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BOISE CHILDREN'S DENTISTRY PLLC

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Company Details

Name: BOISE CHILDREN'S DENTISTRY PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Apr 2019 (6 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 3478327
Place of Formation: IDAHO
File Number: 662544
ZIP code: 83706
County: Ada County
Principal Address: 136 E MALLARD DR BOISE, ID 83706
Mailing Address: 136 E MALLARD DR BOISE, ID 83706-3975

Agent

Name Role Address
ALEXIS PHILLIPS Agent 136 E MALLARD DR, BOISE, ID 83706

Manager

Name Role Address Appointed On Resigned On
Alexis P Lyall Manager 136 E. MALLARD DRIVE, BOISE, ID 83706 2021-03-03 No data
Alexis Lyall Manager 136 E. MALLARD DRIVE, BOISE, ID 83706 2021-01-03 2021-03-03

National Provider Identifier

NPI Number:
1700503133
Certification Date:
2022-10-26

Authorized Person:

Name:
ALEXIS PHILLIPS LYALL
Role:
OWNER DENTIST
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Fax:
2089086178

Filing

Filing Name Filing Number Filing date
Annual Report 0006134534 2025-03-03
Annual Report 0005629393 2024-03-04
Annual Report 0005174433 2023-04-03
Annual Report 0004636418 2022-03-07
Annual Report 0004188061 2021-03-03

USAspending Awards / Financial Assistance

Date:
2020-04-13
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:
27800.00
Total Face Value Of Loan:
27800.00

Paycheck Protection Program

Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
27800
Current Approval Amount:
27800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
28051.34

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State