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BROOKDALE DENTAL, P.A.

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Company Details

Name: BROOKDALE DENTAL, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 22 Dec 1997 (28 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 374520
Place of Formation: IDAHO
File Number: 374520
ZIP code: 83713
County: Ada County
Mailing Address: 13219 W PERSIMMON LN BOISE, ID 83713-1986

Agent

Name Role Address
R ERIC BARNEY DDS Agent 13219 W PERSIMMON LANE, BOISE, ID 83713

President

Name Role Address Appointed On Resigned On
Eric Barney President 13219 W. PERSIMMON LN, BOSIE, ID 83713 2021-01-08 2022-01-18

Secretary

Name Role Address Appointed On
Leesa Barney Secretary 13219 W. PERSIMMON LN, BOSIE, ID 83713 2024-11-03

National Provider Identifier

NPI Number:
1497926521

Authorized Person:

Name:
DR. ROBERT ERIC BARNEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Fax:
2083789676

Form 5500 Series

Employer Identification Number (EIN):
820498494
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
8
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005958723 2024-11-03
Application for Reinstatement 0005511673 2023-12-14
Dissolution/Revocation - Administrative 0005162870 2023-03-21
Annual Report 0004574527 2022-01-18
Annual Report 0004127592 2021-01-08

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$89,500
Date Approved:
2020-04-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$89,500
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$90,363.12
Servicing Lender:
D. L. Evans Bank
Use of Proceeds:
Payroll: $67,125
Utilities: $11,187.5
Mortgage Interest: $11,187.5
Jobs Reported:
9
Initial Approval Amount:
$89,500
Date Approved:
2021-03-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$89,500
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$90,063.97
Servicing Lender:
D. L. Evans Bank
Use of Proceeds:
Payroll: $89,500

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Date of last update: 06 Aug 2025

Sources: Idaho Secretary of State