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  5. DAVID SHERBERG DMD PL

DAVID SHERBERG DMD PL

Company Details

Entity Name: DAVID SHERBERG DMD PL
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 19 Nov 2013 (11 years ago)
Document Number: L13000161950
FEI/EIN Number 46-4143573
Address: 5008 34th Street South, St. Petersburg, FL, 33711, US
Mail Address: 5008 34th St. South, St. Petersburg, FL, 33711, US
ZIP code: 33711
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2023 464143573 2024-08-20 DAVID SHERBERG DMD PL 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142707
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2024-08-20
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2023 464143573 2024-08-02 DAVID SHERBERG DMD PL 6
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142707
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2024-08-02
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2022 464143573 2023-07-24 DAVID SHERBERG DMD PL 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142707
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2021 464143573 2022-07-26 DAVID SHERBERG DMD PL 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142707
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2022-07-26
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2020 464143573 2021-07-22 DAVID SHERBERG DMD PL 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142705
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2019 464143573 2020-07-02 DAVID SHERBERG DMD PL 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142705
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2020-07-02
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2018 464143573 2019-07-23 DAVID SHERBERG DMD PL 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142705
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing STEVEN STOUT
Valid signature Filed with authorized/valid electronic signature
RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2017 464143573 2018-07-27 DAVID SHERBERG DMD PL 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142705
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 821222973
Plan administrator’s name HEALTHEQUITY RETIREMENT SERVICES, LLC
Plan administrator’s address 15 W SCENIC POINTE DR., STE 100, DRAPER, UT, 84020
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing SPENCER BARCLAY
Valid signature Filed with authorized/valid electronic signature
BENEFITGUARD RETIREMENT INCOME SECURITY PLAN-BAYWAY DENTAL 2016 464143573 2017-07-28 DAVID SHERBERG DMD PL 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 7279142705
Plan sponsor’s address 5008 34TH STREET S, ST. PETERSBURG, FL, 33711

Plan administrator’s name and address
Administrator’s EIN 205354793
Plan administrator’s name BENEFITGUARD, LLC
Plan administrator’s address 877 EAST 1200 SOUTH, #1272, OREM, UT, 84097
Administrator’s telephone number 8778602664

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing SPENCER BARCLAY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHERBERG DAVID Agent 5008 34th Street South, St. Petersburg, FL, 33711

Manager

Name Role Address
SHERBERG DAVID Manager 5008 34th Street South, St Petersburg, FL, 33711

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000117115 PATIENT CHOICE FINANCIAL EXPIRED 2017-10-24 2022-12-31 No data 5008 34TH ST S., SAINT PETERSBURG, FL, 33711
G14000076504 BAYWAY DENTAL ACTIVE 2014-07-24 2029-12-31 No data 5008 34TH STREET SOUTH, ST PETERSBURG, FL, 33711

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2022-04-25 5008 34th Street South, St. Petersburg, FL 33711 No data
CHANGE OF PRINCIPAL ADDRESS 2021-02-02 5008 34th Street South, St. Petersburg, FL 33711 No data
CHANGE OF MAILING ADDRESS 2015-02-13 5008 34th Street South, St. Petersburg, FL 33711 No data

Documents

Name Date
ANNUAL REPORT 2024-03-25
ANNUAL REPORT 2023-03-08
ANNUAL REPORT 2022-04-25
ANNUAL REPORT 2021-02-02
ANNUAL REPORT 2020-04-07
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-01-24
ANNUAL REPORT 2016-03-08
ANNUAL REPORT 2015-02-13

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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