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KSS DENTAL GROUP, PLLC

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Company Details

Name: KSS DENTAL GROUP, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 Jun 2016 (9 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 509424
Place of Formation: IDAHO
File Number: 509424
ZIP code: 83686
County: Canyon County
Principal Address: 524 E FUJII DR NAMPA, ID 83686
Mailing Address: 329 E LOGAN ST CALDWELL, ID 83605-4863

Agent

Name Role Address
KEITH L STUCKI Agent 524 E FUJII DR, NAMPA, ID 83686

Manager

Name Role Address Appointed On
Keith Stucki Manager 524 E. FUJII DR, NAMPA, ID 83686 2021-05-03

Member

Name Role Address Appointed On Resigned On
Cameron Kuehne Member 4082 W PINE MEADOWS, EAGLE, ID 83616 2024-05-03 2024-05-03
Jamison Spencer Member 5006 POLE PATCH DR, PLEASANT VIEW, UT 84414 2024-05-03 2024-05-03
Russell Powell Member 1807 S CRIMSON ROSE AVE, BOISE, ID 83709 2024-05-03 2024-05-03

National Provider Identifier

NPI Number:
1457704009

Authorized Person:

Name:
DR. KEITH L STUCKI
Role:
MANAGER
Phone:

Taxonomy:

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

Contacts:

Fax:
2084539295

Filing

Filing Name Filing Number Filing date
Annual Report 0006231924 2025-05-04
Annual Report 0005720235 2024-05-03
Annual Report 0005217336 2023-05-03
Annual Report 0004753568 2022-05-20
Annual Report Amendment 0004355596 2021-07-22

USAspending Awards / Financial Assistance

Date:
2020-04-09
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:
61900.00
Total Face Value Of Loan:
61900.00
Date:
2016-07-14
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:
543500.00
Total Face Value Of Loan:
543500.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
61900
Current Approval Amount:
61900
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Unanswered
Veteran:
Non-Veteran
Forgiveness Amount:
62379.94

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Date of last update: 06 Jun 2025

Sources: Idaho Secretary of State