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  5. GADDIS FAMILY DENTISTRY, PC

GADDIS FAMILY DENTISTRY, PC

Company Details

Name: GADDIS FAMILY DENTISTRY, PC
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 10 Sep 2003 (22 years ago)
Business ID: 738978
ZIP code: 39183
County: Warren
State of Incorporation: MISSISSIPPI
Principal Office Address: 1460 SUMMERSEAT RDVicksburg, MS 39183

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2023 454195712 2024-08-27 GADDIS FAMILY DENTISTRY 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2024-08-27
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2022 454195712 2023-07-06 GADDIS FAMILY DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2021 454195712 2022-07-17 GADDIS FAMILY DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2022-07-17
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2020 454195712 2021-07-06 GADDIS FAMILY DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2021-07-06
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2019 454195712 2020-06-05 GADDIS FAMILY DENTISTRY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2020-06-05
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2018 454195712 2019-06-04 GADDIS FAMILY DENTISTRY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2019-06-04
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2017 454195712 2018-06-18 GADDIS FAMILY DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2018-06-18
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2016 454195712 2017-07-10 GADDIS FAMILY DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2017-07-10
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2015 454195712 2016-07-05 GADDIS FAMILY DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2016-07-05
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
GADDIS FAMILY DENTISTRY PROFIT SHARING PLAN 2014 454195712 2015-03-09 GADDIS FAMILY DENTISTRY 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2015-03-09
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-09
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/04/03/20140403155720P030326782305001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2014-04-03
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-03
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/08/29/20130829111341P040371359715001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Signature of
Role Plan administrator
Date 2013-08-29
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-29
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 454195712
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937918

Signature of
Role Plan administrator
Date 2012-08-27
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-27
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/12/03/20121203135343P040030423489001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937918
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 454195712
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937918

Signature of
Role Plan administrator
Date 2012-12-03
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-12-03
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/02/05/20120205162107P030009924103001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937913
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 640938570
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937913

Signature of
Role Plan administrator
Date 2012-02-05
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-02-05
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937913
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 640938570
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937913

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing ANDREA GADDIS
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing ANDREA GADDIS
Valid signature Filed with incorrect/unrecognized electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937913
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 640938570
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937913

Signature of
Role Plan administrator
Date 2010-10-18
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/20/20101020085036P030005262103001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937913
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 640938570
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937913

Signature of
Role Plan administrator
Date 2010-10-20
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-20
Name of individual signing ANDREA GADDIS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621210
Sponsor’s telephone number 6016937913
Plan sponsor’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183

Plan administrator’s name and address
Administrator’s EIN 640938570
Plan administrator’s name SAME
Plan administrator’s address 1426 SUMMER SEAT ROAD, VICKSBURG, MS, 39183
Administrator’s telephone number 6016937913

Signature of
Role Plan administrator
Date 2010-10-16
Name of individual signing JASMINEBUCK01
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-16
Name of individual signing JASMINEBUCK01
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
NATIONAL REGISTERED AGENTS INC Agent 645 Lakeland East Dr., Ste. 101, Flowood, MS 39232

Incorporator

Name Role Address
Legalzoom.com Inc Incorporator 7083 Hollywood Blvd #180, P O Box 90, Los Angeles, CA 90028

Director

Name Role Address
Andrea Gaddis, DDS Director 1426 Summerseat Rd, Vicksburg, MS 39183

President

Name Role Address
Andrea Gaddis, DDS President 1426 Summerseat Rd, Vicksburg, MS 39183

Filings

Type Status Filed Date Description
Dissolution Filed 2012-01-04 Dissolution
Annual Report Filed 2011-04-25 Annual Report
Annual Report Filed 2011-04-01 Annual Report
Annual Report Filed 2010-04-15 Annual Report
Annual Report Filed 2009-04-15 Annual Report
Annual Report Filed 2008-04-14 Annual Report
Annual Report Filed 2007-04-06 Annual Report
Annual Report Filed 2006-06-07 Annual Report
Annual Report Filed 2006-05-15 Annual Report
Annual Report Filed 2005-04-18 Annual Report

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1282527108 2020-04-10 0470 PPP 1426 SUMMER SEAT RD, VICKSBURG, MS, 39183-9270
Loan Status Date 2021-01-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 46700
Loan Approval Amount (current) 46700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39334
Servicing Lender Name Trustmark National Bank
Servicing Lender Address 248 E Capitol St, JACKSON, MS, 39201-2503
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address VICKSBURG, WARREN, MS, 39183-9270
Project Congressional District MS-02
Number of Employees 5
NAICS code 541990
Borrower Race Black or African American
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 39334
Originating Lender Name Trustmark National Bank
Originating Lender Address JACKSON, MS
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 47033.39
Forgiveness Paid Date 2020-12-31
9660078301 2021-01-31 0470 PPS 1426 Summer Seat Rd, Vicksburg, MS, 39183-9270
Loan Status Date 2022-02-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 29034
Loan Approval Amount (current) 29034
Undisbursed Amount 0
Franchise Name -
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Vicksburg, WARREN, MS, 39183-9270
Project Congressional District MS-02
Number of Employees 5
NAICS code 541990
Borrower Race Black or African American
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 39334
Originating Lender Name Trustmark National Bank
Originating Lender Address JACKSON, MS
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 29242.41
Forgiveness Paid Date 2021-11-01

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Date of last update: 26 Mar 2025

Sources: Mississippi Secretary of State

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