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Northfield Family Dental, P.A.

Company Details

Name: Northfield Family Dental, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 06 Dec 2000 (24 years ago)
Company Number: 6aae65f8-aad4-e011-a886-001ec94ffe7f
File Number: 11K-840
Registered Office Address: 1501 Clinton Lane, Northfield, MN 55057, USA
Principal Executive Office Address: 1501 CLINTON LN, NORTHFIELD, MN 55057–3295, USA
ZIP code: 55057
County: Rice County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST 2023 411572376 2024-07-30 NORTHFIELD FAMILY DENTAL, P.A. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 5076455264
Plan sponsor’s address 1501 CLINTON LANE, NORTHFIELD, MN, 55057

Signature of

Role Plan administrator
Date 2024-07-30
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-30
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST 2022 411572376 2023-09-20 NORTHFIELD FAMILY DENTAL, P.A. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 5076455264
Plan sponsor’s address 1501 CLINTON LANE, NORTHFIELD, MN, 55057

Signature of

Role Plan administrator
Date 2023-09-20
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-20
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST 2021 411572376 2022-06-14 NORTHFIELD FAMILY DENTAL, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 5076455264
Plan sponsor’s DBA name PROFESSIONAL DENTAL GROUP
Plan sponsor’s address 1501 CLINTON LANE, NORTHFIELD, MN, 55057

Signature of

Role Plan administrator
Date 2022-06-14
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-14
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST 2020 411572376 2021-05-11 NORTHFIELD FAMILY DENTAL, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 5076455264
Plan sponsor’s address 1501 CLINTON LANE, NORTHFIELD, MN, 55057

Signature of

Role Plan administrator
Date 2021-05-11
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-11
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature
PROFESSIONAL DENTAL GROUP 401(K) PLAN & TRUST 2019 411572376 2020-06-24 NORTHFIELD FAMILY DENTAL, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 5076455264
Plan sponsor’s DBA name PROFESSIONAL DENTAL GROU
Plan sponsor’s address 1501 CLINTON LANE, NORTHFIELD, MN, 55057

Signature of

Role Plan administrator
Date 2020-06-24
Name of individual signing JULI STANDFUSS
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Becky Johnson Chief Executive Officer 6233 115TH ST E, NORTHFIELD, MN 55057–4426, USA

Filing

Filing Name Filing date
Amendment - Business Corporation (Domestic) (Business Name: Northfield Family Dental, P.A.) 2019-08-06
Original Filing - Business Corporation (Domestic) (Business Name: Professional Drive Dental Group, P.A.)Professional Service - Dentistry & Dental Hygiene 2000-12-06

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website