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Magic Valley Oral Surgery, PLLC

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Company Details

Name: Magic Valley Oral Surgery, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 Nov 2018 (7 years ago)
Financial Date End: 30 Nov 2025
Entity Number: 3354411
Place of Formation: IDAHO
File Number: 645127
ZIP code: 83301
County: Twin Falls County
Mailing Address: 590 FALLS AVE TWIN FALLS, ID 83301-3314

Agent

Name Role Address
Timothy T Hopkins, DDS, MS Agent 590 FALLS AVE, TWIN FALLS, ID 83301

President

Name Role Address Appointed On Resigned On
timothy t hopkins President 590 FALLS AVE, TWIN FALLS, ID 83301-3314 2020-11-05 2023-10-03

Manager

Name Role Address Appointed On
Timothy T Hopkins Manager 590 FALLS AVE, TWIN FALLS, ID 83301 2024-10-04

National Provider Identifier

NPI Number:
1073720009

Authorized Person:

Name:
DR. VINCENT LYNN WILLIAMS
Role:
OWNERPRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary:
Yes

Contacts:

Fax:
2087368339

Filing

Filing Name Filing Number Filing date
Annual Report 0005929127 2024-10-04
Statement of Conversion 0005813845 2024-07-19
Annual Report 0005419136 2023-10-03
Annual Report 0004931900 2022-10-03
Annual Report 0004436856 2021-10-04

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Date of last update: 15 Aug 2025

Sources: Idaho Secretary of State