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  5. Madison Dental Group, PLLC

Madison Dental Group, PLLC

Company Details

Name: Madison Dental Group, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 24 Feb 2004 (21 years ago)
Business ID: 851824
ZIP code: 39110
County: Madison
State of Incorporation: MISSISSIPPI
Principal Office Address: 7731 Old Canton Road, Suite AMADISON, MS 39110
Historical names: Cole Fortenberry, DMD, PLLC

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MADISON DENTAL GROUP, PLLC 401(K) PROFIT SHARING PLAN 2023 901113089 2024-07-15 MADISON DENTAL GROUP, PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 7731 OLD CANTON RD, SUITE A, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2024-07-15
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, PLLC 401(K) PROFIT SHARING PLAN 2022 901113089 2023-07-13 MADISON DENTAL GROUP, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 7731 OLD CANTON RD, SUITE A, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2023-07-13
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2021 901113089 2022-07-07 MADISON DENTAL GROUP, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2022-07-07
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2020 901113089 2021-07-12 MADISON DENTAL GROUP, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2021-07-12
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2019 901113089 2020-07-13 MADISON DENTAL GROUP, PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2020-07-13
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2018 901113089 2019-07-31 MADISON DENTAL GROUP, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2019-07-31
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2017 901113089 2018-07-25 MADISON DENTAL GROUP, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2018-07-25
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
MADISON DENTAL GROUP, P.L.L.C. 401(K) PROFIT SHARING PLAN 2016 901113089 2017-10-10 MADISON DENTAL GROUP, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address 15 BEAUVOIR PLACE, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
COLE FORTENBERRY, D.M.D., P.L.L.C. 401(K) PROFIT SHARING PLAN 2015 640794475 2016-07-28 COLE FORTENBERRY, DMD, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
COLE FORTENBERRY, D.M.D., P.L.L.C. 401(K) PROFIT SHARING PLAN 2014 640794475 2015-08-26 COLE FORTENBERRY, DMD, PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Signature of
Role Plan administrator
Date 2015-08-26
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/12/20140712113304P030010584431001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Signature of
Role Plan administrator
Date 2014-07-12
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/20/20130620173218P040093714517001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/16/20120516185752P030000550151001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Plan administrator’s name and address
Administrator’s EIN 640794475
Plan administrator’s name COLE FORTENBERRY, DMD, PLLC
Plan administrator’s address P.O. BOX 1547, MADISON, MS, 391301547
Administrator’s telephone number 6018533565

Signature of
Role Plan administrator
Date 2012-05-16
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/06/03/20110603192657P040010504850001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Plan administrator’s name and address
Administrator’s EIN 640794475
Plan administrator’s name COLE FORTENBERRY, DMD, PLLC
Plan administrator’s address P.O. BOX 1547, MADISON, MS, 391301547
Administrator’s telephone number 6018533565

Signature of
Role Plan administrator
Date 2011-06-03
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/18/20100718145433P030129512882001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Plan administrator’s name and address
Administrator’s EIN 640794475
Plan administrator’s name COLE FORTENBERRY, DMD, PLLC
Plan administrator’s address P.O. BOX 1547, MADISON, MS, 391301547
Administrator’s telephone number 6018533565

Signature of
Role Plan administrator
Date 2010-06-28
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-28
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621210
Sponsor’s telephone number 6018533565
Plan sponsor’s address P.O. BOX 1547, MADISON, MS, 391301547

Plan administrator’s name and address
Administrator’s EIN 640794475
Plan administrator’s name COLE FORTENBERRY, DMD, PLLC
Plan administrator’s address P.O. BOX 1547, MADISON, MS, 391301547
Administrator’s telephone number 6018533565

Signature of
Role Plan administrator
Date 2010-06-28
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-28
Name of individual signing COLE FORTENBERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Fortenberry, William Coleman Agent 7731 Old Canton Road, Suite A, Madison, MS 39110

Member

Name Role Address
William C Fortenberry Member 7731 Old Canton Road, Suite A, MADISON, MS 39110

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-03-22 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2023-03-09 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2022-03-21 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2021-03-05 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2020-02-20 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2019-03-18 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2018-03-01 Annual Report For Madison Dental Group, PLLC
Annual Report LLC Filed 2017-02-10 Annual Report For Madison Dental Group, PLLC
Amendment Form Filed 2016-04-12 Amendment For Cole Fortenberry, DMD, PLLC
Annual Report LLC Filed 2016-01-28 Annual Report For Cole Fortenberry, DMD, PLLC

Related by officers

William C Fortenberry

WCF Marketing, Inc.

Related by address

No related companies by address

Date of last update: 08 Jan 2025

Sources: Mississippi Secretary of State

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