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  5. Birch Lake Dental, P.A.

Birch Lake Dental, P.A.

Company Details

Name: Birch Lake Dental, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 15 Jun 2000 (25 years ago)
Company Number: d48d9a76-b2d4-e011-a886-001ec94ffe7f
File Number: 11F-135
Registered Office Address: 4641 White Bear Pkwy, White Bear Lake, MN 55110, USA
Principal Executive Office Address: 4641 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110–3300, United States
ZIP code: 55110
County: Ramsey County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2023 411976527 2024-10-14 BIRCH LAKE DENTAL, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing GEETHA J. DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-14
Name of individual signing GEETHA J. DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2022 411976527 2023-09-05 BIRCH LAKE DENTAL, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-05
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2021 411976527 2022-03-11 BIRCH LAKE DENTAL, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2022-03-11
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-03-11
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2020 411976527 2021-10-05 BIRCH LAKE DENTAL, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-05
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2019 411976527 2020-07-27 BIRCH LAKE DENTAL, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2020-07-27
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-27
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2018 411976527 2019-06-18 BIRCH LAKE DENTAL, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2019-06-18
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-18
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2017 411976527 2018-10-09 BIRCH LAKE DENTAL, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2018-10-09
Name of individual signing GEETHA J. DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-09
Name of individual signing GEETHA J. DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2016 411976527 2017-08-14 BIRCH LAKE DENTAL, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2017-08-14
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-14
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2015 411976527 2016-10-10 BIRCH LAKE DENTAL, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
BIRCH LAKE DENTAL, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2014 411976527 2015-05-20 BIRCH LAKE DENTAL, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 6514290404
Plan sponsor’s address 4641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN, 55110

Signature of
Role Plan administrator
Date 2015-05-20
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-20
Name of individual signing GEETHA DAMODARAN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Geetha Damodaran Chief Executive Officer 4641 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110–3300, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2006-02-28
Original Filing - Business Corporation (Domestic) 2000-06-15
Business Corporation (Domestic) Business Name (Business Name: Birch Lake Dental, P.A.) 2000-06-15
Original Filing - Business Corporation (Domestic)Professional Service - Dentistry & Dental Hygiene 2000-06-15

Related by officers

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Related by address

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Date of last update: 12 Jan 2025

Sources: Minnesota's Official State Website

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