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  5. HUFFMAN FAMILY DENTISTRY, LLC

HUFFMAN FAMILY DENTISTRY, LLC

Contents

Company Details

Name: HUFFMAN FAMILY DENTISTRY, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 25 Jun 2002 (23 years ago)
Entity Number: 76864D
ZIP code: 99515
County: Anchorage
Place of Formation: ALASKA
Address: 12350 INDUSTRY WAY, SUITE 210, ANCHORAGE, AK 99515

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621210 OFFICES OF DENTISTS

Officers

Name Role
Clearview Dentistry LLC Member
JSW Dental LLC Member
Vellum Registered Agent Inc. Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2023 753073058 2024-09-11 32
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2024-09-11
Name of individual signing JON WEAVER
Valid signature Filed with authorized/valid electronic signature
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2022 753073058 2023-09-19 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing JON WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2021 753073058 2022-10-11 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JON WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2020 753073058 2021-10-06 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing JON WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2019 753073058 2020-10-15 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JON WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2018 753073058 2019-10-09 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing JON WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2017 753073058 2018-10-15 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing JONATHAN WEAVER
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2016 753073058 2017-07-27 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, STE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing DARRELL J. PETERSON
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2015 753073058 2016-07-25 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY, SUITE 210, ANCHORAGE, AK, 99515

Signature of
Role Plan administrator
Date 2016-07-25
Name of individual signing DARRELL J. PETERSON
HUFFMAN FAMILY DENTISTRY, LLC 401K PLAN 2014 753073058 2015-07-23 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Sponsor HUFFMAN FAMILY DENTISTRY, LLC
Business code 621210
Sponsor’s telephone number 9073457722
Plan sponsor’s address 12350 INDUSTRY WAY STE 210, ANCHORAGE, AK, 995154301

Plan administrator’s name and address
Administrator’s EIN 753073058
Plan administrator’s name HUFFMAN FAMILY DENTISTRY, LLC
Plan administrator’s address 12350 INDUSTRY WAY STE 210, ANCHORAGE, AK, 995154301
Administrator’s telephone number 9073457722

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing DARRELL J. PETERSON

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 424300 Active 2002-07-24 2023-10-09 2025-12-31 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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