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MOUNTAIN WEST DERMATOLOGY, P.C.

Company Details

Name: MOUNTAIN WEST DERMATOLOGY, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 29 Jun 1971 (54 years ago)
Entity Number: 19871316386
ZIP code: 81501
County: Mesa County
Place of Formation: COLORADO
Principal Address: 2655 Little Bookcliff Dr Grand Junction CO 81501 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2023 840611546 2024-05-09 MOUNTAIN WEST DERMATOLOGY, P.C. 47
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2024-05-09
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2022 840611546 2023-06-29 MOUNTAIN WEST DERMATOLOGY, P.C. 40
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2023-06-29
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-29
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2021 840611546 2022-07-22 MOUNTAIN WEST DERMATOLOGY, P.C. 37
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2022-07-22
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-22
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2020 840611546 2021-06-09 MOUNTAIN WEST DERMATOLOGY, P.C. 40
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2021-06-09
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-09
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2019 840611546 2020-05-05 MOUNTAIN WEST DERMATOLOGY, P.C. 39
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2020-05-05
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-05
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2018 840611546 2019-06-03 MOUNTAIN WEST DERMATOLOGY, P.C. 36
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2019-06-03
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2017 840611546 2018-05-23 MOUNTAIN WEST DERMATOLOGY, P.C. 34
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2018-05-23
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-23
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2016 840611546 2017-05-15 MOUNTAIN WEST DERMATOLOGY, P.C. 30
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2017-05-15
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-15
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN WEST DERMATOLOGY, PC SAFE HARBOR 401(K) PROFIT SHARING PLAN 2015 840611546 2016-05-05 MOUNTAIN WEST DERMATOLOGY, P.C. 30
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2001-01-01
Business code 621399
Sponsor’s telephone number 9702455280
Plan sponsor’s address 2655 LITTLE BOOKCLIFF DRIVE, GRAND JUNCTION, CO, 81501

Signature of

Role Plan administrator
Date 2016-05-05
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-05
Name of individual signing LEWIS KIRKEGAARD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Tony J Colaizzi Agent 2655 Little Bookcliff Dr Grand Junction CO 81501 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241594435 File Report 2024-05-30 2024-05-30 No data Principal address changed, Change in registered agent information
20231570234 File Report 2023-05-25 2023-05-25 No data Principal address changed, Change in registered agent information
20221530499 File Report 2022-05-25 2022-05-25 No data Removed agent mailing address;Change of Registered Agent
20211510189 File Report 2021-05-28 2021-05-28 No data No data
20201474848 File Report 2020-05-29 2020-05-29 No data No data
20191431893 File Report 2019-05-24 2019-05-24 No data No data
20181408625 File Report 2018-05-23 2018-05-23 No data No data
20171411265 File Report 2017-05-30 2017-05-30 No data No data
20161362495 File Report 2016-05-24 2016-05-24 No data No data
20151357021 File Report 2015-05-28 2015-05-28 No data No data

Date of last update: 20 Jan 2025

Sources: Colorado's Secretary of State