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  5. FOUNTAIN PEDIATRIC DENTISTRY, PLLC

FOUNTAIN PEDIATRIC DENTISTRY, PLLC

Company Details

Name: FOUNTAIN PEDIATRIC DENTISTRY, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 04 Mar 2014 (11 years ago)
Entity Number: 4538315
ZIP code: 10075
County: New York
Place of Formation: New York
Address: 150 E 77TH STREET, SUITE 1E, NEW YORK, NY, United States, 10075

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2023 464798465 2024-07-29 FOUNTAIN PEDIATRIC DENTISTRY PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2024-07-29
Name of individual signing JENNIFER FOUNTAIN
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2022 464798465 2023-10-02 FOUNTAIN PEDIATRIC DENTISTRY PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2023-09-27
Name of individual signing JENNIFER FOUNTAIN
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2021 464798465 2022-09-28 FOUNTAIN PEDIATRIC DENTISTRY PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2022-09-22
Name of individual signing JENNIFER FOUNTAIN
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2020 464798465 2021-09-30 FOUNTAIN PEDIATRIC DENTISTRY PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2021-09-30
Name of individual signing JENNIFER FOUNTAIN
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2019 464798465 2020-10-03 FOUNTAIN PEDIATRIC DENTISTRY PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2020-10-01
Name of individual signing JENNIFER FOUNTAIN
FOUNTAIN PEDIATRIC DENTISTRY PLLC RETIREMENT PLAN 2018 464798465 2019-10-09 FOUNTAIN PEDIATRIC DENTISTRY PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 2123551003
Plan sponsor’s address 150 E 77TH ST SUITE 1E, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing JENNIFER FOUNTAIN

DOS Process Agent

Name Role Address
FOUNTAIN PEDIATRIC DENTISTRY, PLLC DOS Process Agent 150 E 77TH STREET, SUITE 1E, NEW YORK, NY, United States, 10075

History

Start date End date Type Value
2023-02-27 2024-03-01 Address 150 E 77TH STREET, SUITE 1E, NEW YORK, NY, 10075, USA (Type of address: Service of Process)
2017-11-06 2023-02-27 Address 150 E 77TH STREET, SUITE 1E, NEW YORK, NY, 10075, USA (Type of address: Service of Process)
2014-04-24 2017-11-06 Address 150 E 58TH STREET, 8TH FLOOR ANNEX, NEW YORK, NY, 10155, USA (Type of address: Service of Process)
2014-03-04 2014-04-24 Address 150 EAST 58TH STREET, 8TH FL., NEW YORK, NY, 10019, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240301066228 2024-03-01 BIENNIAL STATEMENT 2024-03-01
230227002535 2023-02-27 BIENNIAL STATEMENT 2022-03-01
200309060106 2020-03-09 BIENNIAL STATEMENT 2020-03-01
171106006837 2017-11-06 BIENNIAL STATEMENT 2016-03-01
140820000632 2014-08-20 CERTIFICATE OF PUBLICATION 2014-08-20
140424000324 2014-04-24 CERTIFICATE OF CHANGE 2014-04-24
140304000684 2014-03-04 ARTICLES OF ORGANIZATION 2014-03-04

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1478678704 2021-03-27 0202 PPS 150 E 77th St Apt 1E, New York, NY, 10075-1922
Loan Status Date 2021-08-21
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 53130
Loan Approval Amount (current) 53130
Undisbursed Amount 0
Franchise Name -
Lender Location ID 499141
Servicing Lender Name Readycap Lending, LLC
Servicing Lender Address 200 Connell Drive Suite 4000, BERKELEY HEIGHTS, NJ, 07922
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10075-1922
Project Congressional District NY-12
Number of Employees 5
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Sole Proprietorship
Originating Lender ID 499141
Originating Lender Name Readycap Lending, LLC
Originating Lender Address BERKELEY HEIGHTS, NJ
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 53290.12
Forgiveness Paid Date 2021-07-20
7953317103 2020-04-14 0202 PPP 150 E. 77th Street Suite 1E, New York, NY, 10075
Loan Status Date 2021-03-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 43700
Loan Approval Amount (current) 43700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 121536
Servicing Lender Name Customers Bank
Servicing Lender Address 40 General Warren Blvd, Malvern, PA, 19355
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10075-0001
Project Congressional District NY-12
Number of Employees 4
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Sole Proprietorship
Originating Lender ID 499141
Originating Lender Name Readycap Lending, LLC
Originating Lender Address BERKELEY HEIGHTS, NJ
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 44043.61
Forgiveness Paid Date 2021-02-19

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State

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