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  5. PEDIATRIC DENTAL ASSOCIATES, LLC

PEDIATRIC DENTAL ASSOCIATES, LLC

Contents

Company Details

Name: PEDIATRIC DENTAL ASSOCIATES, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 11 Jul 2003 (22 years ago)
Entity Number: 81280D
ZIP code: 99503
County: Anchorage
Place of Formation: ALASKA
Address: 330 E TUDOR RD, ANCHORAGE, AK 99503

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621210 OFFICES OF DENTISTS

Officers

Name Role
Michelle L. Slezewski Member
Law Offices of Christina M. Passard, P.C. Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2023 383685227 2024-09-30 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2024-09-30
Name of individual signing MICHELLE SLEZEWSKI
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2022 383685227 2023-10-13 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2021 383685227 2022-10-04 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2022-10-04
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2020 383685227 2021-10-06 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2019 383685227 2020-10-14 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2018 383685227 2019-07-31 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2019-07-31
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2017 383685227 2018-10-13 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2018-10-12
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2016 383685227 2017-07-21 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2017-07-21
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES, LLC 401(K) PLAN 2015 383685227 2016-09-24 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2016-09-23
Name of individual signing MICHELLE SLEZEWSKI
PEDIATRIC DENTAL ASSOCIATES LLC 401K PLAN 2014 383685227 2015-07-31 11
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Sponsor PEDIATRIC DENTAL ASSOCIATES, LLC
Business code 621210
Sponsor’s telephone number 9075221991
Plan sponsor’s address 330 E. TUDOR RD., ANCHORAGE, AK, 99503

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing MICHELLE SLEZEWSKI

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 905826 Active 2007-07-20 2024-01-10 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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