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  5. THOMAS L BLAISDELL DDS PC

THOMAS L BLAISDELL DDS PC

Company Details

Name: THOMAS L BLAISDELL DDS PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 18 Jul 2007 (18 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 527499
Place of Formation: IDAHO
File Number: 527499
ZIP code: 83605
County: Canyon County
Mailing Address: 3611 S 10TH AVE CALDWELL, ID 83605-6209

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2023 260845729 2024-09-16 THOMAS L. BLAISDELL DDS PC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2024-09-16
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2022 260845729 2023-08-07 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2023-08-07
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2021 260845729 2022-10-03 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2022-10-03
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2020 260845729 2021-10-11 THOMAS L. BLAISDELL DDS PC 8
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2020 260845729 2023-01-16 THOMAS L. BLAISDELL DDS PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2023-01-16
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2019 260845729 2020-09-23 THOMAS L. BLAISDELL DDS PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2020-09-23
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2018 260845729 2019-10-08 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2019-10-08
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2017 260845729 2018-09-13 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 3611 S 10TH AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2018-09-13
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2016 260845729 2017-08-31 THOMAS L. BLAISDELL DDS PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 1916 ELLIS AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2017-08-31
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature
THOMAS L. BLAISDELL DDS PC 401(K) PLAN 2015 260845729 2016-09-21 THOMAS L. BLAISDELL DDS PC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 2084592376
Plan sponsor’s address 1916 ELLIS AVE., CALDWELL, ID, 83605

Signature of
Role Plan administrator
Date 2016-09-21
Name of individual signing THOMAS L. BLAISDELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
THOMAS L BLAISDELL Agent 3611 S 10TH AVE, TOM BLAISDELL, CALDWELL, ID 83605

President

Name Role Address Appointed On
THOMAS BLAISDELL President 3611 S 10TH AVE, CALDWELL, ID 83605 2020-08-05

Secretary

Name Role Address Appointed On
Sheri Blaisdell Secretary 3611 S 10TH AVE, CALDWELL, ID 83605 2023-06-13

Filing

Filing Name Filing Number Filing date
Annual Report 0005759469 2024-06-04
Annual Report 0005279174 2023-06-13
Annual Report 0004774662 2022-06-07
Annual Report 0004322242 2021-06-22
Annual Report 0003959741 2020-08-05
Annual Report 0003550788 2019-06-25
Annual Report 0003132626 2018-05-29
Annual Report 0003132624 2017-07-05
Annual Report 0003132623 2016-06-21
Annual Report 0003132622 2015-05-20

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4354577203 2020-04-27 1087 PPP 3611 S 10th Ave, CALDWELL, ID, 83605
Loan Status Date 2021-08-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 80400
Loan Approval Amount (current) 80400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 72601
Servicing Lender Name Zions Bank, A Division of
Servicing Lender Address 1 S Main St, SALT LAKE CITY, UT, 84133-1109
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address CALDWELL, CANYON, ID, 83605-0400
Project Congressional District ID-01
Number of Employees 10
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 72601
Originating Lender Name Zions Bank, A Division of
Originating Lender Address SALT LAKE CITY, UT
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 81422.07
Forgiveness Paid Date 2021-08-09

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Related by address

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Date of last update: 10 Apr 2025

Sources: Idaho Secretary of State

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