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  5. Northpark Dental, P.A.

Northpark Dental, P.A.

Company Details

Name: Northpark Dental, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 07 Oct 1975 (49 years ago)
Company Number: 047bd9c3-a5d4-e011-a886-001ec94ffe7f
File Number: 2R-185
Registered Office Address: 9120 Baltimore Str NE, Blaine, MN 55434, USA
Principal Executive Office Address: 9120 BALTIMORE ST NE, BLAINE, MN 55449–4337, USA
ZIP code: 55434
County: Anoka County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2023 411265506 2024-09-26 NORTHPARK DENTAL, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2024-09-26
Name of individual signing PAUL CHADBOURN, DDS
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2022 411265506 2023-09-26 NORTHPARK DENTAL, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2023-09-26
Name of individual signing PAUL CHADBOURN, DDS
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2021 411265506 2022-10-04 NORTHPARK DENTAL, P.A. 9
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2022-10-04
Name of individual signing PAUL CHADBOURN, DDS
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2021 411265506 2022-11-02 NORTHPARK DENTAL, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2022-11-02
Name of individual signing PAUL CHADBOURN, DDS
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2020 411265506 2021-09-02 NORTHPARK DENTAL, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2021-09-02
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-02
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2019 411265506 2020-06-23 NORTHPARK DENTAL, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2020-06-23
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-23
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2018 411265506 2019-10-10 NORTHPARK DENTAL, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-10
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2017 411265506 2018-10-05 NORTHPARK DENTAL, P.A. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-05
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2016 411265506 2017-10-05 NORTHPARK DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2017-10-05
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-05
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
NORTHPARK DENTAL, P.A. PROFIT SHARING PLAN 2015 411265506 2016-09-21 NORTHPARK DENTAL, P.A. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-02-01
Business code 621210
Sponsor’s telephone number 7637861560
Plan sponsor’s address 9120 BALTIMORE STREET N.E., BLAINE, MN, 55449

Signature of
Role Plan administrator
Date 2016-09-20
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-20
Name of individual signing PAUL W. CHADBOURN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Paul W Chadbourn Chief Executive Officer 9120 BALTIMORE ST NE, BLAINE, MN 55449–4337, USA

Filing

Filing Name Filing date
Business Corporation (Domestic) Business Name (Business Name: Northpark Dental, P.A.) 1987-11-19
Registered Office and/or Agent - Business Corporation (Domestic) 1987-11-19
Business Corporation (Domestic) Restated Articles 1987-11-19
Business Corporation (Domestic) Change of Shares 1987-11-19
Business Corporation (Domestic) Business Name (Business Name: A. D. JALLO, D.D.S. & P. W. CHADBOURN, D.D.S, P.A.) 1982-08-18
Business Corporation (Domestic) Business Name (Business Name: A. D. Jallo, D.D.S. & Associates, P.A.) 1980-03-18
Business Corporation (Domestic) Active Status Report 1979-11-15
Original Filing - Business Corporation (Domestic) 1975-10-07
Business Corporation (Domestic) Business Name (Business Name: A. D. Jallo, D.D.S. & D. E. Wolff, D.D.S., P.A.) 1975-10-07

Related by officers

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Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website

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