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  5. Nicolas A. Belk, DMD, PC

Nicolas A. Belk, DMD, PC

Company Details

Name: Nicolas A. Belk, DMD, PC
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 21 Oct 2009 (15 years ago)
Business ID: 956782
ZIP code: 39601
County: Lincoln
State of Incorporation: MISSISSIPPI
Principal Office Address: 321 West Cherokee StreetBrookhaven, MS 39601

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BELK DITCHARO DENTAL 401(K) PLAN 2023 271112181 2024-04-01 NICOLAS A. BELK DMD PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2024-04-01
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-01
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2022 271112181 2023-03-28 NICOLAS A. BELK DMD PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2023-03-28
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-28
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2021 271112181 2022-05-24 NICOLAS A. BELK DMD PC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2022-05-24
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-24
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2020 271112181 2021-04-06 NICOLAS A. BELK DMD PC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2021-04-06
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-06
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2019 271112181 2020-04-01 NICOLAS A. BELK DMD PC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2020-04-01
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-01
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2018 271112181 2019-03-08 NICOLAS A. BELK DMD PC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2019-03-08
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-08
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2017 271112181 2018-05-15 NICOLAS A. BELK DMD PC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2018-05-15
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-15
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2016 271112181 2017-09-26 NICOLAS A. BELK DMD PC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2017-09-26
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-26
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2015 271112181 2016-05-19 NICOLAS A. BELK DMD PC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2016-05-19
Name of individual signing NIC BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-19
Name of individual signing NIC BELK
Valid signature Filed with authorized/valid electronic signature
BELK DITCHARO DENTAL 401(K) PLAN 2014 271112181 2015-04-23 NICOLAS A. BELK DMD PC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2015-04-23
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-23
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/03/13/20140313155554P040253319171001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2014-03-13
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-13
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/03/29/20130329132503P030050832165001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Signature of
Role Plan administrator
Date 2013-03-29
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-29
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/13/20121013170116P040001647430001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Plan administrator’s name and address
Administrator’s EIN 271112181
Plan administrator’s name NICOLAS A. BELK DMD PC
Plan administrator’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601
Administrator’s telephone number 6018350353

Signature of
Role Plan administrator
Date 2012-10-13
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-13
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/12/06/20111206161102P030000516419001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Plan administrator’s name and address
Administrator’s EIN 271112181
Plan administrator’s name NICOLAS A. BELK DMD PC
Plan administrator’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601
Administrator’s telephone number 6018350353

Signature of
Role Plan administrator
Date 2011-12-06
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-12-06
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Plan administrator’s name and address
Administrator’s EIN 271112181
Plan administrator’s name NICOLAS A. BELK DMD PC
Plan administrator’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601
Administrator’s telephone number 6018350353

Signature of
Role Plan administrator
Date 2011-10-11
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-11
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/20/20100720132859P070056735457001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1998-05-15
Business code 621210
Sponsor’s telephone number 6018350353
Plan sponsor’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601

Plan administrator’s name and address
Administrator’s EIN 271112181
Plan administrator’s name NICOLAS A. BELK DMD PC
Plan administrator’s address 321 WEST CHEROKEE STREET, BROOKHAVEN, MS, 39601
Administrator’s telephone number 6018350353

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-20
Name of individual signing NICOLAS BELK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Belk, Nicolas A. Agent 321 West Cherokee Street, Brookhaven, MS 39601

Incorporator

Name Role Address
Nicolas A. Belk Incorporator 321 West Cherokee Street, Brookhaven, MS 39601

President

Name Role Address
Nicolas A. Belk President 321 West Cherokee Street, Brookhaven, MS 39601

Director

Name Role Address
Nicolas A. Belk Director 321 West Cherokee Street, Brookhaven, MS 39601

Filings

Type Status Filed Date Description
Annual Report Filed 2024-02-26 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2023-02-14 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2022-03-11 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2021-03-14 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2020-03-18 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2019-09-04 Annual Report For Nicolas A. Belk, DMD, PC
Notice to Dissolve/Revoke Filed 2019-08-22 Notice to Dissolve/Revoke
Annual Report Filed 2018-03-29 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2017-03-22 Annual Report For Nicolas A. Belk, DMD, PC
Annual Report Filed 2016-02-18 Annual Report For Nicolas A. Belk, DMD, PC

Related by officers

Belk, Nicolas A.

Belk Holdings, LLC

Related by address

321 West Cherokee StreetBrookhaven, MS 39601

Belk Holdings, LLC

Date of last update: 04 Jan 2025

Sources: Mississippi Secretary of State

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