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NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC

Details

Name: NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 17 Apr 2015 (10 years ago)
Entity Number: 000-334-351
Register Number: 000334351
County: Madison
Place of Formation: Madison County
Registered Office Street Address: 44 HUGHES ROAD SUITE 1500MADISON, AL 35758
Registered Office Street Address ZIP Code: 35758

Activities MEDICAL PRACTICE SPECIALIZING IN ORAL/FACIAL SURGERY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1700273208 2015-04-22 2015-04-22 44 HUGHES RD, MADISON, AL, 357583045, US 44 HUGHES RD, MADISON, AL, 357583045, US

Contacts
Phone +1 256-774-3535
Fax 2563256145

Authorized person
Name MR. JASON R MILLER
Role PHYSICIAN/OWNER
Phone 2562654950

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 25550
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2023 473753747 2024-04-22 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 44
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2023 473753747 2024-04-22 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 44
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2022 473753747 2023-07-27 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 51
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2023-07-27
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2021 473753747 2022-10-10 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 42
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2020 473753747 2021-09-10 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2021-09-10
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2019 473753747 2020-05-01 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2020-05-01
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2018 473753747 2019-08-19 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2019-08-19
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC CASH BALANCE PLAN 2017 473753747 2018-10-10 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2567743535
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing LAURA HOLYFIELD
NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 401(K) PLAN 2016 473753747 2017-07-28 NORTH ALABAMA ORAL AND FACIAL SURGERY, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-06-01
Business code 621111
Sponsor’s telephone number 2563252435
Plan sponsor’s address 44 HUGHES ROAD, SUITE 1500, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing CHEZNEY MCCULLOUGH
Role Employer/plan sponsor
Date 2017-07-28
Name of individual signing CHEZNEY MCCULLOUGH

Agent

Name Role
SHAH, RAKESH A Agent

Organizer

Name Role Address
JONES, D ASHLEY Organizer 100 WASHINGTON STREET STE 100HUNTSVILLE, AL 35801

Related by officers

SHAH, RAKESH A

NORTH ALABAMA ORAL SURGERY PROPERTIES, LLC

JONES, D ASHLEY

Messrs. Bedsole & Bedsole, LLC TITAN PROPERTIES, LLC M&R SMALL GAME HABITAT RESTORATION,LLC MSC-Hughes, LLC. HUGHES ROAD MEDICAL, LLC NORTH ALABAMA HOUSING ASSISTANCE, LLC Telecommunications and Satellite Broadband, LLC NANNY'S COUNTRY CAFE, LLC 3 Eagles, LLC Five Star Properties, LLC

Related by address

44 HUGHES ROAD SUITE 1500MADISON, AL 35758

NORTH ALABAMA ORAL SURGERY PROPERTIES, LLC

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State

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