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  5. Prairie Dental Group, P.A.

Prairie Dental Group, P.A.

Company Details

Name: Prairie Dental Group, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 05 Jan 1982 (43 years ago)
Company Number: 91890beb-afd4-e011-a886-001ec94ffe7f
File Number: 4A-823
Principal Executive Office Address: 6608 Flying Cloud Drv #200, Eden Prairie, MN 55344, USA
Registered Office Address: 6628 Flying Cloud Drive Suite 200, Eden, MN 55344, USA
ZIP code: 55344
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRAIRIE DENTAL GROUP 401(K) PLAN 2023 411417797 2024-03-19 PRAIRIE DENTAL GROUP, P.A. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2024-03-19
Name of individual signing PAIGE JECHORT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-03-19
Name of individual signing PAIGE JECHORT
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2022 411417797 2023-06-06 PRAIRIE DENTAL GROUP, P.A. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2023-06-05
Name of individual signing PAIGE JECHORT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-05
Name of individual signing PAIGE JECHORT
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2021 411417797 2023-02-02 PRAIRIE DENTAL GROUP, P.A. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2023-02-01
Name of individual signing BEN FENGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-02-01
Name of individual signing BEN FENGER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2020 411417797 2022-04-04 PRAIRIE DENTAL GROUP, P.A. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2022-04-04
Name of individual signing BEN FEGNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-04
Name of individual signing BEN FEGNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2019 411417797 2021-05-24 PRAIRIE DENTAL GROUP, P.A. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2021-05-24
Name of individual signing JUDD HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-24
Name of individual signing JUDD HEITNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2018 411417797 2020-08-11 PRAIRIE DENTAL GROUP, P.A. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2020-08-11
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-11
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2017 411417797 2019-05-17 PRAIRIE DENTAL GROUP, P.A. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2019-05-15
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-15
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2016 411417797 2018-04-19 PRAIRIE DENTAL GROUP, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2018-04-19
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-19
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2015 411417797 2017-05-03 PRAIRIE DENTAL GROUP, P.A. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2017-05-03
Name of individual signing JUDSON W HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-03
Name of individual signing JUDSON W HEITNER
Valid signature Filed with authorized/valid electronic signature
PRAIRIE DENTAL GROUP 401(K) PLAN 2014 411417797 2016-05-16 PRAIRIE DENTAL GROUP, P.A. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-05-01
Business code 621210
Sponsor’s telephone number 9529035000
Plan sponsor’s address 6608 FLYING CLOUD DRIVE, SUITE 200, EDEN PRAIRIE, MN, 55344

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-16
Name of individual signing JUDSON HEITNER
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Benjamin S Fenger Chief Executive Officer 6608 Flying Cloud Drive Suite 200, Eden Prairie, MN 55334, USA

Filing

Filing Name Filing date
Amendment - Business Corporation (Domestic) 2024-11-04
Business Corporation (Domestic) Business Name (Business Name: Prairie Dental Group, P.A.) 2005-06-06
Registered Office and/or Agent - Business Corporation (Domestic) 1988-09-01
Merger - Business Corporation (Domestic) 1987-04-23
Original Filing - Business Corporation (Domestic) 1982-01-05
Business Corporation (Domestic) Business Name (Business Name: Nagy, Osborn & Heitner, D.D.S., P.A.) 1982-01-05

Related by officers

No related officers

Related by address

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Date of last update: 23 Dec 2024

Sources: Minnesota's Official State Website

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