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  5. JACK W. BEHN, D.D.S., P.A.

JACK W. BEHN, D.D.S., P.A.

Company Details

Entity Name: JACK W. BEHN, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 16 Aug 1982 (42 years ago)
Document Number: F96113
FEI/EIN Number 592211352
Address: 131 NW 100TH AVE, PLANTATION, FL, 33324, US
Mail Address: % JACK W. BEHN, 8200 W. SUNRISE BLVD STE A-1, PLANTATION, FL, 33322, US
ZIP code: 33324
County: Broward
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACK W. BEHN, D.D.S., P.A. RETIREMENT PLAN & TRUS 2014 592211352 2015-09-01 JACK W. BEHN, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 9543181966
Plan sponsor’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322

Signature of
Role Plan administrator
Date 2015-09-01
Name of individual signing JACK W. BEHN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
JACK W. BEHN, D. D. S. , P. A. RETIREMENT PLAN & TRUST 2014 592211352 2015-12-29 JACK W. BEHN, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 9543181966
Plan sponsor’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322

Signature of
Role Plan administrator
Date 2015-12-29
Name of individual signing JACK W. BEHN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
JACK W. BEHN, D.D.S., P.A. RETIREMENT PLAN & TRUS 2013 592211352 2014-08-27 JACK W. BEHN, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 9543181966
Plan sponsor’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322

Signature of
Role Plan administrator
Date 2014-08-27
Name of individual signing JACK W. BEHN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
JACK W. BEHN, D.D.S., P.A. RETIREMENT PLAN & TRUS 2012 592211352 2013-03-01 JACK W. BEHN, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 9543181966
Plan sponsor’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322

Signature of
Role Plan administrator
Date 2013-03-01
Name of individual signing JACK W. BEHN, D.D.S.
Valid signature Filed with authorized/valid electronic signature
JACK W. BEHN, D.D.S., P.A. RETIREMENT PLAN & TRUS 2011 592211352 2012-05-08 JACK W. BEHN, D.D.S., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-01-01
Business code 621210
Sponsor’s telephone number 9543181966
Plan sponsor’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322

Plan administrator’s name and address
Administrator’s EIN 592211352
Plan administrator’s name JACK W. BEHN, D.D.S., P.A.
Plan administrator’s address 8200 WEST SUNRISE BLVD, PLANTATION, FL, 33322
Administrator’s telephone number 9543181966

Signature of
Role Plan administrator
Date 2012-05-08
Name of individual signing JACK W. BEHN, D.D.S.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BEHN, JACK W Agent 8200 W. SUNRISE BLVD, PLANTATION, FL, 33322

President

Name Role Address
BEHN, JACK W President 8200 W. SUNRISE BLVD, PLANTATION, FL

Director

Name Role Address
BEHN, JACK W Director 8200 W. SUNRISE BLVD, PLANTATION, FL

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2016-12-16 No data No data

Related by officers

No related officers

Related by address

131 NW 100TH AVE, PLANTATION, FL, 33324, US

SANTIAGOLOPEZC DMD PA LOPEZBORGENICHT INVESTMENTS, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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