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  5. TWELVE CORNERS DENTISTRY PLLC

TWELVE CORNERS DENTISTRY PLLC

Company Details

Name: TWELVE CORNERS DENTISTRY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 13 Sep 2016 (9 years ago)
Entity Number: 5007626
ZIP code: 14618
County: Monroe
Place of Formation: New York
Address: 4 CHELMSFORD ROAD, ROCHESTER, NY, United States, 14618

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TWELVE CORNERS DENTISTRY PLLC 401(K) PROFIT SHARING PLAN AND TRUST 2023 813856177 2024-10-08 TWELVE CORNERS DENTISTRY PLLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 5852441177
Plan sponsor’s address 4 CHELMSFORD ROAD, ROCHESTER, NY, 14618

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
TWELVE CORNERS DENTISTRY PLLC 401(K) PROFIT SHARING PLAN AND TRUST 2022 813856177 2024-10-08 TWELVE CORNERS DENTISTRY PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 5852441177
Plan sponsor’s address 4 CHELMSFORD ROAD, ROCHESTER, NY, 14618

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
TWELVE CORNERS DENTISTRY PLLC 401(K) PROFIT SHARING PLAN & TRUST 2020 813856177 2021-10-15 TWELVE CORNERS DENTISTRY PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 5852441177
Plan sponsor’s address 4 CHELMSFORD RD, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing ABRAHIM CAROCI
TWELVE CORNERS DENTISTRY PLLC 401(K) PROFIT SHARING PLAN & TRUST 2019 813856177 2020-06-30 TWELVE CORNERS DENTISTRY PLLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 5852441177
Plan sponsor’s address 4 CHELMSFORD RD, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing ABRAHIM CAROCI
TWELVE CORNERS DENTISTRY PLLC 401 K PROFIT SHARING PLAN TRUST 2018 813856177 2019-06-25 TWELVE CORNERS DENTISTRY PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621210
Sponsor’s telephone number 5852441177
Plan sponsor’s address 4 CHELMSFORD RD, ROCHESTER, NY, 14618

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing ABRAHIM CAROCI

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 4 CHELMSFORD ROAD, ROCHESTER, NY, United States, 14618

History

Start date End date Type Value
2016-09-13 2024-10-10 Address 4 CHELMSFORD ROAD, ROCHESTER, NY, 14618, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
241010001476 2024-10-10 BIENNIAL STATEMENT 2024-10-10
161202000021 2016-12-02 CERTIFICATE OF PUBLICATION 2016-12-02
160913000660 2016-09-13 ARTICLES OF ORGANIZATION 2016-09-13

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5077787801 2020-05-29 0219 PPP 4 Chelmsford Road, ROCHESTER, NY, 14618-1726
Loan Status Date 2021-11-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 92100
Loan Approval Amount (current) 92100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 112131
Servicing Lender Name Genesee Regional Bank
Servicing Lender Address 1850 S Winton Rd, ROCHESTER, NY, 14618-3923
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Unanswered
Project Address ROCHESTER, MONROE, NY, 14618-1726
Project Congressional District NY-25
Number of Employees 12
NAICS code 621210
Borrower Race White
Borrower Ethnicity Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 112131
Originating Lender Name Genesee Regional Bank
Originating Lender Address ROCHESTER, NY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 92849.59
Forgiveness Paid Date 2021-03-25
3490888405 2021-02-05 0219 PPS 4 Chelmsford Rd, Rochester, NY, 14618-1755
Loan Status Date 2022-01-20
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 102100
Loan Approval Amount (current) 102100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 112131
Servicing Lender Name Genesee Regional Bank
Servicing Lender Address 1850 S Winton Rd, ROCHESTER, NY, 14618-3923
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Rochester, MONROE, NY, 14618-1755
Project Congressional District NY-25
Number of Employees 14
NAICS code 621210
Borrower Race White
Borrower Ethnicity Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 112131
Originating Lender Name Genesee Regional Bank
Originating Lender Address ROCHESTER, NY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 102987.7
Forgiveness Paid Date 2021-12-23

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Related by address

4 CHELMSFORD ROAD, ROCHESTER, NY, United States, 14618

AC & CC PROPERTIES LLC CALJERMEIN, INC. JEFFREY D. BEIDEMAN DMD, P.C. TC GREECE PEDIATRIC DENTISTRY PLLC BRIGHTON CHILD, FAMILY & INDIVIDUAL PSYCHOLOGICAL SERVICES, LLP

Date of last update: 24 Mar 2025

Sources: New York Secretary of State

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