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  5. Dermatology Specialists of Boulder PC

Dermatology Specialists of Boulder PC

Company Details

Name: Dermatology Specialists of Boulder PC
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 15 Feb 2007 (18 years ago)
Entity Number: 20071064569
ZIP code: 80027
County: Boulder County
Place of Formation: COLORADO
Principal Address: 1056 S 88th Street Louisville CO 80027 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2018 208455320 2019-09-30 DERMATOLOGY SPECIALISTS OF BOULDER 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2019-09-30
Name of individual signing SHAWN ALLEN
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2017 208455320 2018-10-02 DERMATOLOGY SPECIALISTS OF BOULDER 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing SHAWN ALLEN
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2016 208455320 2017-09-08 DERMATOLOGY SPECIALISTS OF BOULDER 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2017-09-08
Name of individual signing SHAWN ALLEN
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2015 208455320 2016-10-03 DERMATOLOGY SPECIALISTS OF BOULDER 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing SUZANNE CARLSON
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2014 208455320 2015-10-13 DERMATOLOGY SPECIALISTS OF BOULDER 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing SUZI CARLSON
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2013 208455320 2014-05-15 DERMATOLOGY SPECIALISTS OF BOULDER 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2014-05-15
Name of individual signing SHAWN ALLEN
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2012 208455320 2013-05-14 DERMATOLOGY SPECIALISTS OF BOULDER 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034422696
Plan sponsor’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 2880 FOLSOM ST, #200, BOULDER, CO, 80304
Administrator’s telephone number 3034422696

Signature of
Role Plan administrator
Date 2013-05-14
Name of individual signing ANGIE OCONNELL
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2011 208455320 2012-04-13 DERMATOLOGY SPECIALISTS OF BOULDER 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 4840 RIVERBEND ROAD, SUITE 100, BOULDER, CO, 80301

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 4840 RIVERBEND ROAD, SUITE 100, BOULDER, CO, 80301
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2012-04-13
Name of individual signing TONYA CLEMENT
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY SPECIALISTS OF BOULDER 401(K) P/S PLAN 2010 208455320 2011-04-06 DERMATOLOGY SPECIALISTS OF BOULDER 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3034426647
Plan sponsor’s address 4840 RIVERBEND ROAD, SUITE 100, BOULDER, CO, 80301

Plan administrator’s name and address
Administrator’s EIN 208455320
Plan administrator’s name DERMATOLOGY SPECIALISTS OF BOULDER
Plan administrator’s address 4840 RIVERBEND ROAD, SUITE 100, BOULDER, CO, 80301
Administrator’s telephone number 3034426647

Signature of
Role Plan administrator
Date 2011-04-06
Name of individual signing SHAWN ALLEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Mia Jasper Agent 1056 S 88th Street Louisville CO 80027 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241131454 File Report 2024-01-30 2024-01-30 No data No data
20231128277 File Report 2023-01-31 2023-01-31 No data Change in registered agent information
20221074914 File Report 2022-01-24 2022-01-24 No data No data
20211098873 File Report 2021-01-28 2021-01-28 No data No data
20201104636 File Report 2020-01-31 2020-01-31 No data Change of Registered Agent
20191059391 File Report 2019-01-23 2019-01-23 No data Change of Registered Agent Address / Change of Entity Address
20181306277 File Report 2018-04-13 2018-04-13 No data No data
20181028761 Statement of Change Changing the Registered Agent Information 2018-01-10 2018-01-10 No data Registered agent information changed;
20171064926 File Report 2017-01-24 2017-01-24 No data No data
20161112089 File Report 2016-02-17 2016-02-17 No data Change of Registered Agent

Related by officers

No related officers

Related by address

1056 S 88th Street Louisville CO 80027 US

710 Copper LLC 88th Street Louisville LLC Flatirons Holdings LLC 770 Eisenhower LLC 2439 Norwood LLC

Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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