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  5. LARISSA O. NAVARRO D.D.S., P.C.

LARISSA O. NAVARRO D.D.S., P.C.

Company Details

Entity Name: LARISSA O. NAVARRO D.D.S., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 06 Oct 2006
Company Number: CORP_65194171
File Number: 65194171
Type of Business: Incorporated under the Professional Service Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2013 363661605 2014-11-07 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6303696222
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Signature of
Role Plan administrator
Date 2014-11-07
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-11-07
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2013 363661605 2014-10-08 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6309043998
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2012 363661605 2013-09-13 PEBBLEWOOD DENTAL 4
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6303696222
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-13
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2012 363661605 2013-09-13 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6303696222
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-13
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2011 363661605 2012-10-03 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6303696222
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363661605
Plan administrator’s name PEBBLEWOOD DENTAL
Plan administrator’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563
Administrator’s telephone number 6303696222

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-03
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2010 363661605 2011-10-07 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6309043998
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363661605
Plan administrator’s name PEBBLEWOOD DENTAL
Plan administrator’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563
Administrator’s telephone number 6309043998

Signature of
Role Plan administrator
Date 2011-10-07
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-07
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
PEBBLEWOOD DENTAL DEFINED BENEFIT PENSION PLAN 2009 363661605 2010-09-24 PEBBLEWOOD DENTAL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621210
Sponsor’s telephone number 6309043998
Plan sponsor’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363661605
Plan administrator’s name PEBBLEWOOD DENTAL
Plan administrator’s address 1550 N. ROUTE 59, NAPERVILLE, IL, 60563
Administrator’s telephone number 6309043998

Signature of
Role Plan administrator
Date 2010-09-24
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-24
Name of individual signing PHILLIP MACH
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JOSEPH A. LAZARA, 7246 W TOUHY AVE, CHICAGO, 60631, COOK-NOT IN CITY OF CHICAGO Agent 2006-10-06

President

Name and Address Role
LARISSA O NAVARRO, 1550 NORTHROUTE 59 STE 148 NAPERVILLE IL President

Secretary

Name and Address Role
60563 Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
PEBBLEWOOD DENTAL Assume Name 2014-04-21 No data No data No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 1000000 No data

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Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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