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KISTLER DENTAL PLLC

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Company Details

Name: KISTLER DENTAL PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Sep 2021 (4 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 4420502
Place of Formation: IDAHO
File Number: 782080
ZIP code: 83404
County: Bonneville County
Principal Address: 2818 S 25TH E IDAHO FALLS, ID 83404-6509

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Manager

Name Role Address Appointed On
AMANDA M. KISTLER Manager 2818 S 25TH E, IDAHO FALLS, ID 83404 2022-09-19

National Provider Identifier

NPI Number:
1780355453
Certification Date:
2023-06-20

Authorized Person:

Name:
AMANDA KISTLER
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006273721 2025-05-27
Annual Report 0005909348 2024-09-23
Annual Report 0005405991 2023-09-19
Change of Registered Office/Agent/Both (by Entity) 0004956437 2022-10-20
Annual Report 0004919161 2022-09-19

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Date of last update: 09 Jul 2025

Sources: Idaho Secretary of State