0001998391-23-000001.txt : 20231024 0001998391-23-000001.hdr.sgml : 20231024 20231024114147 ACCESSION NUMBER: 0001998391-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20231024 DATE AS OF CHANGE: 20231024 EFFECTIVENESS DATE: 20231024 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen Stickney Dental Support Services, LLC CENTRAL INDEX KEY: 0001998391 IRS NUMBER: 933481125 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-495483 FILM NUMBER: 231341742 BUSINESS ADDRESS: STREET 1: 16220 N. SCOTTSDALE ROAD STREET 2: SUITE 400 CITY: SCOTTSDALE STATE: AZ ZIP: 85254 BUSINESS PHONE: (480) 590-3396 MAIL ADDRESS: STREET 1: 16220 N. SCOTTSDALE ROAD STREET 2: SUITE 400 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: 021-495483-01 FILM NUMBER: 231341743 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 0001998391 Imagen Stickney Dental Support Services, LLC 16220 N. SCOTTSDALE ROAD SUITE 400 SCOTTSDALE AZ ARIZONA 85254 (480) 590-3396 DELAWARE None None Limited Liability Company true 2023 0001819319 IMAGEN DENTAL PARTNERS, LLC 16220 N. SCOTTSDALE ROAD SUITE 400 SCOTTSDALE AZ ARIZONA 85254 (480) 590-3396 DELAWARE None None Limited Liability Company true 2020 Rezwan Manji 16220 N. SCOTTSDALE ROAD SUITE 400 SCOTTSDALE AZ ARIZONA 85254 Executive Officer Rezwan Manji is an executive officer of Imagen Dental Partners, LLC and Imagen Stickney Dental Support Services, LLC. Michael Augins 16220 N. SCOTTSDALE ROAD SUITE 400 SCOTTSDALE AZ ARIZONA 85254 Executive Officer Michael Augins is an executive officer of Imagen Dental Partners, LLC and Imagen Stickney Dental Support Services, LLC. Other Health Care Decline to Disclose 06b false 2023-10-19 true true true 0 1286492 1186492 100000 false 2 0 0 0 false Imagen Stickney Dental Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-10-24 IMAGEN DENTAL PARTNERS, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-10-24