| Name: | LAKESHORE PEDIATRIC DENTISTRY, PLLC |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY |
| Status: | Active |
| Date of registration: | 28 Jun 2019 (6 years ago) |
| Entity Number: | 5579235 |
| ZIP code: | 12972 |
| County: | Clinton |
| Place of Formation: | New York |
| Address: | 2993 MAIN STREET, SUITE 2, PERU, NY, United States, 12972 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKESHORE PEDIATRIC DENTISTRY 401(K) PLAN | 2023 | 833581030 | 2024-05-06 | LAKESHORE PEDIATRIC DENTISTRY | 11 | |||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-06 |
| Name of individual signing | QIAN LIU |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5182825519 |
| Plan sponsor’s address | 2993 MAIN STREET, SUITE 2, PERU, NY, 12972 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | CHRISTINE RIMER |
| Name | Role | Address |
|---|---|---|
| LAKESHORE PEDIATRIC DENTISTRY, PLLC | DOS Process Agent | 2993 MAIN STREET, SUITE 2, PERU, NY, United States, 12972 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2021-06-16 | 2023-06-28 | Address | 2993 MAIN STREET, SUITE 2, PERU, NY, 12972, USA (Type of address: Service of Process) |
| 2019-06-28 | 2021-06-16 | Address | 104 JABEZ ALLEN ROAD, PERU, NY, 12972, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 230628004210 | 2023-06-28 | BIENNIAL STATEMENT | 2023-06-01 |
| 210616060314 | 2021-06-16 | BIENNIAL STATEMENT | 2021-06-01 |
| 190905000232 | 2019-09-05 | CERTIFICATE OF PUBLICATION | 2019-09-05 |
| 190628000133 | 2019-06-28 | ARTICLES OF ORGANIZATION | 2019-06-28 |
Date of last update: 23 Mar 2025
Sources: New York Secretary of State
