0002004171-23-000001.txt : 20231219 0002004171-23-000001.hdr.sgml : 20231219 20231219150102 ACCESSION NUMBER: 0002004171-23-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20231219 DATE AS OF CHANGE: 20231219 EFFECTIVENESS DATE: 20231219 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen Dream Smile Support Services, LLC CENTRAL INDEX KEY: 0002004171 ORGANIZATION NAME: IRS NUMBER: 933834496 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-500132 FILM NUMBER: 231496949 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 ORGANIZATION NAME: IRS NUMBER: 845189859 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-500132-01 FILM NUMBER: 231496950 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 0002004171 Imagen Dream Smile 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 Dream Smile 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 Dream Smile Support Services, LLC. Other Health Care Decline to Disclose 06b false 2023-12-11 true true true 0 669700 619700 50000 false 1 0 0 0 false Imagen Dream Smile Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-12-19 IMAGEN DENTAL PARTNERS, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2023-12-19