Search icon

Blackrock Dental Partners, PLLC

Company Details

Name: Blackrock Dental Partners, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 16 Aug 2019 (6 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 3597213
Place of Formation: IDAHO
File Number: 677370
ZIP code: 83201
County: Bannock County
Principal Address: 1606 EAST CENTER ST POCATELLO, ID 83201
Mailing Address: 1606 E CENTER ST POCATELLO, ID 83201-4007

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLACKROCK DENTAL PARTNERS PLLC 401(K) PLAN 2023 842764709 2024-05-06 BLACKROCK DENTAL PARTNERS PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 2082325294
Plan sponsor’s address 1606 E CENTER ST, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of

Role Plan administrator
Date 2024-05-06
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
BLACKROCK DENTAL PARTNERS PLLC 401(K) PLAN 2022 842764709 2023-07-28 BLACKROCK DENTAL PARTNERS PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 2082325294
Plan sponsor’s address 1606 E CENTER ST, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of

Role Plan administrator
Date 2023-07-24
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature
BLACKROCK DENTAL PARTNERS PLLC 401(K) PLAN 2021 842764709 2022-07-31 BLACKROCK DENTAL PARTNERS PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-01-01
Business code 621210
Sponsor’s telephone number 2082325294
Plan sponsor’s address 1606 E CENTER ST, POCATELLO, ID, 83201

Plan administrator’s name and address

Administrator’s EIN 842925395
Plan administrator’s name 401GO, INC.
Plan administrator’s address 8427 OLD BINGHAM HWY, WEST JORDAN, UT, 84088
Administrator’s telephone number 8012142125

Signature of

Role Plan administrator
Date 2022-07-26
Name of individual signing FIDUCIARY ASSISTANCE
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address Appointed On Resigned On
Joshua R Gibbons Manager 1606 E CENTER ST, POCATELLO, ID 83201 2020-08-26 2021-11-17
Joshua Gibbons Manager 1606 E CENTER ST, POCATELLO, ID 83201 2023-07-11 No data
Joshua Miles Manager 1606 E CENTER ST, POCATELLO, ID 83201 2021-11-17 No data

Agent

Name Role Address
Josh Gibbons Agent 1606 EAST CENTER ST, POCATELLO, ID 83201

Filing

Filing Name Filing Number Filing date
Annual Report 0005810499 2024-07-08
Annual Report 0005315957 2023-07-11
Annual Report 0004920308 2022-09-20
Application for Reinstatement 0004500206 2021-11-17
Dissolution/Revocation - Administrative 0004489678 2021-11-06
Annual Report 0003980202 2020-08-26
Initial Filing 0003597213 2019-08-16

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1879897400 2020-05-05 1087 PPP 1606 E CENTER ST, POCATELLO, ID, 83201
Loan Status Date 2021-08-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 151167
Loan Approval Amount (current) 151167
Undisbursed Amount 0
Franchise Name -
Lender Location ID 12096
Servicing Lender Name Wells Fargo Bank, National Association
Servicing Lender Address 101 N Philips Ave, SIOUX FALLS, SD, 57104-6738
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address POCATELLO, BANNOCK, ID, 83201-1800
Project Congressional District ID-02
Number of Employees 14
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 12096
Originating Lender Name Wells Fargo Bank, National Association
Originating Lender Address SIOUX FALLS, SD
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 152914.74
Forgiveness Paid Date 2021-07-15

Date of last update: 22 Mar 2025

Sources: Idaho Secretary of State