Bluegrass Endodontics LLC

Company Details

Name:	Bluegrass Endodontics LLC
Jurisdiction:	Kentucky
Profit or Non-Profit:	Profit
Legal type:	Kentucky Limited Liability Company
Status:	Active
Standing:	Good
File Date:	12 Feb 2013 (12 years ago)
Organization Date:	12 Feb 2013 (12 years ago)
Organization Number:	0849757
Industry:	Health Services
Number of Employees:	Small (0-19)
Primary County:	Fayette
Place of Formation:	KENTUCKY
Last Annual Report:	10 Oct 2024 (a month ago)
Managed By:	Members
Principal Office:	1636 Nicholasville Road, Suite No. 2, Lexington, KY 40503
Principal Office ZIP code:	40503

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

BLUEGRASS ENDODONTICS, LLC 401(K) RETIREMENT SAVINGS PLAN

2023

272715876

2024-10-10

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2024-10-10
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC CASH BALANCE PLAN

2023

272715876

2024-10-02

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2024-10-02
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS CBS BENEFIT PLAN

2023

272715876

2024-04-29

BLUEGRASS ENDODONTICS

File	View Page
Three-digit plan number (PN)	501
Effective date of plan	2023-07-31
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD UNIT 2, LEXINGTON, KY, 40503

Plan administrator’s name and address

Administrator’s EIN	846429706
Plan administrator’s name	SHAWNA BURTON
Plan administrator’s address	464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number	5026954700

Signature of

Role	Plan administrator
Date	2024-04-29
Name of individual signing	SHAWNA BURTON
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC 401(K) RETIREMENT SAVINGS PLAN

2022

272715876

2023-10-12

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2023-10-12
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC CASH BALANCE PLAN

2022

272715876

2023-10-13

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2023-10-13
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC 401(K) RETIREMENT SAVINGS PLAN

2021

272715876

2022-10-11

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2022-10-11
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC CASH BALANCE PLAN

2021

272715876

2022-10-11

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2022-10-11
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC 401(K) RETIREMENT SAVINGS PLAN

2020

272715876

2021-09-28

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2021-09-28
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC CASH BALANCE PLAN

2020

272715876

2021-09-28

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2021-09-28
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

BLUEGRASS ENDODONTICS, LLC 401(K) RETIREMENT SAVINGS PLAN

2019

272715876

2020-10-09

BLUEGRASS ENDODONTICS, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2020-10-09
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2020/10/09/20201009123504NAL0000168529001.pdf
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2020-10-09
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2019/10/10/20191010120641P030047403469001.pdf
Three-digit plan number (PN)	002
Effective date of plan	2018-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2019-10-10
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2019/10/09/20191009153631P030046048253001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2019-10-09
Name of individual signing	MERUNISSA LAMBAT
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2018/09/21/20180921142826P040200908167001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

File	https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/13/20171013073035P030193812327001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

File	https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/17/20161017130038P030020220685001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

File	https://efast2-filings-public.s3.amazonaws.com/prd/2015/06/29/20150629082531P030069995015001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Signature of

Role	Plan administrator
Date	2015-06-29
Name of individual signing	S. DOUGLAS COX
Valid signature	Filed with authorized/valid electronic signature

Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Plan administrator’s name and address

Administrator’s EIN	272715876
Plan administrator’s name	BLUEGRASS ENDODONTICS, LLC
Plan administrator’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432
Administrator’s telephone number	8592771124

Signature of

Role	Plan administrator
Date	2014-08-29
Name of individual signing	S. DOUGLAS COX
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2015/12/31/20151231125346P030131762903001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Plan administrator’s name and address

Administrator’s EIN	272715876
Plan administrator’s name	BLUEGRASS ENDODONTICS, LLC
Plan administrator’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432
Administrator’s telephone number	8592771124

File	https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/14/20131014121233P040044322577001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Plan administrator’s name and address

Administrator’s EIN	272715876
Plan administrator’s name	BLUEGRASS ENDODONTICS, LLC
Plan administrator’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432
Administrator’s telephone number	8592771124

Signature of

Role	Plan administrator
Date	2013-10-14
Name of individual signing	S. DOUGLAS COX
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/12/20121012093924P040001388150001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Plan administrator’s name and address

Administrator’s EIN	311561534
Plan administrator’s name	BLUEGRASS ENDODONTICS, LLC
Plan administrator’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432
Administrator’s telephone number	8592771124

Signature of

Role	Plan administrator
Date	2012-10-12
Name of individual signing	S. DOUGLAS COX
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/29/20110729133920P040105854225001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2003-01-01
Business code	621210
Sponsor’s telephone number	8592771124
Plan sponsor’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432

Plan administrator’s name and address

Administrator’s EIN	311561534
Plan administrator’s name	BLUEGRASS ENDODONTICS, LLC
Plan administrator’s address	1636 NICHOLASVILLE RD, LEXINGTON, KY, 405031432
Administrator’s telephone number	8592771124

Signature of

Role	Plan administrator
Date	2011-07-29
Name of individual signing	S. DOUGLAS COX
Valid signature	Filed with authorized/valid electronic signature

Member

Name	Role
S. DOUGLAS COX	Member
MERUNISSA S LAMBAT	Member

Organizer

Name	Role
Stephen Douglas Cox	Organizer

Registered Agent

Name	Role
Stephen Douglas Cox	Registered Agent

Filings

Name	File Date
Reinstatement Certificate of Existence	2024-10-10
Reinstatement Approval Letter Revenue	2024-10-10
Registered Agent name/address change	2024-10-10
Reinstatement	2024-10-10
Administrative Dissolution	2023-10-04
Annual Report	2022-03-07
Annual Report	2021-05-03
Annual Report	2020-04-01
Annual Report	2019-05-15
Annual Report	2018-04-18
Reinstatement Approval Letter Revenue	2017-10-20
Reinstatement Certificate of Existence	2017-10-20
Reinstatement	2017-10-20
Administrative Dissolution	2017-10-09
Annual Report	2016-03-08
Annual Report	2015-07-29
Annual Report	2014-09-18

Date of last update: 14 Nov 2024

Sources: Kentucky Secretary of State

Bluegrass Endodontics LLC

Company Details

form 5500

Member

Organizer

Registered Agent

Filings

Related by officers

Related by address