0002026256-24-000001.txt : 20240607
0002026256-24-000001.hdr.sgml : 20240607
20240606184909
ACCESSION NUMBER: 0002026256-24-000001
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06b
FILED AS OF DATE: 20240607
DATE AS OF CHANGE: 20240606
EFFECTIVENESS DATE: 20240607
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Imagen Lakeview Dental Support Services, LLC
CENTRAL INDEX KEY: 0002026256
ORGANIZATION NAME:
IRS NUMBER: 991435880
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-515395
FILM NUMBER: 241026763
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: 021-515395-01
FILM NUMBER: 241026764
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
0002026256
Imagen Lakeview 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 North Scottsdale Road
Suite 400
Scottsdale
AZ
ARIZONA
85254
Executive Officer
Rezwan Manji is an executive officer of Imagen Dental Partners, LLC and Imagen Lakeview Dental Support Services, LLC.
Michael
Augins
16220 North Scottsdale Road
Suite 400
Scottsdale
AZ
ARIZONA
85254
Executive Officer
Michael Augins is an executive officer of Imagen Dental Partners, LLC and Imagen Lakeview Dental Support Services, LLC.
Other Health Care
Decline to Disclose
- 06b
false
2024-05-24
true
true
true
0
2000000
1750000
250000
false
1
0
0
0
false
Imagen Lakeview Dental Support Services, LLC
/s/ Rezwan Manji
Rezwan Manji
Chief Executive Officer
2024-06-06
IMAGEN DENTAL PARTNERS, LLC
/s/ Rezwan Manji
Rezwan Manji
Chief Executive Officer
2024-06-06