| Name: | PHILMONT FAMILY DENTISTRY, PLLC |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY |
| Status: | Active |
| Date of registration: | 25 Jan 2005 (20 years ago) |
| Entity Number: | 3155167 |
| ZIP code: | 12305 |
| County: | Columbia |
| Place of Formation: | New York |
| Address: | 650 Franklin Street, Suite 502, Schenectady, NY, United States, 12305 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHILMONT FAMILY DENTISTRY, PLLC 401(K) PROFIT SHARING PLAN & TRUST | 2010 | 202257840 | 2010-11-23 | PHILMONT FAMILY DENTISTRY, PLLC | 6 | |||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 202257840 |
| Plan administrator’s name | PHILMONT FAMILY DENTISTRY, PLLC |
| Plan administrator’s address | 1078 ROUTE 217, P.O. BOX 817, PHILMONT, NY, 12565 |
| Administrator’s telephone number | 5186724077 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-23 |
| Name of individual signing | GERALD NOEL |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2005-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5186724077 |
| Plan sponsor’s address | 1078 ROUTE 217, P.O. BOX 817, PHILMONT, NY, 12565 |
Plan administrator’s name and address
| Administrator’s EIN | 202257840 |
| Plan administrator’s name | PHILMONT FAMILY DENTISTRY, PLLC |
| Plan administrator’s address | 1078 ROUTE 217, P.O. BOX 817, PHILMONT, NY, 12565 |
| Administrator’s telephone number | 5186724077 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-11 |
| Name of individual signing | TAREQ KHALIFEH |
| Role | Employer/plan sponsor |
| Date | 2010-08-11 |
| Name of individual signing | TAREQ KHALIFEH |
| Name | Role | Address |
|---|---|---|
| NICHOLAS J. GRASSO | Agent | GRASSO RODRIGUEZ & GRASSO, 751 STATE STREET, SCHENECTADY, NY, 12307 |
| Name | Role | Address |
|---|---|---|
| VILLANO LAW FIRM, PLLC | DOS Process Agent | 650 Franklin Street, Suite 502, Schenectady, NY, United States, 12305 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2024-09-05 | 2025-01-21 | Address | GRASSO RODRIGUEZ & GRASSO, 751 STATE STREET, SCHENECTADY, NY, 12307, USA (Type of address: Registered Agent) |
| 2024-09-05 | 2025-01-21 | Address | 650 Franklin Street, Suite 502, Schenectady, NY, 12305, USA (Type of address: Service of Process) |
| 2005-01-25 | 2024-09-05 | Address | GRASSO RODRIGUEZ & GRASSO, 751 STATE STREET, SCHENECTADY, NY, 12307, USA (Type of address: Registered Agent) |
| 2005-01-25 | 2024-09-05 | Address | P.O. BOX 817, 1078 ROUTE 217, PHILMONT, NY, 12565, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 250121000474 | 2025-01-21 | BIENNIAL STATEMENT | 2025-01-21 |
| 240905003135 | 2024-09-05 | BIENNIAL STATEMENT | 2024-09-05 |
| 210114060141 | 2021-01-14 | BIENNIAL STATEMENT | 2021-01-01 |
| 190114061095 | 2019-01-14 | BIENNIAL STATEMENT | 2019-01-01 |
| 170105007304 | 2017-01-05 | BIENNIAL STATEMENT | 2017-01-01 |
| 150113007349 | 2015-01-13 | BIENNIAL STATEMENT | 2015-01-01 |
| 110125003116 | 2011-01-25 | BIENNIAL STATEMENT | 2011-01-01 |
| 081231002246 | 2008-12-31 | BIENNIAL STATEMENT | 2009-01-01 |
| 061227002642 | 2006-12-27 | BIENNIAL STATEMENT | 2007-01-01 |
| 050418000882 | 2005-04-18 | AFFIDAVIT OF PUBLICATION | 2005-04-18 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 343331575 | 0213100 | 2018-07-25 | 1078 ROUTE 217, PHILMONT, NY, 12565 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Citation ID | 01001A |
| Citaton Type | Other |
| Standard Cited | 19101200 E01 |
| Issuance Date | 2019-01-23 |
| Abatement Due Date | 2019-02-27 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2019-02-20 |
| Nr Instances | 2 |
| Nr Exposed | 7 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1200(e)(1): The employer did not develop, implement, and/or maintain at the workplace a written hazard communication program which describes how the criteria specified in 29 CFR 1910.1200(f), (g), and (h) will be met: a). On or about 7/25/18, on site, for employees handling Opti-cide Disinfectant and Cleaner solution on a daily basis to wipe down equipment. Opti-cide contains the following chemicals to include, but not limited to, Isopropanol and Ethylene Glycol. The employer did not maintain a hazard communication program to include a written program and site specific training. b). On or about 7/25/18, on site, for employees handling Enzyme Ultrasonic tablets on a daily basis to disinfect dental instruments. Enzyme Ultrasonic tablets contains chemicals to include, but not limited to, Sodium Carbonate. The employer did not maintain a hazard communication program to include a written program and site specific training. |
| Citation ID | 01001B |
| Citaton Type | Other |
| Standard Cited | 19101200 H01 |
| Issuance Date | 2019-01-23 |
| Abatement Due Date | 2019-02-27 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2019-02-20 |
| Nr Instances | 2 |
| Nr Exposed | 7 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1200(h)(1): Employees were not provided effective information and training on hazardous chemicals in their work area at the time of their initial assignment and whenever a new hazard that the employees had not been previously trained about was introduced into their work area: a). On or about 7/25/18, on site, for employees handling Opti-cide Disinfectant and Cleaner solution on a daily basis to wipe down equipment. Opti-cide contains the following chemicals to include, but not limited to, Isopropanol and Ethylene Glycol. The employer did not provide site specific training. b). On or about 7/25/18, on site, for employees handling Enzyme Ultrasonic tablets on a daily basis to disinfect dental instruments. Enzyme Ultrasonic tablets contains chemicals to include, but not limited to, Sodium Carbonate. The employer did not provide site specific training. |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6080727005 | 2020-04-06 | 0248 | PPP | 1078 Route 217, PHILMONT, NY, 12565 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 9370768309 | 2021-01-30 | 0248 | PPS | 1078 Route 217, Philmont, NY, 12565 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 29 Mar 2025
Sources: New York Secretary of State
