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EAGLE ORAL SURGERY & DENTAL IMPLANT CENTER, PLLC

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Company Details

Name: EAGLE ORAL SURGERY & DENTAL IMPLANT CENTER, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 28 Aug 2014 (11 years ago)
Financial Date End: 31 Aug 2025
Entity Number: 431587
Place of Formation: IDAHO
File Number: 431587
ZIP code: 83616
County: Ada County
Principal Address: 197 W STATE ST EAGLE, ID 83616
Mailing Address: 197 W STATE ST EAGLE, ID 83616-4959

Agent

Name Role Address
JEREMY HIXSON Agent 4641 W CORNERSTONE LN, EAGLE, ID 83616

Manager

Name Role Address Appointed On
Jeremy Hixson Manager 4641 W CORNERSTONE LN, EAGLE, ID 83616 2020-08-31

National Provider Identifier

NPI Number:
1780074864

Authorized Person:

Name:
JEREMY L HIXSON
Role:
OWNER/PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
471717180
Plan Year:
2023
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005870367 2024-08-26
Annual Report 0005388515 2023-09-07
Annual Report 0004917705 2022-09-16
Application for Reinstatement 0004511152 2021-12-02
Dissolution/Revocation - Administrative 0004489136 2021-11-06

USAspending Awards / Financial Assistance

Date:
2020-04-07
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:
67500.00
Total Face Value Of Loan:
67500.00
Date:
2019-06-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
-350000.00
Total Face Value Of Loan:
0.00

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Date of last update: 05 Jun 2025

Sources: Idaho Secretary of State