| Name: | Children's Dentistry of Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 11 Aug 2015 (9 years ago) |
| Entity Number: | 000-342-022 |
| Register Number: | 000342022 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 3321 WILLIS DRIVEBIRMINGHAM, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114390325 | 2015-11-10 | 2015-11-30 | 6930 CAHABA VALLEY RD, SUITE 200, BIRMINGHAM, AL, 352422672, US | 6930 CAHABA VALLEY RD, SUITE 200, BIRMINGHAM, AL, 352422672, US | |||||||||||||||||
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| Phone | +1 205-613-6475 |
Authorized person
| Name | DR. JEFFREY HARRIS FLANNERY JR. |
| Role | MANAGER |
| Phone | 2056136475 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 6049 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OAK MOUNTAIN PEDIATRIC DENTISTRY 401(K) PLAN | 2023 | 474779493 | 2024-05-07 | CHILDREN'S DENTISTRY OF ALABAMA LLC | 13 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-07 |
| Name of individual signing | QIAN LIU |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2059801338 |
| Plan sponsor’s address | 6930 CAHABA VALLEY ROAD, SUITE 200, BIRMINGHAM, AL, 35242 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | CHRISTINE RIMER |
| Name | Role | Address |
|---|---|---|
| FLANNERY, JEFFREY H JR | Agent | 3321 WILLIS DRIVEBIRMINGHAM, AL 35243 |
| Name | Role | Address |
|---|---|---|
| ANDERSON, BRAD S | Organizer | 1819 5TH AVENUE NORTH, SUITE 1000BIRMINGHAM, AL 35203-1112 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
