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Bay Pediatric and Adolescent Dentistry, P.C.

Details

Name: Bay Pediatric and Adolescent Dentistry, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Mar 2005 (20 years ago)
Entity Number: 000-240-167
Register Number: 000240167
County: Baldwin
Place of Formation: Baldwin County
Principal Address: FAIRHOPE, AL
Registered Office Street Address: 115 LOTTIE LANEFAIRHOPE, AL 36532
Registered Office Street Address ZIP Code: 36532
Authorized Capital: $5,000
Paid Share Capital: $1,000

Activities PRACTICE OF DENTISTRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609848308 2006-02-06 2013-02-19 115 LOTTIE LN, FAIRHOPE, AL, 365322995, US 115 LOTTIE LN, FAIRHOPE, AL, 365322995, US

Contacts
Phone +1 251-928-5045
Fax 2519293335

Authorized person
Name DR. WILLIAM WELLS HAMMOCK
Role OWNER
Phone 2519285045

Taxonomy
Taxonomy Code 1223P0221X - Pediatric Dentist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529923190
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2023 202455551 2024-09-16 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-09-16
Name of individual signing WILLIAM WELLS HAMMOCK
Valid signature Filed with authorized/valid electronic signature
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2022 202455551 2023-03-14 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2023-03-14
Name of individual signing ELIZABETH HAMMOCK
Role Employer/plan sponsor
Date 2023-03-14
Name of individual signing ELIZABETH HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2021 202455551 2022-03-17 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2022-03-17
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2022-03-17
Name of individual signing ELIZABETH HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2020 202455551 2021-05-24 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2021-05-24
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2021-05-24
Name of individual signing ELIZABETH HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2019 202455551 2020-04-22 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2020-04-22
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2020-04-22
Name of individual signing ELIZABETH HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2018 202455551 2019-05-07 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2019-05-07
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2019-05-07
Name of individual signing ELIZABETH HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2017 202455551 2018-04-20 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2018-04-20
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2018-04-20
Name of individual signing ELIZABETH R. HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2016 202455551 2017-05-09 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2017-05-09
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2017-05-09
Name of individual signing ELIZABETH R. HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2015 202455551 2016-04-06 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2016-04-06
Name of individual signing ELIZABETH R. HAMMOCK
BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 401(K) PLAN 2014 202455551 2015-05-15 BAY PEDIATRIC AND ADOLESCENT DENTISTRY, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621210
Sponsor’s telephone number 2519285045
Plan sponsor’s address 115 LOTTIE LANE, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2015-05-15
Name of individual signing ELIZABETH R. HAMMOCK
Role Employer/plan sponsor
Date 2015-05-15
Name of individual signing ELIZABETH R. HAMMOCK

Agent

Name Role Address
FELLERS, PAUL H III Agent 303 SECTION STREETFAIRHOPE, AL 36532

Incorporator

Name Role Address
FELLERS, PAUL H III Incorporator 303 SECTION STREETFAIRHOPE, AL 36532
HAMMOCK, WILLIAM WELLS Incorporator No data

Related by officers

FELLERS, PAUL H III

Dr. Trey's Children's Dentistry, P.C. Flying Fellers, L.L.C.

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115 LOTTIE LANEFAIRHOPE, AL 36532

Snaggle Tooth, L.L.C.

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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