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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 2025-03-01 Annual Report For Madison Dental Group, PLLC
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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1959938308 2021-01-20 0470 PPS 7731 Old Canton Rd Ste A, Madison, MS, 39110-6115
Loan Status Date 2021-09-25
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 118600
Loan Approval Amount (current) 118600
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39535
Servicing Lender Name BankFirst Financial Services
Servicing Lender Address 900 Main St, COLUMBUS, MS, 39701-4721
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Madison, MADISON, MS, 39110-6115
Project Congressional District MS-03
Number of Employees 10
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 39535
Originating Lender Name BankFirst Financial Services
Originating Lender Address COLUMBUS, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 119328.07
Forgiveness Paid Date 2021-08-31
7973297205 2020-04-28 0470 PPP 7731 OLD CANTON RD, MADISON, MS, 39110-6114
Loan Status Date 2020-11-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 95900
Loan Approval Amount (current) 95900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39535
Servicing Lender Name BankFirst Financial Services
Servicing Lender Address 900 Main St, COLUMBUS, MS, 39701-4721
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address MADISON, MADISON, MS, 39110-6114
Project Congressional District MS-03
Number of Employees 9
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 39535
Originating Lender Name BankFirst Financial Services
Originating Lender Address COLUMBUS, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 96376.84
Forgiveness Paid Date 2020-11-02

Related by officers

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Related by address

No related companies by address

Date of last update: 26 Mar 2025

Sources: Mississippi Secretary of State

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