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WHITEWATER ORAL SURGERY GROUP PLLC

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Company Details

Name: WHITEWATER ORAL SURGERY GROUP PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 Sep 2013 (12 years ago)
Financial Date End: 30 Sep 2025
Date dissolved: 06 Dec 2024
Entity Number: 396247
Place of Formation: IDAHO
File Number: 396247
ZIP code: 83702
County: Ada County
Mailing Address: STE 130 3003 W MAIN ST BOISE, ID 83702-2026

Agent

Name Role Address
KEVIN KEMPERS Agent 3003 W. MAIN ST, 130, BOISE, ID 83702

Manager

Name Role Address Appointed On
KEVIN KEMPERS Manager 3003 W. MAIN STREET #130, BOISE, ID 83702 2020-08-03

National Provider Identifier

NPI Number:
1104248053
Certification Date:
2020-09-04

Authorized Person:

Name:
DR. KEVIN GLENN KEMPERS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary:
No
Selected Taxonomy:
1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary:
Yes

Contacts:

Fax:
2083441799

Form 5500 Series

Employer Identification Number (EIN):
463726284
Plan Year:
2022
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
34
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
33
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006030998 2024-12-19
Dissolution/Revocation - Administrative 0006013642 2024-12-06
Annual Report 0005344152 2023-08-03
Annual Report 0004838963 2022-08-03
Annual Report 0004369016 2021-08-04

USAspending Awards / Financial Assistance

Date:
2020-04-14
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:
271702.50
Total Face Value Of Loan:
271702.50

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Date of last update: 04 Jun 2025

Sources: Idaho Secretary of State