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Idaho Falls Pediatric Dentistry, PLLC

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Company Details

Name: Idaho Falls Pediatric Dentistry, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 08 May 2019 (6 years ago)
Financial Date End: 31 May 2026
Entity Number: 3506279
Place of Formation: IDAHO
File Number: 665467
ZIP code: 83404
County: Bonneville County
Principal Address: ESTHER MACHEN 3387 MERLIN DRIVE IDAHO FALLS, ID 83404
Mailing Address: KAILEY HOUSLEY 3015 EAGLE DRIVE AMMON, ID 83406

Agent

Name Role Address
Kailey A Housley Agent 3015 EAGLE DRIVE, AMMON, ID 83406

Member

Name Role Address Appointed On Resigned On
ESTHER MACHEN Member 3387 MERLIN DRIVE, IDAHO FALLS, ID 83404 2021-04-03 2024-07-30
Kailey Housley Member 3015 EAGLE DRIVE, AMMON, ID 83406 2024-07-30 No data

National Provider Identifier

NPI Number:
1700447596
Certification Date:
2025-05-28

Authorized Person:

Name:
DR. KAILEY ANNE HOUSLEY
Role:
PEDIATRIC DENTIST, OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2084193461

Filing

Filing Name Filing Number Filing date
Annual Report 0006249049 2025-05-12
Annual Report 0005832716 2024-07-30
Change of Registered Office/Agent/Both (by Entity) 0005326820 2023-07-19
Annual Report 0005183414 2023-04-05
Annual Report 0004692536 2022-04-08

USAspending Awards / Financial Assistance

Date:
2020-04-19
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
4000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-07
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:
23100.00
Total Face Value Of Loan:
23100.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$23,100
Date Approved:
2020-04-03
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$23,100
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$23,311.38
Servicing Lender:
The Bank of Commerce
Use of Proceeds:
Payroll: $23,100

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State