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NORTHWEST DENTAL CENTER, PA

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Company Details

Name: NORTHWEST DENTAL CENTER, PA
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 03 Jan 2001 (24 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 418345
Place of Formation: IDAHO
File Number: 418345
ZIP code: 83704
County: Ada County
Mailing Address: 8300 W NORTHVIEW ST BOISE, ID 83704-7132

Agent

Name Role Address
DON R COOK Agent 8300 NORTHVIEW ST, BOISE, ID 83704

President

Name Role Address Appointed On
Don Cook President 8300 W. NORTHVIEW ST, BOISE, ID 83704 2020-12-03

National Provider Identifier

NPI Number:
1639278146
Certification Date:
2022-11-17

Authorized Person:

Name:
DON R COOK
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
2083773689

Form 5500 Series

Employer Identification Number (EIN):
820526879
Plan Year:
2017
Number Of Participants:
10
Sponsors DBA Name:
PA
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
9
Sponsors DBA Name:
PA
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
9
Sponsors DBA Name:
PA
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
9
Sponsors DBA Name:
PA
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
9
Sponsors DBA Name:
PA
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006007685 2024-12-05
Annual Report 0005498542 2023-12-04
Annual Report 0005010717 2022-12-05
Annual Report 0004513504 2021-12-03
Annual Report 0004083144 2020-12-03

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Date of last update: 05 Jun 2025

Sources: Idaho Secretary of State