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Magic Valley Dental Anesthesia PLLC

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Company Details

Name: Magic Valley Dental Anesthesia PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Mar 2021 (4 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 4214154
Place of Formation: IDAHO
File Number: 753797
ZIP code: 83646
County: Ada County
Principal Address: SUITE 100 37 W ARCHERFIELD STREET MERIDIAN, ID 83646
Mailing Address: 3245 S BRANDENBERG AVE EAGLE, ID 83616-4413

Agent

Name Role Address
RYAN W JUDD Agent 3245 S BRANDENBERG AVE, EAGLE, ID 83616

Manager

Name Role Address Appointed On
Ryan Judd DMD Manager 3245 S BRANDENBERG AVE, EAGLE, ID 83616 2022-02-04

National Provider Identifier

NPI Number:
1346824422
Certification Date:
2021-05-05

Authorized Person:

Name:
DR. RYAN JUDD
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
No
Selected Taxonomy:
1223D0004X - Dentist Anesthesiologist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006096310 2025-02-04
Annual Report 0005681989 2024-04-06
Annual Report 0005094300 2023-02-03
Annual Report 0004594950 2022-02-04
Initial Filing 0004214154 2021-03-19

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Date of last update: 23 Jul 2025

Sources: Idaho Secretary of State