0002021428-24-000001.txt : 20240430 0002021428-24-000001.hdr.sgml : 20240430 20240429193507 ACCESSION NUMBER: 0002021428-24-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20240430 DATE AS OF CHANGE: 20240429 EFFECTIVENESS DATE: 20240430 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Imagen North Tahoe Dental Support Services, LLC CENTRAL INDEX KEY: 0002021428 ORGANIZATION NAME: IRS NUMBER: 992116697 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-511896 FILM NUMBER: 24893466 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: 021-511896-01 FILM NUMBER: 24893467 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 0002021428 Imagen North Tahoe Dental Support Services, LLC 16220 N. SCOTTSDALE ROAD SUITE 400 SCOTTSDALE AZ ARIZONA 85254 (480) 590-3396 DELAWARE None None Limited Liability Company true 2024 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 North Tahoe 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 North Tahoe Dental Support Services, LLC. Other Health Care Decline to Disclose 06b false 2024-04-19 false true true 0 1295411 1295411 0 false 1 0 0 0 false Imagen North Tahoe Dental Support Services, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2024-04-29 IMAGEN DENTAL PARTNERS, LLC /s/ Rezwan Manji Rezwan Manji Chief Executive Officer 2024-04-29