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  5. PEDIATRIC DENTISTRY, P.A.

PEDIATRIC DENTISTRY, P.A.

Company Details

Name: PEDIATRIC DENTISTRY, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 15 Dec 1988 (36 years ago)
Business ID: 559592
ZIP code: 39209
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 5315 HIGHWAY 18 WJACKSON, MS 39209-9666

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRIC DENTISTRY, P.A. 401(K) PLAN 2023 640680145 2024-07-30 PEDIATRIC DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2024-07-30
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY, P.A. CASH BALANCE PLAN 2023 640680145 2024-07-30 PEDIATRIC DENTISTRY, P.A. 12
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2023-01-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2024-07-30
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2022 640680145 2023-08-01 PEDIATRIC DENTISTRY, P.A. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2023-08-01
Name of individual signing SUSAN FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-08-01
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2021 640680145 2022-08-12 PEDIATRIC DENTISTRY, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2022-08-08
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-08
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2020 640680145 2021-09-28 PEDIATRIC DENTISTRY, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2021-09-28
Name of individual signing LEE COPE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-28
Name of individual signing LEE COPE
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2019 640680145 2020-09-22 PEDIATRIC DENTISTRY, P.A. 26
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2020-09-22
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-22
Name of individual signing CHARLYNE BROWN
Valid signature Filed with incorrect/unrecognized electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2019 640680145 2020-11-13 PEDIATRIC DENTISTRY, P.A. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2020-11-13
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-11-13
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2018 640680145 2019-08-05 PEDIATRIC DENTISTRY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2019-07-19
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P. A. 401(K) PLAN 2017 640680145 2018-09-25 PEDIATRIC DENTISTRY, P.A. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2018-09-25
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY P.A. 401(K) PLAN 2016 640680145 2017-07-06 PEDIATRIC DENTISTRY, P.A. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/06/29/20160629151246P030011144413001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/31/20150731135158P030146760737001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2015-07-31
Name of individual signing CHARLYNE BROWN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/30/20140730170451P040027240461001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2002-10-01
Business code 621210
Sponsor’s telephone number 6019220066
Plan sponsor’s address 5315 HIGHWAY 18, JACKSON, MS, 39209

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing LEE COPE
Valid signature Filed with authorized/valid electronic signature

Secretary

Name Role Address
MARY ANN COPE Secretary 5315 HIGHWAY 18 WEST, , MS 39212

Treasurer

Name Role Address
MARY ANN COPE Treasurer 5315 HIGHWAY 18 WEST, , MS 39212

Director

Name Role Address
LIVY L COPE Director 7637 AKERSWOOD DRIVE, GERMANTOWN, TN 38138

President

Name Role Address
L LEE COPE President 5315 HIGHWAY 18 W, JACKSON, MS 39209

Incorporator

Name Role Address
LIVY L COPE Incorporator 7637 AKERSWOOD DRIVE, GERMANTOWN, TN 38138

Agent

Name Role Address
L LEE COPE Agent 5315 HIGHWAY 18 W, JACKSON, MS 39209

Filings

Type Status Filed Date Description
Dissolution Filed 1990-04-09 Dissolution
Annual Report Filed 1990-03-12 Annual Report
Annual Report Filed 1989-11-30 Annual Report
Notice to Dissolve/Revoke Filed 1989-10-26 Notice to Dissolve/Revoke
Amendment Form Filed 1989-03-21 Amendment
Name Reservation Form Filed 1988-12-15 Name Reservation

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6207807101 2020-04-14 0470 PPP 5315 HIGHWAY 18, JACKSON, MS, 39209
Loan Status Date 2021-05-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 108885
Loan Approval Amount (current) 108885
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39848
Servicing Lender Name Cadence Bank
Servicing Lender Address 201 S Spring St, TUPELO, MS, 38804-4811
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address JACKSON, HINDS, MS, 39209-0002
Project Congressional District MS-02
Number of Employees 13
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 39848
Originating Lender Name Cadence Bank
Originating Lender Address TUPELO, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 109970.83
Forgiveness Paid Date 2021-04-20

Related by officers

MARY ANN COPE

THE PEDIATRIC DENTAL GROUP, P.A.

LIVY L COPE

THE PEDIATRIC DENTAL GROUP, P.A.

L LEE COPE

L. LEE COPE, D.D.S., P.A. THE PEDIATRIC DENTAL GROUP, P.A. CRESTWOOD CLINIC FOR CHRIST, INC. MISSION FIRST, INC.

Related by address

5315 HIGHWAY 18 WJACKSON, MS 39209-9666

THE PEDIATRIC DENTAL GROUP, P.A.

Date of last update: 13 Mar 2025

Sources: Mississippi Secretary of State

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