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CHERRY LANE DENTAL, P.C.

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Company Details

Name: CHERRY LANE DENTAL, P.C.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 28 Jul 2000 (25 years ago)
Financial Date End: 31 Jul 2026
Entity Number: 412159
Place of Formation: IDAHO
File Number: 412159
ZIP code: 83642
County: Ada County
Mailing Address: 1104 W CHERRY LN MERIDIAN, ID 83642-1513

Agent

Name Role Address
John Bergloff Agent 1104 W CHERRY LANE, MERIDIAN, ID 83642

President

Name Role Address Appointed On Resigned On
John Bergloff President 1104 W. CHERRY LANE, MERIDIAN, ID 83642 2021-08-11 2023-08-03
John A Bergloff President 2499 N CORSEY WAY, EAGLE, ID 83616 2025-06-03 No data

National Provider Identifier

NPI Number:
1083660021

Authorized Person:

Name:
JOHN ANDREW BERGLOFF
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
305S00000X - Point of Service
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006292750 2025-06-03
Application for Reinstatement 0005939324 2024-10-11
Dissolution/Revocation - Administrative 0005938597 2024-10-11
Annual Report 0005347666 2023-08-03
Annual Report 0004855051 2022-08-10

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
117500
Current Approval Amount:
117500
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
118143.84
Date Approved:
2021-02-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
75086
Current Approval Amount:
75086
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
75367.83

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Date of last update: 30 Jun 2025

Sources: Idaho Secretary of State