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HERITAGE DENTAL, P.C.

Company Details

Entity Name: HERITAGE DENTAL, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 22 Feb 1993
Company Number: CORP_57193972
File Number: 57193972
Type of Business: Incorporated under the Medical Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HERITAGE DENTAL 401(K) PLAN 2023 363869109 2024-10-15 HERITAGE DENTAL 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002
HERITAGE DENTAL 401(K) PLAN 2022 363869109 2023-09-21 HERITAGE DENTAL 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2023-09-21
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-21
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2021 363869109 2022-06-29 HERITAGE DENTAL 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2022-06-29
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-29
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2020 363869109 2021-04-29 HERITAGE DENTAL 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2021-04-29
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-29
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2019 363869109 2020-05-19 HERITAGE DENTAL 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2020-05-19
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-19
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2018 363869109 2019-05-22 HERITAGE DENTAL 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2019-05-22
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-22
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2017 363869109 2018-05-24 HERITAGE DENTAL 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2018-05-24
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-24
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2016 363869109 2017-06-13 HERITAGE DENTAL 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2017-06-13
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-13
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature
HERITAGE DENTAL 401(K) PLAN 2015 363869109 2016-06-21 HERITAGE DENTAL 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 8473951461
Plan sponsor’s address 800 N MAIN STREET, ANTIOCH, IL, 60002

Signature of

Role Plan administrator
Date 2016-06-21
Name of individual signing KENNETH JAZDZEWSKI
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SCOTT GARTNER, 345 PARK AVE STE 7, ANTIOCH, 60002, LAKE Agent 2024-01-25

President

Name and Address Role
KENNETH JAZDZEWSKI 800 MAIN STANTIOCH 60002 President

Secretary

Name and Address Role
MARK BOARINI Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 300 300000 No data

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State