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IDAHO FAMILY DENTAL PLLC

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Company Details

Name: IDAHO FAMILY DENTAL PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Mar 2014 (11 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 414187
Place of Formation: IDAHO
File Number: 414187
ZIP code: 83646
County: Ada County
Principal Address: 2661 W DITCH CREEK DR MERIDIAN, ID 83646
Mailing Address: 9203 W OVERLAND RD BOISE, ID 83709-2502

Agent

Name Role Address
ANNA BUDOLFSON Agent 1100 E TRINITY LN, EAGLE, ID 83616

Member

Name Role Address Appointed On
anna budolfson Member 9203 W OVERLAND RD, BOISE, ID 83709 2021-02-03

National Provider Identifier

NPI Number:
1356021489
Certification Date:
2023-07-24

Authorized Person:

Name:
DR. ANNA BUDOLFSON
Role:
DENTIST/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
122300000X - Dentist
Is Primary:
Yes

Contacts:

Fax:
2083751098

Form 5500 Series

Employer Identification Number (EIN):
465169949
Plan Year:
2023
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006094521 2025-02-03
Annual Report 0005581113 2024-02-03
Annual Report 0005094252 2023-02-03
Annual Report 0004601018 2022-02-08
Annual Report 0004153161 2021-02-03

USAspending Awards / Financial Assistance

Date:
2021-02-02
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:
24770.00
Total Face Value Of Loan:
24770.00
Date:
2020-04-11
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:
25600.00
Total Face Value Of Loan:
25600.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$25,600
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$25,600
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$25,764.82
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $25,600
Jobs Reported:
4
Initial Approval Amount:
$24,770
Date Approved:
2021-02-02
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$24,770
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$24,911.83
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $24,768
Utilities: $1

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Date of last update: 21 Jul 2025

Sources: Idaho Secretary of State