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  5. HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C.

HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C.

Company Details

Name: HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 18 Mar 1993 (32 years ago)
Entity Number: 1711509
ZIP code: 11946
County: Suffolk
Place of Formation: New York
Principal Address: 97 N MAIN STREET, SOUTHAMPTON, NY, United States, 11968
Address: 42 PONQUOGUE AVE, HAMPTON BAYS, NY, United States, 11946

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2023 113153636 2024-10-02 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing NANCY COSENZA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-02
Name of individual signing NANCY COSENZA
Valid signature Filed with authorized/valid electronic signature
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2022 113153636 2023-09-27 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2023-09-27
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2023-09-27
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2021 113153636 2022-09-19 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2022-09-19
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2022-09-19
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2020 113153636 2021-10-04 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2021-10-04
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2019 113153636 2020-10-10 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2020-10-10
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2020-10-10
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2018 113153636 2019-10-11 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2019-10-11
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2016 113153636 2017-10-10 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 9 BURGUNDY LANE, NESCONSET, NY, 11767

Signature of
Role Plan administrator
Date 2017-10-07
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2017-10-07
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2015 113153636 2016-10-11 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 9 BURGUNDY LANE, NESCONSET, NY, 11767

Signature of
Role Plan administrator
Date 2016-10-11
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2016-10-11
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) PLAN 2014 113153636 2015-10-13 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 9 BURGUNDY LANE, NESCONSET, NY, 11767

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2015-10-13
Name of individual signing NANCY COSENZA
HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 401(K) / PROFIT SHARING PLAN 2012 113153636 2013-10-07 HAMPTON PEDIATRIC DENTAL ASSOCIATES, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621210
Sponsor’s telephone number 6312878687
Plan sponsor’s address 9 BURGUNDY LANE, NESCONSET, NY, 11767

Signature of
Role Plan administrator
Date 2013-10-03
Name of individual signing NANCY COSENZA
Role Employer/plan sponsor
Date 2013-10-03
Name of individual signing NANCY COSENZA

Chief Executive Officer

Name Role Address
NANCY COSENZA, DDS Chief Executive Officer 97 NORTH MAIN STREET, SOUTHAMPTON, NY, United States, 11968

DOS Process Agent

Name Role Address
JAMES VLAHADAMOS DOS Process Agent 42 PONQUOGUE AVE, HAMPTON BAYS, NY, United States, 11946

History

Start date End date Type Value
2011-03-24 2013-03-08 Address 149 HAMPTON ROAD, SOUTHAMPTON, NY, 11968, USA (Type of address: Service of Process)
2007-03-26 2011-03-24 Address 97 N MAIN STREET, SOUTHAMPTON, NY, 11968, 3309, USA (Type of address: Principal Executive Office)
2007-03-26 2011-03-24 Address 97 N MAIN STREET, SOUTHAMPTON, NY, 11968, USA (Type of address: Chief Executive Officer)
2007-03-26 2011-03-24 Address 149 HAMPTON ROAD, SOUTHAMPTON, NY, 11968, USA (Type of address: Service of Process)
1999-03-31 2007-03-26 Address 149 HAMPTON RD, SOUTHAMPTON, NY, 11968, USA (Type of address: Service of Process)
1997-05-08 2007-03-26 Address 97 NORTH MAIN ST, SOUTHAMPTON, NY, 11968, 3309, USA (Type of address: Principal Executive Office)
1997-05-08 2007-03-26 Address 97 NORTH MAIN ST, SOUTHAMPTON, NY, 11968, USA (Type of address: Chief Executive Officer)
1994-03-30 1997-05-08 Address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968, USA (Type of address: Principal Executive Office)
1994-03-30 1997-05-08 Address 97 NORTH MAIN STREET, SOUTHAMPTON, NY, 11968, USA (Type of address: Chief Executive Officer)
1993-03-18 1999-03-31 Address 100 CLARK AVENUE, MASSAPEQUA, NY, 11758, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
190305060001 2019-03-05 BIENNIAL STATEMENT 2019-03-01
170301006251 2017-03-01 BIENNIAL STATEMENT 2017-03-01
150317006006 2015-03-17 BIENNIAL STATEMENT 2015-03-01
130308006421 2013-03-08 BIENNIAL STATEMENT 2013-03-01
110324002262 2011-03-24 BIENNIAL STATEMENT 2011-03-01
090223002837 2009-02-23 BIENNIAL STATEMENT 2009-03-01
070326003265 2007-03-26 BIENNIAL STATEMENT 2007-03-01
050426002813 2005-04-26 BIENNIAL STATEMENT 2005-03-01
030324002440 2003-03-24 BIENNIAL STATEMENT 2003-03-01
010403002836 2001-04-03 BIENNIAL STATEMENT 2001-03-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9475137101 2020-04-15 0235 PPP 97 North Street, SOUTHAMPTON, NY, 11969-0001
Loan Status Date 2021-11-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 168000
Loan Approval Amount (current) 168000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46104
Servicing Lender Name Dime Community Bank
Servicing Lender Address 2200 Montauk Hwy, BRIDGEHAMPTON, NY, 11932
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address SOUTHAMPTON, SUFFOLK, NY, 11969-0001
Project Congressional District NY-01
Number of Employees 12
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 46104
Originating Lender Name Dime Community Bank
Originating Lender Address BRIDGEHAMPTON, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 170039.33
Forgiveness Paid Date 2021-07-06

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Date of last update: 15 Mar 2025

Sources: New York Secretary of State

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