0001819319-20-000009.txt : 20201217 0001819319-20-000009.hdr.sgml : 20201217 20201217112657 ACCESSION NUMBER: 0001819319-20-000009 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20201217 DATE AS OF CHANGE: 20201217 EFFECTIVENESS DATE: 20201217 FILER: COMPANY DATA: COMPANY CONFORMED NAME: IMAGEN DENTAL PARTNERS, LLC CENTRAL INDEX KEY: 0001819319 IRS NUMBER: 845189859 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-383518 FILM NUMBER: 201394680 BUSINESS ADDRESS: STREET 1: 6320 EAST THOMAS ROAD, SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 BUSINESS PHONE: 480-590-5701 MAIL ADDRESS: STREET 1: 6320 EAST THOMAS ROAD, SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen Smilemore Dental Support Services, LLC CENTRAL INDEX KEY: 0001833985 IRS NUMBER: 853886144 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-383518-01 FILM NUMBER: 201394681 BUSINESS ADDRESS: STREET 1: 6320 EAST THOMAS ROAD STREET 2: SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 BUSINESS PHONE: 480-590-5701 MAIL ADDRESS: STREET 1: 6320 EAST THOMAS ROAD STREET 2: SUITE 100 CITY: SCOTTSDALE STATE: AZ ZIP: 85251 D 1 primary_doc.xml X0708 D LIVE 0001819319 IMAGEN DENTAL PARTNERS, LLC 6320 EAST THOMAS ROAD, SUITE 100 SCOTTSDALE AZ ARIZONA 85251 480-590-5701 DELAWARE None None Limited Liability Company true 2020 0001833985 Imagen Smilemore Dental Support Services, LLC 6320 EAST THOMAS ROAD SUITE 100 SCOTTSDALE AZ ARIZONA 85251 480-590-5701 DELAWARE None None Limited Liability Company true 2020 Rezwan Manji 6320 East Thomas Road, Suite 100 Scottsdale AZ ARIZONA 85251 Executive Officer Michael Augins 6320 East Thomas Road, Suite 100 Scottsdale AZ ARIZONA 85251 Executive Officer Mike Augins is an executive officer of Imagen Dental Partners, LLC and Imagen Smilemore Dental Support Services, LLC Other Health Care Decline to Disclose 06b false true false true true 0 643000 0 643000 false 0 0 0 0 true IMAGEN DENTAL PARTNERS, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2020-12-17