0001867561-22-000001.txt : 20220325 0001867561-22-000001.hdr.sgml : 20220325 20220325101820 ACCESSION NUMBER: 0001867561-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220325 DATE AS OF CHANGE: 20220325 EFFECTIVENESS DATE: 20220325 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen Meadowbrook Smiles Support Services, LLC CENTRAL INDEX KEY: 0001867561 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-438942 FILM NUMBER: 22768695 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 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: 021-438942-01 FILM NUMBER: 22768696 BUSINESS ADDRESS: STREET 1: 16220 N. SCOTTSDALE ROAD, SUITE 300 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 BUSINESS PHONE: 480-590-5701 MAIL ADDRESS: STREET 1: 16220 N. SCOTTSDALE ROAD, SUITE 300 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 D 1 primary_doc.xml X0708 D LIVE 0001867561 Imagen Meadowbrook Smiles Support Services, LLC 16220 N. SCOTTSDALE ROAD, SUITE 300 SCOTTSDALE AZ ARIZONA 85254 480-590-5701 DELAWARE None None Limited Liability Company true 2022 0001819319 IMAGEN DENTAL PARTNERS, LLC 16220 N. SCOTTSDALE ROAD, SUITE 300 SCOTTSDALE AZ ARIZONA 85254 480-590-5701 DELAWARE None None Limited Liability Company true 2020 Rezwan Manji 16220 North Scottsdale Road Suite 300 Scottsdale AZ ARIZONA 85254 Executive Officer Michael Augins 16220 N. Scottsdale Road, Suite 300 Scottsdale AZ ARIZONA 85254 Executive Officer Michael Augins is an executive officer of Imagen Dental Partners, LLC and Imagen Meadowbrook Smiles Support Services, LLC Other Health Care Decline to Disclose 06b false 2022-03-24 true true true 0 1500000 1500000 0 false 1 0 0 0 true Imagen Meadowbrook Smiles Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2022-03-22