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Hugh P. Brindley, D.M.D., P.A.

Details

Name: Hugh P. Brindley, D.M.D., P.A.
Jurisdiction: Alabama
Legal type: Domestic Professional Association
Status: Dissolved
Date of registration: 01 Dec 1980 (44 years ago)
Date of dissolution: 26 Jul 2024
Entity Number: 000-059-915
Register Number: 000059915
County: Jefferson
Place of Formation: Jefferson County
Principal Address: 48 MEDICAL PARK E DR STE 158BIRMINGHAM, AL 35235
Principal Address ZIP Code: 35235

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1306141692 2011-01-18 2018-09-18 PO BOX 190, TRUSSVILLE, AL, 351730190, US 103 2ND AVE NE, CULLMAN, AL, 350552903, US

Contacts
Phone +1 205-838-3060
Fax 8556815911
Phone +1 256-734-4655

Authorized person
Name DR. HUGH P. BRINDLEY
Role PRESIDENT
Phone 2058383060

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 2948
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 000000695
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HUGH P. BRINDLEY, D.M.D, P.A. PROFIT SHARING PLAN 2017 630801396 2018-08-13 HUGH P BRINDLEY, D.M.D, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address P.O. BOX 190, TRUSSVILLE, AL, 35173

Signature of
Role Plan administrator
Date 2018-08-13
Name of individual signing DIANE R SMITH
Role Employer/plan sponsor
Date 2018-08-13
Name of individual signing HUGH P. BRINDLEY
HUGH P. BRINDLEY, D.M.D, P.A. PROFIT SHARING PLAN 2017 630801396 2018-06-01 HUGH P BRINDLEY, D.M.D, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address P.O. BOX 190, TRUSSVILLE, AL, 35173

Signature of
Role Plan administrator
Date 2018-06-01
Name of individual signing DIANE R SMITH
Role Employer/plan sponsor
Date 2018-06-01
Name of individual signing HUGH P BRINDLEY, D.M.D.
HUGH P. BRINDLEY, D.M.D, P.A. PROFIT SHARING PLAN 2016 630801396 2017-06-13 HUGH P BRINDLEY, D.M.D, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2017-06-13
Name of individual signing HUGH P. BRINDLEY, D.M.D.
Role Employer/plan sponsor
Date 2017-06-13
Name of individual signing HUGH P. BRINDLEY, D.M.D.
HUGH P. BRINDLEY, D.M.D, P.A. PROFIT SHARING PLAN 2015 630801396 2016-07-12 HUGH P BRINDLEY, D.M.D, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2016-05-03
Name of individual signing HUGH P. BRINDLEY, D.M.D.
Role Employer/plan sponsor
Date 2016-05-03
Name of individual signing HUGH P. BRINDLEY, D.M.D.
HUGH P. BRINDLEY, D.M.D, P.A. PROFIT SHARING PLAN 2014 630801396 2015-07-16 HUGH P. BRINDLEY, D. M. D, P. A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing DIANE R SMITH
Role Employer/plan sponsor
Date 2015-06-29
Name of individual signing HUGH P BRINDLEY
HUGH P. BRINDLEY, DMD, PA PROFIT SHARING PLAN 2013 630801396 2014-06-16 HUGH P BRINDLEY, D. M. D, P. A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2014-06-16
Name of individual signing HUGH P BRINDLEY D M D
Role Employer/plan sponsor
Date 2014-06-16
Name of individual signing HUGH P BRINDLEY D M D
HUGH P. BRINDLEY, DMD, PA PROFIT SHARING PLAN 2012 630801396 2013-06-25 HUGH P BRINDLEY, D. M. D, P. A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Signature of
Role Plan administrator
Date 2013-06-25
Name of individual signing HUGH P. BRINDLEY, D.M.D., P.A.
Role Employer/plan sponsor
Date 2013-06-25
Name of individual signing HUGH P. BRINDLEY, D.M.D.,P.A.
HUGH P. BRINDLEY, DMD, PA PROFIT SHARING PLAN 2011 630801396 2012-06-04 HUGH P BRINDLEY, D. M. D, P. A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1983-01-01
Business code 621111
Sponsor’s telephone number 2058383060
Plan sponsor’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235

Plan administrator’s name and address
Administrator’s EIN 630801396
Plan administrator’s name HUGH P BRINDLEY, D. M. D, P. A.
Plan administrator’s address 48 MEDICAL PARK EAST DRIVE, SUITE 158, BIRMINGHAM, AL, 35235
Administrator’s telephone number 2058383060

Signature of
Role Plan administrator
Date 2012-06-04
Name of individual signing HUGH P. BRINDLEY, D.M.D., P.A.

Member

Name Role
BRINDLEY, HUGH P Member

Related by officers

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Related by address

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Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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