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GADDIS FAMILY DENTISTRY, PC

Company Details

Name: GADDIS FAMILY DENTISTRY, PC
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 10 Sep 2003 (21 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
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
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/2012/02/05/20120205162107P030009924103001.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

Date of last update: 07 Jan 2025

Sources: Mississippi Secretary of State