Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Hubbard County
    4. ›
  4. 56470
    5. ›
  5. JAY C. JORGENSON, D.D.S., P.A.

JAY C. JORGENSON, D.D.S., P.A.

Company Details

Name: JAY C. JORGENSON, D.D.S., P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 29 Dec 1997 (27 years ago)
Company Number: d035f095-9ad4-e011-a886-001ec94ffe7f
File Number: 9Y-527
Registered Office Address: 406 Pleasant Ave, Park Rapids, MN 56470–1428, USA
Principal Executive Office Address: 14841 CIRCLE PINES DR, PARK RAPIDS, MN 56470–6093, USA
ZIP code: 56470
County: Hubbard County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2018 411896617 2019-02-13 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2019-02-13
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C. JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2018 411896617 2019-02-13 JAY C. JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2019-02-13
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2017 411896617 2018-06-09 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2018-06-09
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2016 411896617 2017-07-15 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2017-07-15
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2015 411896617 2016-07-27 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2014 411896617 2015-07-30 JAY C JORGENSON D.D.S., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2013 411896617 2014-07-30 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2012 411896617 2013-09-04 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Signature of
Role Plan administrator
Date 2013-09-04
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2011 411896617 2012-10-04 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Plan administrator’s name and address
Administrator’s EIN 411896617
Plan administrator’s name JAY C JORGENSON D.D.S., P.A.
Plan administrator’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428
Administrator’s telephone number 2182377200

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature
JAY C JORGENSON D.D.S., P.A. 401(K) RETIREMENT PLAN 2010 411896617 2011-10-13 JAY C JORGENSON D.D.S., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621210
Sponsor’s telephone number 2182377200
Plan sponsor’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428

Plan administrator’s name and address
Administrator’s EIN 411896617
Plan administrator’s name JAY C JORGENSON D.D.S., P.A.
Plan administrator’s address 406 PLEASANT AVENUE SOUTH, PARK RAPIDS, MN, 564701428
Administrator’s telephone number 2182377200

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing JAY C JORGENSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Jay Jorgenson Chief Executive Officer 406 PLEASANT AVE S, PARK RAPIDS, MN 56470–1428, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2000-10-04
Original Filing - Business Corporation (Domestic) 1997-12-29
Business Corporation (Domestic) Business Name (Business Name: JAY C. JORGENSON, D.D.S., P.A.) 1997-12-29
Original Filing - Business Corporation (Domestic)Professional Service - Dentistry & Dental Hygiene 1997-12-29

Related by officers

No related officers

Related by address

14841 CIRCLE PINES DR, PARK RAPIDS, MN 56470–6093, USA

Sisu Acres DL LLC Sisu Acres Minnesota LLC

Date of last update: 07 Dec 2024

Sources: Minnesota's Official State Website

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 mnprof.com, Part of Big Data Integrated