| Name: | MAYFIELD FAMILY DENTISTRY PLLC |
| Legal type: | Kentucky Limited Liability Company |
| Status: | Active |
| Standing: | Good |
| Profit or Non-Profit: | Profit |
| File Date: | 16 Jul 2014 (11 years ago) |
| Organization Date: | 16 Jul 2014 (11 years ago) |
| Last Annual Report: | 20 Mar 2024 (a year ago) |
| Managed By: | Members |
| Organization Number: | 0892297 |
| Industry: | Health Services |
| Number of Employees: | Small (0-19) |
| ZIP code: | 42066 |
| City: | Mayfield |
| Primary County: | Graves County |
| Principal Office: | 315 SOUTH 6TH STREET, MAYFIELD, KY 42066 |
| Place of Formation: | KENTUCKY |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MAYFIELD FAMILY DENTISTRY CBS BENEFIT PLAN | 2023 | 471358720 | 2024-04-29 | MAYFIELD FAMILY DENTISTRY | 2 | |||||||||||||||||||||||||||||||
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| 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 | 2024-04-29 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2022-11-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2702472552 |
| Plan sponsor’s address | 315 S 6TH ST, MAYFIELD, KY, 42066 |
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 |
| Name | Role |
|---|---|
| Zakari Miller Taylor | Member |
| Stephen Orr | Member |
| Name | Role |
|---|---|
| ZAKARI TAYLOR | Registered Agent |
| Name | Role |
|---|---|
| David Taylor | Organizer |
| Name | Action |
|---|---|
| Mayfield Family Dentistry LLC | Old Name |
| Name | Status | Expiration Date |
|---|---|---|
| ELEVATION DENTISTRY OF MAYFIELD | Inactive | 2024-01-29 |
| Name | File Date |
|---|---|
| Annual Report | 2024-03-20 |
| Annual Report | 2023-05-11 |
| Annual Report | 2022-04-01 |
| Annual Report | 2021-02-11 |
| Annual Report | 2020-03-20 |
| Annual Report Amendment | 2019-09-23 |
| Annual Report | 2019-06-17 |
| Certificate of Assumed Name | 2019-01-29 |
| Principal Office Address Change | 2019-01-18 |
| Annual Report | 2018-05-09 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7343617004 | 2020-04-07 | 0457 | PPP | 315 S 6th St, MAYFIELD, KY, 42066-2309 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sources: Kentucky Secretary of State
