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SMILES 4 KIDS BLACKFOOT PLLC

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Company Details

Name: SMILES 4 KIDS BLACKFOOT PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 19 Mar 2015 (10 years ago)
Financial Date End: 31 Mar 2021
Date dissolved: 15 Jun 2021
Entity Number: 454278
Place of Formation: IDAHO
File Number: 454278
ZIP code: 83427
County: Bonneville County
Principal Address: PO BOX 191 IONA, ID 83427
Mailing Address: 621 JENSEN GROVE DR BLACKFOOT, ID 83221-1685

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 1555 W SHORELINE DR, STE 100, BOISE, ID 83702

Member

Name Role Address Appointed On
JOHN BURTENSHAW Member 621 JENSEN GROVE, BLACKFOOT, ID 83221 2021-01-22

National Provider Identifier

NPI Number:
1154799047

Authorized Person:

Name:
DR. KORY D BINGHAM
Role:
MANAGING PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0004902779 2022-09-12
Dissolution/Revocation - Administrative 0004315732 2021-06-15
Annual Report Amendment 0004141266 2021-01-22
Annual Report 0003759410 2020-02-01
Annual Report 0003420461 2019-02-01

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Date of last update: 11 May 2025

Sources: Idaho Secretary of State