31
Annual Report 2018-06-14
Annual Report 2017-05-30
Annual Report 2016-04-11
Annual Report 2015-05-05

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 14 Nov 2024

Sources: Kentucky Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 kyprofile.com, Part of Big Data Integrated