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  5. VALLEY PEDIATRIC DENTISTRY

VALLEY PEDIATRIC DENTISTRY

Company Details

Name: VALLEY PEDIATRIC DENTISTRY
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 20 Feb 2018 (7 years ago)
Entity Number: 604672
Place of Formation: IDAHO
File Number: 0000604672
ZIP code: 83333
County: Blaine County
Mailing Address: 317 S RIVER ST HAILEY, ID 83333

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
VALLEY PEDIATRIC DENTISTRY 401(K) PLAN 2023 461713392 2024-05-06 VALLEY PEDIATRIC DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-10-01
Business code 621210
Sponsor’s telephone number 2082401717
Plan sponsor’s address 317 S RIVER STREET, HAILEY, ID, 83333

Plan administrator’s name and address
Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of
Role Plan administrator
Date 2024-05-06
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
VALLEY PEDIATRIC DENTISTRY 401(K) PLAN 2022 461713392 2023-07-28 VALLEY PEDIATRIC DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-10-01
Business code 621210
Sponsor’s telephone number 2082401717
Plan sponsor’s address 317 S RIVER STREET, HAILEY, ID, 83333

Plan administrator’s name and address
Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of
Role Plan administrator
Date 2023-07-17
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
VALLEY PEDIATRIC DENTISTRY 401(K) PLAN 2021 461713392 2022-07-31 VALLEY PEDIATRIC DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-10-01
Business code 621210
Sponsor’s telephone number 2082401717
Plan sponsor’s address 317 S RIVER STREET, HAILEY, ID, 83333

Plan administrator’s name and address
Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
VALLEY PEDIATRIC DENTISTRY 401(K) PLAN 2020 461713392 2021-07-30 VALLEY PEDIATRIC DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-10-01
Business code 621210
Sponsor’s telephone number 2082401717
Plan sponsor’s address 317 S RIVER STREET, HAILEY, ID, 83333

Plan administrator’s name and address
Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HIGHWAY, SUITE A, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
VALLEY PEDIATRIC DENTISTRY 401(K) PLAN 2019 461713392 2020-07-31 VALLEY PEDIATRIC DENTISTRY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-10-01
Business code 621210
Sponsor’s telephone number 2082401717
Plan sponsor’s address 317 S RIVER ST, HAILEY, ID, 833338426

Plan administrator’s name and address
Administrator’s EIN 842925395
Plan administrator’s name 401GO
Plan administrator’s address 8427 S OLD BINGHAM HWY, WEST JORDAN, UT, 840885277
Administrator’s telephone number 8012142125

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Initial Filing 0000604672 2018-02-20

Related by officers

No related officers

Related by address

317 S RIVER ST HAILEY, ID 83333

SMILES 4 KIDS HAILEY PLLC TR HAILEY HOLDINGS LLC

Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State

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