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  5. COLORADO DENTAL ASSOCIATION

COLORADO DENTAL ASSOCIATION

Company Details

Name: COLORADO DENTAL ASSOCIATION
Jurisdiction: Colorado
Legal type: Domestic nonprofit corporation
Status: Good Standing
Date of registration: 03 Mar 1908 (117 years ago)
Entity Number: 19871156846
ZIP code: 80111
County: Arapahoe County
Place of Formation: COLORADO
Principal Address: 8301 E Prentice Ave Ste 400 Greenwood Village CO 80111 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2023 846031478 2024-10-08 COLORADO DENTAL ASSOCIATION 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2022 846031478 2024-10-22 COLORADO DENTAL ASSOCIATION 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-10-22
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2021 846031478 2022-10-05 COLORADO DENTAL ASSOCIATION 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-10-05
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2020 846031478 2021-10-11 COLORADO DENTAL ASSOCIATION 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2020 846031478 2021-09-24 COLORADO DENTAL ASSOCIATION 11
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-09-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PENSION PLAN 2020 846031478 2021-06-18 COLORADO DENTAL ASSOCIATION 13
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE STE 400, GREENWOOD VILLAGE, CO, 801112906

Signature of
Role Plan administrator
Date 2021-06-18
Name of individual signing PAM BROCKHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-18
Name of individual signing PAM BROCKHAUS
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2019 846031478 2021-01-05 COLORADO DENTAL ASSOCIATION 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-01-05
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOCIATION PROFIT SHARING PLAN 2018 846031478 2019-10-30 COLORADO DENTAL ASSOCIATION 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE., SUITE 400, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2019-10-30
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
COLORADO DENTAL ASSOICATION PENSION PLAN 2018 846031478 2019-04-08 COLORADO DENTAL ASSOCIATION 16
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVE STE 400, GREENWOOD VILLAGE, CO, 801112906
COLORADO DENTAL ASSOCIATION PENSION PLAN 2017 846031478 2018-12-10 COLORADO DENTAL ASSOCIATION 12
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1998-07-01
Business code 621210
Sponsor’s telephone number 3037406900
Plan sponsor’s address 8301 E PRENTICE AVENUE,, SUITE 400, GREENWOOD VILLAGE, CO, 80111

Signature of
Role Plan administrator
Date 2018-12-10
Name of individual signing PAM BROCKHAUS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Pam Brockhaus Agent 8301 E Prentice Ave Ste 400 Greenwood Village CO 80111 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241206008 File Report 2024-02-23 2024-02-23 No data Principal address changed, Change in registered agent information
20231202889 File Report 2023-02-23 2023-02-23 No data Principal address changed, Change in registered agent information
20221221425 File Report 2022-02-28 2022-02-28 No data No data
20211480984 File Report 2021-05-24 2021-05-24 No data No data
20201168764 File Report 2020-02-24 2020-02-24 No data No data
20191443766 File Report 2019-05-28 2019-05-28 No data No data
20181162471 File Report 2018-02-26 2018-02-26 No data No data
20171138274 File Report 2017-02-23 2017-02-23 No data No data
20161160018 File Report 2016-03-01 2016-03-01 No data No data
20151133086 File Report 2015-02-24 2015-02-24 No data No data

Related by officers

Pam Brockhaus

THE DENTAL LIMITED LIABILITY COMPANY COLORADO DENTAL ASSOCIATION FOUNDATION, INC. CDA, LLC Colorado Dental Supply Company, Inc.

Related by address

8301 E Prentice Ave Ste 400 Greenwood Village CO 80111 US

CDA ENTERPRISES, INC. COLORADO DENTAL ASSOCIATION FOUNDATION, INC. CDA, LLC Colorado Dental Supply Company, Inc.

Date of last update: 27 Jan 2025

Sources: Colorado's Secretary of State

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