0001930060-22-000001.txt : 20220715 0001930060-22-000001.hdr.sgml : 20220715 20220714174213 ACCESSION NUMBER: 0001930060-22-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220715 DATE AS OF CHANGE: 20220714 EFFECTIVENESS DATE: 20220715 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen East Towne Dental Support Services, LLC CENTRAL INDEX KEY: 0001930060 IRS NUMBER: 872791999 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-452493 FILM NUMBER: 221083718 BUSINESS ADDRESS: STREET 1: 16220 NORTH SCOTTSDALE ROAD STREET 2: SUITE 300 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 BUSINESS PHONE: 480-590-5701 MAIL ADDRESS: STREET 1: 16220 NORTH SCOTTSDALE ROAD STREET 2: SUITE 300 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 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: 021-452493-01 FILM NUMBER: 221083719 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 0001930060 Imagen East Towne Dental Support Services, LLC 16220 NORTH 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 N. Scottsdale Rd. Suite 300 Scottsdale AZ ARIZONA 85254 Executive Officer Michael Augins 16220 N. Scottsdale Rd. Suite 300 Scottsdale AZ ARIZONA 85254 Executive Officer Michael Augins is an executive officer of Imagen Dental Partners, LLC and Imagen East Towne Dental Support Services, LLC Other Health Care Decline to Disclose 06b false 2022-06-30 true true true 0 1291000 1066000 225000 false 1 0 0 0 true Imagen East Towne Dental Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2022-06-30