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DHDA ProviderCo, PLLC

Company Details

Name: DHDA ProviderCo, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 04 Feb 2020 (5 years ago)
Organization Date: 04 Feb 2020 (5 years ago)
Organization Number: 1085966
Industry: Health Services
Number of Employees: Medium (20-99)
Primary County: Jefferson
Place of Formation: KENTUCKY
Last Annual Report: 19 Mar 2024 (8 months ago)
Managed By: Members
Principal Office: 13104 W US HWY 42, PROSPECT, KY 40059
Principal Office ZIP code: 40059

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DHDA PROVIDERCO PLLC 401(K) PROFIT SHARING PLAN & TRUST 2023 844585626 2024-05-03 DHDA PROVIDERCO PLLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 5023245960
Plan sponsor’s address 120 WEBSTER STREET SUITE 332, LOUISVILLE, KY, 40206

Plan administrator’s name and address

Administrator’s EIN 471637791
Plan administrator’s name ERISA FIDUCIARY SERVICES, INC.
Plan administrator’s address 1373 VETERANS HIGHWAY, SUITE 10, HAUPPAUGE, NY, 11788
Administrator’s telephone number 6312490500

Signature of

Role Plan administrator
Date 2024-05-03
Name of individual signing ERISA FIDUCIARY SERVICES
Valid signature Filed with authorized/valid electronic signature
DHDA PROVIDERCO. PLLC 401(K) PLAN 2022 844585626 2023-07-28 DHDA PROVIDERCO PLLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 5022280234
Plan sponsor’s address 120 WEBSTER ST STE 332, LOUISVILLE, KY, 402061895

Signature of

Role Plan administrator
Date 2023-07-28
Name of individual signing PAUL LAVELLE
Valid signature Filed with authorized/valid electronic signature
DHDA PROVIDERCO. PLLC 401(K) PLAN 2021 844585626 2022-07-18 DHDA PROVIDERCO PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 5022280234
Plan sponsor’s address 120 WEBSTER ST STE 332, LOUISVILLE, KY, 402061895

Signature of

Role Plan administrator
Date 2022-07-18
Name of individual signing PAUL LAVELLE
Valid signature Filed with authorized/valid electronic signature
DHDA PROVIDERCO. PLLC 401(K) PLAN 2020 844585626 2021-07-08 DHDA PROVIDERCO PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 5022280234
Plan sponsor’s address 120 WEBSTER ST STE 332, LOUISVILLE, KY, 402061895

Signature of

Role Plan administrator
Date 2021-07-08
Name of individual signing PAUL LAVELLE
Valid signature Filed with authorized/valid electronic signature

Member

Name Role
Paul T Lavelle Member

Registered Agent

Name Role
Timothy Lavelle Registered Agent
TIMOTHY LAVELLE Registered Agent

Organizer

Name Role
Paul Lavelle Organizer

Assumed Names

Name Status Expiration Date
VIE SMILE DESIGN Active 2029-04-16
LAVELLE FAMILY & COSMETIC DENTISTRY Expiring 2025-03-09

Filings

Name File Date
Certificate of Assumed Name 2024-04-16
Annual Report 2024-03-19
Registered Agent name/address change 2023-09-19
Annual Report 2023-03-22
Annual Report 2022-02-15
Registered Agent name/address change 2022-02-15
Principal Office Address Change 2021-04-26
Annual Report 2021-04-26
Annual Report 2020-06-05
Certificate of Assumed Name 2020-02-03

Date of last update: 08 Nov 2024

Sources: Kentucky Secretary of State