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Apple Valley Dental Care, Ltd.

Company Details

Name: Apple Valley Dental Care, Ltd.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 23 Mar 1999 (26 years ago)
Company Number: 9f2ee574-aad4-e011-a886-001ec94ffe7f
File Number: 10P-233
Registered Office Address: 14636 Pennock Ave #100, Apple Valley, MN 55124, USA
Principal Executive Office Address: 14635 Pennock Ave #100, Apple Valley, MN 55124, USA
ZIP code: 55124
County: Dakota County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
APPLE VALLEY DENTAL CARE CASH BALANCE PLAN 2022 411934663 2024-11-20 APPLE VALLEY DENTAL CARE LTD. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVE. #100, APPLE VALLEY, MN, 55124
APPLE VALLEY DENTAL CARE 401(K) PLAN 2022 411934663 2023-06-27 APPLE VALLEY DENTAL CARE, LTD. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVENUE #100, APPLE VALLEY, MN, 55124

Signature of

Role Plan administrator
Date 2023-06-27
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-27
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
APPLE VALLEY DENTAL CARE 401(K) PLAN 2021 411934663 2022-05-03 APPLE VALLEY DENTAL CARE, LTD. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVENUE #100, APPLE VALLEY, MN, 55124

Signature of

Role Plan administrator
Date 2022-05-03
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-03
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
APPLE VALLEY DENTAL CARE CASH BALANCE PLAN 2021 411934663 2022-10-17 APPLE VALLEY DENTAL CARE LTD. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVE. #100, APPLE VALLEY, MN, 55124
APPLE VALLEY DENTAL CARE CASH BALANCE PLAN 2020 411934663 2021-06-03 APPLE VALLEY DENTAL CARE LTD. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVE. #100, APPLE VALLEY, MN, 55124
APPLE VALLEY DENTAL CARE 401(K) PLAN 2020 411934663 2021-04-14 APPLE VALLEY DENTAL CARE, LTD. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVENUE #100, APPLE VALLEY, MN, 55124

Signature of

Role Plan administrator
Date 2021-04-14
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-14
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
APPLE VALLEY DENTAL CARE 401(K) PLAN 2019 411934663 2020-08-12 APPLE VALLEY DENTAL CARE, LTD. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVENUE #100, APPLE VALLEY, MN, 55124

Signature of

Role Plan administrator
Date 2020-08-12
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-12
Name of individual signing MICHAEL BAKKEN
Valid signature Filed with authorized/valid electronic signature
APPLE VALLEY DENTAL CARE CASH BALANCE PLAN 2019 411934663 2020-09-03 APPLE VALLEY DENTAL CARE LTD. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9522217293
Plan sponsor’s address 14635 PENNOCK AVE. #100, APPLE VALLEY, MN, 55124

Chief Executive Officer

Name Role Address
Mike Bakken Chief Executive Officer 14635 Pennock Ave #100, Apple Valley, MN 55124, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2006-04-14
Annual Reinstatement - Business Corporation (Domestic) 2006-04-14
Administrative Dissolution - Business Corporation (Domestic) 2006-01-17
Original Filing - Business Corporation (Domestic) 1999-03-23
Business Corporation (Domestic) Business Name (Business Name: Apple Valley Dental Care, Ltd.) 1999-03-23

Date of last update: 01 Oct 2024

Sources: Minnesota's Official State Website