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Northcutt Dental Practice, P.C.

Details

Name: Northcutt Dental Practice, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 21 Jul 1997 (27 years ago)
Entity Number: 000-189-351
Register Number: 000189351
County: Baldwin
Place of Formation: Baldwin County
Principal Address: FAIRHOPE, AL
Registered Office Street Address: 23678 HIGHWAY 98FAIRHOPE, AL 36532
Registered Office Street Address ZIP Code: 36532
Authorized Capital: 2,000 NPV

Activities PRACTICE OF DENTISTRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295890515 2006-12-27 2020-08-22 23678 US HIGHWAY 98, FAIRHOPE, AL, 365323336, US 23678 US HIGHWAY 98, FAIRHOPE, AL, 365323336, US

Contacts
Phone +1 251-928-8770
Fax 2519288724

Authorized person
Name DR. JOHN DAVID NORTHCUTT III
Role PRESIDENT
Phone 2519288770

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 4593
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHCUTT DENTAL MANAGEMENT SERVICES, INC. 401(K) PLAN 2023 721383657 2024-10-11 NORTHCUTT DENTAL PRACTICE, P.C. 112
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 US HWY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-10-11
Name of individual signing DR. TRACY NORTHCUTT
Valid signature Filed with authorized/valid electronic signature
NORTHCUTT DENTAL MANAGEMENT SERVICES, INC. 401(K) PLAN 2022 721383657 2023-10-12 NORTHCUTT DENTAL PRACTICE, P.C. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 US HWY 98, FAIRHOPE, AL, 36532
NORTHCUTT DENTAL PRACTICE PC 401(K) PROFIT SHARING PLAN & TRUST 2021 721383657 2022-07-29 NORTHCUTT DENTAL PRACTICE, P.C. 114
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing CHRISTINA OWEN
NORTHCUTT DENTAL PRACTICE PC 401(K) PROFIT SHARING PLAN & TRUST 2020 721383657 2021-07-12 NORTHCUTT DENTAL PRACTICE, P.C. 103
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2021-07-12
Name of individual signing CHRISTINA OWEN
NORTHCUTT DENTAL PRACTICE PC 401(K) PLAN 2019 721383657 2020-08-11 NORTHCUTT DENTAL PRACTICE, P.C. 100
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2020-08-11
Name of individual signing CHRISTINA OWEN
NORTHCUTT DENTAL PRACTICE PC 401(K) PLAN 2018 721383657 2020-01-02 NORTHCUTT DENTAL PRACTICE, P.C. 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2020-01-02
Name of individual signing CHRISTINA OWEN
NORTHCUTT DENTAL PRACTICE PC 401(K) PLAN 2018 721383657 2019-10-14 NORTHCUTT DENTAL PRACTICE, P.C. 98
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing CHRISTINA OWEN
NORTHCUTT DENTAL PRACTICE PC 401(K) PLAN 2017 721383657 2018-05-30 NORTHCUTT DENTAL PRACTICE, P.C. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2018-05-30
Name of individual signing BURT ARTHUR
Role Employer/plan sponsor
Date 2018-05-30
Name of individual signing BURT ARTHUR
NORTHCUTT DENTAL PRACTICE, P.C. 401(K) PROFIT SHARING PLAN & TRUST 2016 721383657 2017-07-20 NORTHCUTT DENTAL, PRACTICE, P.C. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing TRACY NORTHCUTT
NORTHCUTT DENTAL PRACTICE, P.C. 401(K) PROFIT SHARING PLAN & TRUST 2015 721383657 2016-10-03 NORTHCUTT DENTAL, PRACTICE, P.C. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 2519288770
Plan sponsor’s address 23678 HIGHWAY 98, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing TRACY NORTHCUTT

Agent

Name Role Address
NORTHCUTT, TRACY M Agent 23678 HIGHWAY 98FAIRHOPE, AL 36532

Incorporator

Name Role
GREGORY, KIMBROUGH Incorporator

Related by officers

NORTHCUTT, TRACY M

NCUTT, LLC Northcutt Dental Holdings, P.C. Northcutt Dental Management Services, Inc.

Related by address

FAIRHOPE, AL

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23678 HIGHWAY 98FAIRHOPE, AL 36532

Northcutt Dental - Fairhope, LLC Northcutt Dental - Semmes, LLC Northcutt Dental Management Services, Inc. Northcutt Dental - Helena, LLC Northcutt Dental - Hoover, LLC

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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