Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Latah County
    4. ›
  4. 83843
    5. ›
  5. J. CLAYTON HANSEN, D.D.S. PLLC

J. CLAYTON HANSEN, D.D.S. PLLC

Company Details

Name: J. CLAYTON HANSEN, D.D.S. PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 17 Feb 2005 (20 years ago)
Financial Date End: 28 Feb 2025
Entity Number: 122721
Place of Formation: IDAHO
File Number: 122721
ZIP code: 83843
County: Latah County
Principal Address: 1526 LEVICK ST MOSCOW, ID 83843
Mailing Address: 1526 S LEVICK ST MOSCOW, ID 83843-2560

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2023 202279421 2024-04-03 J. CLAYTON HANSEN, D.D.S., PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S. LEVICK ST., MOSCOW, ID, 838432560
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2022 202279421 2023-05-01 J. CLAYTON HANSEN, D.D.S., PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S. LEVICK ST., MOSCOW, ID, 838432560
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2021 202279421 2022-06-09 J. CLAYTON HANSEN, D.D.S., PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S. LEVICK ST., MOSCOW, ID, 838432560
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2020 202279421 2021-10-05 J. CLAYTON HANSEN, D.D.S., PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S. LEVICK ST., MOSCOW, ID, 838432560
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2019 202279421 2020-09-30 J. CLAYTON HANSEN, D.D.S., PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S. LEVICK ST., MOSCOW, ID, 838432560
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2018 202279421 2019-07-09 J. CLAYTON HANSEN, D.D.S., PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560

Plan administrator’s name and address
Administrator’s EIN 202279421
Plan administrator’s name J. CLAYTON HANSEN, D.D.S., PLLC
Plan administrator’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560
Administrator’s telephone number 2088824923

Signature of
Role Plan administrator
Date 2019-07-09
Name of individual signing J. CLAYTON HANSEN
Valid signature Filed with authorized/valid electronic signature
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2017 202279421 2018-09-20 J. CLAYTON HANSEN, D.D.S., PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560

Plan administrator’s name and address
Administrator’s EIN 202279421
Plan administrator’s name J. CLAYTON HANSEN, D.D.S., PLLC
Plan administrator’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560
Administrator’s telephone number 2088824923

Signature of
Role Plan administrator
Date 2018-09-20
Name of individual signing J. CLAYTON HANSEN
Valid signature Filed with authorized/valid electronic signature
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2016 202279421 2017-04-04 J. CLAYTON HANSEN, D.D.S., PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560

Plan administrator’s name and address
Administrator’s EIN 202279421
Plan administrator’s name J. CLAYTON HANSEN, D.D.S., PLLC
Plan administrator’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560
Administrator’s telephone number 2088824923

Signature of
Role Plan administrator
Date 2017-03-31
Name of individual signing JAY HANSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-31
Name of individual signing JAY HANSEN
Valid signature Filed with authorized/valid electronic signature
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2015 202279421 2016-04-25 J. CLAYTON HANSEN, D.D.S., PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560

Plan administrator’s name and address
Administrator’s EIN 202279421
Plan administrator’s name J. CLAYTON HANSEN, D.D.S., PLLC
Plan administrator’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560
Administrator’s telephone number 2088824923

Signature of
Role Plan administrator
Date 2016-04-25
Name of individual signing JAY HANSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-25
Name of individual signing JAY HANSEN
Valid signature Filed with authorized/valid electronic signature
J. CLAYTON HANSEN, D.D.S., PLLC RETIREMENT PLAN 2014 202279421 2015-06-24 J. CLAYTON HANSEN, D.D.S., PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-09-01
Business code 621210
Sponsor’s telephone number 2088824923
Plan sponsor’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560

Plan administrator’s name and address
Administrator’s EIN 202279421
Plan administrator’s name J. CLAYTON HANSEN, D.D.S., PLLC
Plan administrator’s address 1526 S LEVICK ST, MOSCOW, ID, 838432560
Administrator’s telephone number 2088824923

Signature of
Role Plan administrator
Date 2015-06-24
Name of individual signing LAURIE VEIEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-22
Name of individual signing JAY HANSEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WYNN MOSMAN ATTY Agent 803 S JEFFERSON STE 4, MOSCOW, ID 83843

Member

Name Role Address Appointed On
Jay C Hansen Member 751 VICTORIA DR, MOSCOW, ID 83843 2021-02-09

Filing

Filing Name Filing Number Filing date
Annual Report 0005559307 2024-01-11
Annual Report 0005105776 2023-02-09
Annual Report 0004579551 2022-01-24
Annual Report 0004169871 2021-02-09
Annual Report 0003787258 2020-02-24
Annual Report 0003436778 2019-02-26
Annual Report 0001388480 2018-02-21
Annual Report 0001388479 2017-02-23
Annual Report 0001388478 2016-03-29
Annual Report 0001388475 2014-12-17

Related by officers

No related officers

Related by address

1526 LEVICK ST MOSCOW, ID 83843

PALOUSE VIEW DENTAL CENTER Pioneer Peak Realty LLC

Date of last update: 30 Nov 2024

Sources: Idaho Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 idorgs.com, Part of Big Data Integrated