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BRIAN J. JACOBSEN, DMD, PC

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Company Details

Legal Name: BRIAN J. JACOBSEN, DMD, PC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL SERVICE CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: February 1st 2010
Expiration date: 28 Feb 2026
UBI Number: 602 989 873
ZIP code: 98823
City: Ephrata
County: GRANT
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 103 1ST AVE SW, EPHRATA, WA, 98823, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $19,087

Contact Details

E-Mail: DRBRIANJACOBSEN@GMAIL.COM
Phone Number: +1 509-754-3262

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
BRIAN JACOBSEN Registered Agent 103 1ST AVE SW, EPHRATA, WA, 98823-1842, UNITED STATES

Key Officers & Management

Name Role
LAURA JACOBSEN Governing Person
BRIAN JACOBSEN Governing Person

National Provider Identifier

NPI Number:
1942758180
Link:
View on NPI website

Authorized Person:

Name:
DR. BRIAN JAMES JACOBSEN
Role:
OWNER
Phone:
5097543262

Taxonomy:

Selected Taxonomy:
332BC3200X - Customized Equipment (DME)
Is Primary:
No
Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Phone:
+1 509-754-3262
Fax:
5097544975

Form 5500 Series

Employer Identification Number (EIN):
272095527
Plan Year:
2024
Number Of Participants:
11
Plan Name:
401(K)
Sponsor's telephone number:
5097543262
File:
View File
Plan Administrator / Signatory:
QIAN LIU(Plan administrator)
Plan Year:
2023
Number Of Participants:
9
Plan Name:
401(K)
Sponsor's telephone number:
5097543262
File:
View File
Plan Administrator / Signatory:
QIAN LIU(Plan administrator)
Plan Year:
2022
Number Of Participants:
8
Plan Name:
401(K)
Sponsor's telephone number:
5097543262
File:
View File
Plan Administrator / Signatory:
CHRISTINE RIMER(Plan administrator)
Plan Year:
2021
Number Of Participants:
8
Plan Name:
401(K)
Sponsor's telephone number:
5097543262
File:
View File
Plan Administrator / Signatory:
CHRISTINE RIMER(Plan administrator)
Plan Year:
2020
Number Of Participants:
7
Plan Name:
401(K)
Sponsor's telephone number:
5097543262
File:
View File
Plan Administrator / Signatory:
CAROL HO(Plan administrator)

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$87,693
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$87,693
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$88,615.58
Servicing Lender:
Umpqua Bank
Use of Proceeds:
Payroll: $87,693
Jobs Reported:
9
Initial Approval Amount:
$87,692
Date Approved:
2021-01-22
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$87,692
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$88,239.77
Servicing Lender:
Umpqua Bank
Use of Proceeds:
Payroll: $87,690
Utilities: $1
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