0001964435-23-000001.txt : 20230206 0001964435-23-000001.hdr.sgml : 20230206 20230206145845 ACCESSION NUMBER: 0001964435-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20230206 DATE AS OF CHANGE: 20230206 EFFECTIVENESS DATE: 20230206 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen Skiffey Family Dentistry Support Services, LLC CENTRAL INDEX KEY: 0001964435 IRS NUMBER: 921498621 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-472721 FILM NUMBER: 23590238 BUSINESS ADDRESS: STREET 1: 16220 NORTH SCOTTSDALE ROAD STREET 2: SUITE 300 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 BUSINESS PHONE: (480) 590-3396 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: 021-472721-01 FILM NUMBER: 23590239 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 0001964435 Imagen Skiffey Family Dentistry Support Services, LLC 16220 NORTH SCOTTSDALE ROAD SUITE 300 SCOTTSDALE AZ ARIZONA 85254 (480) 590-3396 DELAWARE None None Limited Liability Company true 2022 0001819319 IMAGEN DENTAL PARTNERS, LLC 16220 NORTH SCOTTSDALE ROAD SUITE 300 SCOTTSDALE AZ ARIZONA 85254 (480) 590-3396 DELAWARE None None Limited Liability Company true 2020 Rezwan Manji 16220 NORTH SCOTTSDALE ROAD SUITE 300 SCOTTSDALE AZ ARIZONA 85254 Executive Officer Rezwan Manji is an executive officer of Imagen Dental Partners, LLC and Imagen Skiffey Family Dentistry Support Services, LLC. Michael Augins 16220 NORTH SCOTTSDALE ROAD SUITE 300 SCOTTSDALE AZ ARIZONA 85254 Executive Officer Michael Augins is an executive officer of Imagen Dental Partners, LLC and Imagen Skiffey Family Dentistry Support Services, LLC. Other Health Care Decline to Disclose 06b false 2023-01-30 false true true 0 578500 578500 0 false 2 0 0 0 false Imagen Skiffey Family Dentistry Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-02-06 IMAGEN DENTAL PARTNERS, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-02-06