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  5. Jeffrey D. Erickson, D.D.S., P.A.

Jeffrey D. Erickson, D.D.S., P.A.

Company Details

Name: Jeffrey D. Erickson, D.D.S., P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 27 Jul 1981 (43 years ago)
Company Number: d4c422d9-afd4-e011-a886-001ec94ffe7f
File Number: 3Y-37
Registered Office Address: 8900 Penn Ave S, Blmgtn, MN 55431–2068, USA
Principal Executive Office Address: 8900 Penn Ave S #105, Bloomington, MN 55431–2068, USA
ZIP code: 55431
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JEFFREY D. ERICKSON, D.D.S., P.A. PROFIT SHARING PLAN 2018 411404115 2019-04-30 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2019-04-30
Name of individual signing JEFF ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-30
Name of individual signing JEFF ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. PROFIT SHARING PLAN 2017 411404115 2018-01-15 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2018-01-15
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-15
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. PROFIT SHARING PLAN 2016 411404115 2017-03-01 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2017-03-01
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-01
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. PROFIT SHARING PLAN 2015 411404115 2016-02-16 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2016-02-16
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-02-16
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. PROFIT SHARING PLAN 2014 411404115 2015-01-29 JEFFREY D. ERICKSON, D.D.S., P.A. 0
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2014-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2015-01-29
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-01-29
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. DEFINED BENEFIT PENSION PLAN 2014 411404115 2015-01-26 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2015-01-26
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-01-26
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. DEFINED BENEFIT PENSION PLAN 2013 411404115 2014-04-14 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2014-04-14
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-14
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. DEFINED BENEFIT PENSION PLAN 2012 411404115 2013-03-28 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 105, BLOOMINGTON, MN, 55431

Signature of
Role Plan administrator
Date 2013-03-28
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-28
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. DEFINED BENEFIT PENSION PLAN 2011 411404115 2012-02-23 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 101, BLOOMINGTON, MN, 55431

Plan administrator’s name and address
Administrator’s EIN 411404115
Plan administrator’s name JEFFREY D. ERICKSON, D.D.S., P.A.
Plan administrator’s address 8900 PENN AVENUE SOUTH, SUITE 101, BLOOMINGTON, MN, 55431
Administrator’s telephone number 9528845500

Signature of
Role Plan administrator
Date 2012-02-23
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-02-23
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
JEFFREY D. ERICKSON, D.D.S., P.A. DEFINED BENEFIT PENSION PLAN 2010 411404115 2011-03-28 JEFFREY D. ERICKSON, D.D.S., P.A. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 9528845500
Plan sponsor’s address 8900 PENN AVENUE SOUTH, SUITE 101, BLOOMINGTON, MN, 55431

Plan administrator’s name and address
Administrator’s EIN 411404115
Plan administrator’s name JEFFREY D. ERICKSON, D.D.S., P.A.
Plan administrator’s address 8900 PENN AVENUE SOUTH, SUITE 101, BLOOMINGTON, MN, 55431
Administrator’s telephone number 9528845500

Signature of
Role Plan administrator
Date 2011-03-28
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-28
Name of individual signing JEFFREY ERICKSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Jeffrey D Erickson DDS PA Chief Executive Officer 8900 Penn Ave S #105, Bloomington, MN 55431–2068, USA

Filing

Filing Name Filing date
Dissolution - Business Corporation (Domestic) 2019-02-07
Intent to Dissolve - Business Corporation (Domestic) 2018-12-31
Business Corporation (Domestic) Change of Shares 2010-10-20
Business Corporation (Domestic) Restated Articles 2010-10-20
Business Corporation (Domestic) Election 2010-10-20
Business Corporation (Domestic) Business Name (Business Name: Jeffrey D. Erickson, D.D.S., P.A.) 2010-10-20
Original Filing - Business Corporation (Domestic) 1981-07-27
Business Corporation (Domestic) Business Name (Business Name: Jeffrey D. Erickson, D.D.S., Limited) 1981-07-27

Related by officers

No related officers

Related by address

8900 Penn Ave S, Blmgtn, MN 55431–2068, USA

Twin Cities Dental Support, Inc.

Date of last update: 09 Dec 2024

Sources: Minnesota's Official State Website

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