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CHILDREN'S KIDNEY SPECIALISTS, PLLC

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Company Details

Name: CHILDREN'S KIDNEY SPECIALISTS, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 30 Jul 1999 (26 years ago)
Financial Date End: 31 Jul 2023
Date dissolved: 04 Oct 2023
Entity Number: 43447
Place of Formation: IDAHO
File Number: 43447
ZIP code: 83702
County: Ada County
Principal Address: 222 N 2ND ST STE 215 BOISE, ID 83702
Mailing Address: RANDALL JENKINS MD 1935 NW NORFOLK CT PORTLAND, OR 97229-8448

Agent

Name Role Address
RON JENKINS Agent 471 RAVENWOOD DR, SANDPOINT, ID 83864

Member

Name Role Address Appointed On
Randall Jenkins MD Member 1935 NW NORFOLK CT, PORTLAND, OR 97229 2021-03-17

National Provider Identifier

NPI Number:
1700088002

Authorized Person:

Name:
DR. RANDALL JENKINS
Role:
DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
2080P0210X - Pediatric Nephrology Physician
Is Primary:
Yes

Contacts:

Fax:
2083817495

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0005426276 2023-10-04
Annual Report 0004212396 2021-03-17
Annual Report 0003528973 2019-06-01
Annual Report 0003304169 2018-10-01
Application for Reinstatement 0001091614 2017-04-12

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Date of last update: 14 Jul 2025

Sources: Idaho Secretary of State