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ALLIGATOR PEDIATRIC DENTISTRY, PLLC

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Company Details

Name: ALLIGATOR PEDIATRIC DENTISTRY, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 12 Aug 2010 (15 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 296108
Place of Formation: IDAHO
File Number: 296108
ZIP code: 83404
County: Bonneville County
Principal Address: 3365 S HOLMES AVE IDAHO FALLS, ID 83404
Mailing Address: 2805 EAGLE DRIVE AMMON, ID 83406

Agent

Name Role Address
RANDY G SMITH Agent 2805 EAGLE DRIVE, AMMON, ID 83406

Member

Name Role Address Appointed On
RANDY SMITH Member 362 PALOMINO, IDAHO FALLS, ID 83404 2020-07-15
MARK MARLOWE Member 2326 PTARMINGAN WAY, IDAHO FALLS, ID 83401 2023-08-09

National Provider Identifier

NPI Number:
1679747588

Authorized Person:

Name:
DR. RANDY G. SMITH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Fax:
2085527296

Form 5500 Series

Employer Identification Number (EIN):
273230544
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
22
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005796226 2024-07-03
Annual Report 0005358590 2023-08-09
Annual Report 0004805848 2022-07-06
Annual Report 0004381847 2021-08-12
Annual Report 0003940452 2020-07-15

USAspending Awards / Financial Assistance

Date:
2021-01-27
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
108580.00
Total Face Value Of Loan:
108580.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
151300.00
Total Face Value Of Loan:
151300.00

Paycheck Protection Program

Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
151300
Current Approval Amount:
151300
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
153289.7
Date Approved:
2021-01-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
108580
Current Approval Amount:
108580
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
109210.66

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Date of last update: 01 Jun 2025

Sources: Idaho Secretary of State