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  5. Lakeview Dental Clinic of Bemidji, P.A.

Lakeview Dental Clinic of Bemidji, P.A.

Company Details

Name: Lakeview Dental Clinic of Bemidji, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 04 Aug 1986 (38 years ago)
Company Number: fdbcea5b-a9d4-e011-a886-001ec94ffe7f
File Number: 5H-903
Registered Office Address: 603 Bemidji Ave, Bemidji, MN 56601, USA
ZIP code: 56601
County: Beltrami County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2018 411561751 2019-07-19 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2019-07-19
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P. A. 401(K) 2018 411561751 2019-12-23 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2019-12-23
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2017 411561751 2018-07-19 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2016 411561751 2017-06-26 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2017-06-22
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2015 411561751 2016-07-19 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2016-07-19
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-19
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2014 411561751 2015-07-07 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-06
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2013 411561751 2014-07-08 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2014-07-08
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2012 411561751 2013-06-17 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Signature of
Role Plan administrator
Date 2013-06-17
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature
LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2011 411561751 2012-07-11 LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 2187514523
Plan sponsor’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601

Plan administrator’s name and address
Administrator’s EIN 411561751
Plan administrator’s name LAKEVIEW DENTAL CLINIC OF BEMIDJI, P.A.
Plan administrator’s address 603 BEMIDJI AVENUE, BEMIDJI, MN, 56601
Administrator’s telephone number 2187514523

Signature of
Role Plan administrator
Date 2012-07-11
Name of individual signing ANN JOHNSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Kevin Johnson Chief Executive Officer 603 Bemidji Ave, Bemidji, MN 56601, USA

Filing

Filing Name Filing date
Intent to Dissolve - Business Corporation (Domestic) 2020-04-22
Dissolution - Business Corporation (Domestic) 2020-04-22
Business Corporation (Domestic) Business Name (Business Name: Lakeview Dental Clinic of Bemidji, P.A.) 1991-04-26
Original Filing - Business Corporation (Domestic) 1986-08-04
Business Corporation (Domestic) Business Name (Business Name: RICHARD A. JOHNSON, P.A.) 1986-08-04

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Date of last update: 02 Oct 2024

Sources: Minnesota's Official State Website

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