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  5. Scott L. Bjerke, D.D.S., P.A.

Scott L. Bjerke, D.D.S., P.A.

Company Details

Name: Scott L. Bjerke, D.D.S., P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 29 Dec 1983 (41 years ago)
Company Number: 80a1d3f1-9ed4-e011-a886-001ec94ffe7f
File Number: 4N-601
Registered Office Address: 2130 Cliff Rd #107, Eagan, MN 55122, USA
ZIP code: 55122
County: Dakota County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2019 411468165 2020-04-27 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2020-04-27
Name of individual signing SCOTT L. BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2018 411468165 2019-09-25 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing SCOTT L BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing SCOTT L BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2017 411468165 2018-07-27 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-27
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2016 411468165 2017-08-09 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2017-08-09
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-09
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2015 411468165 2016-09-18 SCOTT L. BJERKE, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2016-09-18
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-18
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2014 411468165 2015-07-27 SCOTT L. BJERKE, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2013 411468165 2014-05-30 SCOTT L. BJERKE, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2014-05-30
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-30
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2012 411468165 2013-09-18 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Signature of
Role Plan administrator
Date 2013-09-18
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-18
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2011 411468165 2012-10-08 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Plan administrator’s name and address
Administrator’s EIN 411468165
Plan administrator’s name SCOTT L. BJERKE, D.D.S., P.A.
Plan administrator’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122
Administrator’s telephone number 6514523112

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-08
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
SCOTT L. BJERKE, D.D.S., P.A. PROFIT SHARING PLAN 2010 411468165 2011-10-11 SCOTT L. BJERKE, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-02-01
Business code 621210
Sponsor’s telephone number 6514523112
Plan sponsor’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122

Plan administrator’s name and address
Administrator’s EIN 411468165
Plan administrator’s name SCOTT L. BJERKE, D.D.S., P.A.
Plan administrator’s address 2130 CLIFF ROAD, SUITE 107, EAGAN, MN, 55122
Administrator’s telephone number 6514523112

Signature of
Role Plan administrator
Date 2011-10-11
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-11
Name of individual signing SCOTT BJERKE
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Scott L Bjerke Chief Executive Officer 2130 Cliff Rd #107, Eagan, MN 55122, USA

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2006-07-20
Registered Office and/or Agent - Business Corporation (Domestic) 2006-07-20
Administrative Dissolution - Business Corporation (Domestic) 2006-01-17
Business Corporation (Domestic) Business Name (Business Name: Scott L. Bjerke, D.D.S., P.A.) 1993-09-13
Original Filing - Business Corporation (Domestic) 1983-12-29
Business Corporation (Domestic) Business Name (Business Name: Douglas M. Bauer, D.D.S. & Scott L. Bjerke, D.D.S., P.A.) 1983-12-29

Related by officers

No related officers

Related by address

2130 Cliff Rd #107, Eagan, MN 55122, USA

Bjerke Dental

Date of last update: 07 Oct 2024

Sources: Minnesota's Official State Website

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