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  5. Oral Surgery Associates of Alaska, LLC

Oral Surgery Associates of Alaska, LLC

Contents

Company Details

Name: Oral Surgery Associates of Alaska, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 22 Jul 1974 (50 years ago)
Entity Number: 13367D
ZIP code: 99501
County: Anchorage
Place of Formation: ALASKA
Address: 420 L STREET, SUITE 310, ANCHORAGE, AK 99501-6206
Mailing Address: 111 W 16TH AVENUE SUITE 203, ANCHORAGE, AK 99501-6206

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621210 OFFICES OF DENTISTS

Officers

Name Role
Ray Holloway Member
Law Offices of Christina M. Passard, P.C. Registered Agent
Ray Holloway Manager

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300FCEH3V6W696703 13367D US-AK GENERAL ACTIVE -

Addresses
Legal C/O Law Offices of Christina M. Passard, P.C., 4241 B Street, Suite 201, Anchorage, US-AK, US, 99503
Headquarters 111 West 16th Avenue, Suite 203, Anchorage, US-AK, US, 99501

Registration details
Registration Date 2014-01-09
Last Update 2023-08-04
Status LAPSED
Next Renewal 2015-01-07
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 13367D

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2023 920047574 2024-09-05 14
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9076322043
Plan sponsor’s address 625 E 34TH AVE, SUITE 302, ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2024-09-04
Name of individual signing RAY HOLLOWAY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-04
Name of individual signing RAY HOLLOWAY
Valid signature Filed with authorized/valid electronic signature
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2022 920047574 2023-09-21 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9076322043
Plan sponsor’s address 625 E 34TH AVE, SUITE 302, ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2023-09-08
Name of individual signing MICHELLE SLEZEWSKI
Role Employer/plan sponsor
Date 2023-09-21
Name of individual signing RAY HOLLOWAY
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2021 920047574 2022-10-06 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2022-10-06
Name of individual signing RANDI DEETER
Role Employer/plan sponsor
Date 2022-10-06
Name of individual signing RAY HOLLOWAY
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2020 920047574 2021-05-03 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2021-05-03
Name of individual signing RANDI DEETGER
Role Employer/plan sponsor
Date 2021-05-03
Name of individual signing RANDI DEETER
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2019 920047574 2020-10-14 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2020-06-18
Name of individual signing RANDI DEETER
Role Employer/plan sponsor
Date 2020-06-18
Name of individual signing RANDI DEETER
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2018 920047574 2019-06-06 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2019-06-06
Name of individual signing RAY HOLLOWAY
Role Employer/plan sponsor
Date 2019-06-06
Name of individual signing RAY HOLLOWAY
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2017 920047574 2018-07-18 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2018-07-18
Name of individual signing RANDI DEETER
Role Employer/plan sponsor
Date 2018-07-18
Name of individual signing RANDI DEETER
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2016 920047574 2017-06-06 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2017-06-06
Name of individual signing RAY HOLLOWAY
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2015 920047574 2016-07-12 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing RAY HOLLOWAY
ORAL SURGERY ASSOCIATES OF ALASKA PROFIT SHARING PLAN AND TRUST 2014 920047574 2015-08-14 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-08-07
Sponsor ORAL SURGERY ASSOCIATES OF ALASKA
Business code 621210
Sponsor’s telephone number 9075611430
Plan sponsor’s address 111 WEST 16TH AVENUE, SUITE 203, ANCHORAGE, AK, 99501

Signature of
Role Plan administrator
Date 2015-08-14
Name of individual signing RANDI DEETER
Role Employer/plan sponsor
Date 2015-08-14
Name of individual signing RANDI DEETER

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 933356 Active 2009-08-28 2022-10-06 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621210 - OFFICES OF DENTISTS

Date of last update: 10 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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