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  5. BEAN SPROUT, INC.

BEAN SPROUT, INC. - Florida Company Profile

Company Details

Entity Name: BEAN SPROUT, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

BEAN SPROUT, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 03 Oct 2012 (13 years ago)
Document Number: P12000083880
FEI/EIN Number 800855560

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 2008 Riverside Avenue, Suite 1, JACKSONVILLE, FL, 32204, US
Mail Address: 5045 TOPROYAL LANE, JACKSONVILLE, FL, 32277, US
ZIP code: 32204
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1942698204 2015-01-08 2015-01-08 2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL, 322044443, US 2008 RIVERSIDE AVE, SUITE 101, JACKSONVILLE, FL, 322044443, US

Contacts
Phone +1 904-372-3260
Fax 9043853704

Authorized person
Name DR. JODI MASON
Role PEDIATRIC DENTIST
Phone 9043723260

Taxonomy
Taxonomy Code 261QD0000X - Dental Clinic/Center
License Number 17658
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BEAN SPROUT 401(K) PLAN 2023 800855560 2024-05-02 BEAN SPROUT, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-02
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2022 800855560 2023-05-26 BEAN SPROUT, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-26
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2021 800855560 2022-05-19 BEAN SPROUT, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-05-19
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2020 800855560 2021-04-27 BEAN SPROUT, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-04-27
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2019 800855560 2020-07-01 BEAN SPROUT, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2018 800855560 2019-07-17 BEAN SPROUT, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2019-07-17
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
BEAN SPROUT 401(K) PLAN 2017 800855560 2018-07-25 BEAN SPROUT, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 9043723260
Plan sponsor’s address 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2018-07-25
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
MASON JODI D President 2008 Riverside Avenue, JACKSONVILLE, FL, 32204
Mason Arlo Treasurer 2008 Riverside Avenue, JACKSONVILLE, FL, 32204
Farah Law Agent 6550 St. Augustine Road, JACKSONVILLE, FL, 32217

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000062508 BEAN TREE PEDIATRIC DENTISTRY ACTIVE 2023-05-18 2028-12-31 - 2008 RIVERSIDE AVENUE, SUITE 101, JACKSONVILLE, FL, 32204
G12000101797 BEAN TREE PEDIATRIC DENTISTRY EXPIRED 2012-10-18 2017-12-31 - 5045 TOPROYAL LANE, JACKSONVILLE, FL, 32277

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-03-17 Farah Law -
REGISTERED AGENT ADDRESS CHANGED 2014-02-03 6550 St. Augustine Road, Suite 103, JACKSONVILLE, FL 32217 -
CHANGE OF PRINCIPAL ADDRESS 2013-03-25 2008 Riverside Avenue, Suite 1, JACKSONVILLE, FL 32204 -

Documents

Name Date
ANNUAL REPORT 2025-02-18
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-03-10
ANNUAL REPORT 2021-02-23
ANNUAL REPORT 2020-03-17
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-03-20
ANNUAL REPORT 2017-04-10
ANNUAL REPORT 2016-04-23

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1416927204 2020-04-15 0491 PPP 2008 RIVERSIDE AVE, JACKSONVILLE, FL, 32204-4439
Loan Status Date 2021-06-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 49200
Loan Approval Amount (current) 49200
Undisbursed Amount 0
Franchise Name -
Lender Location ID 44449
Servicing Lender Name PNC Bank, National Association
Servicing Lender Address 222 Delaware Ave, WILMINGTON, DE, 19801-1621
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address JACKSONVILLE, DUVAL, FL, 32204-4439
Project Congressional District FL-04
Number of Employees 4
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Subchapter S Corporation
Originating Lender ID 44449
Originating Lender Name PNC Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Female Owned
Veteran Unanswered
Forgiveness Amount 49745.3
Forgiveness Paid Date 2021-05-26
5294168501 2021-02-27 0491 PPS 2008 Riverside Ave 2008 Riverside Ave, Jacksonville, FL, 32204-4443
Loan Status Date 2021-11-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 42346
Loan Approval Amount (current) 42346
Undisbursed Amount 0
Franchise Name -
Lender Location ID 44449
Servicing Lender Name PNC Bank, National Association
Servicing Lender Address 222 Delaware Ave, WILMINGTON, DE, 19801-1621
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Jacksonville, DUVAL, FL, 32204-4443
Project Congressional District FL-04
Number of Employees 4
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Subchapter S Corporation
Originating Lender ID 44449
Originating Lender Name PNC Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Female Owned
Veteran Unanswered
Forgiveness Amount 42594.19
Forgiveness Paid Date 2021-10-06

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Companies related by address

No other companies in our directory share the same address as BEAN SPROUT, INC.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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