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ID SDS II, PLLC

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Company Details

Name: ID SDS II, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 20 Apr 2023 (2 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 5207160
Place of Formation: IDAHO
File Number: 875252
ZIP code: 83201
County: Bannock County
Principal Address: 625 E ALAMEDA ROAD POCATELLO, ID 83201
Mailing Address: LEGAL STE 205 1610 54TH AVE N NASHVILLE, TN 37209-1442

Agent

Name Role Address
REGISTERED AGENT SOLUTIONS, INC. Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Member

Name Role Address Appointed On
Kevin C Lambourne DDS Member 1610 54TH AVENUE NORTH, NASHVILLE, TN 37209 2024-03-04

National Provider Identifier

NPI Number:
1538909379
Certification Date:
2025-03-03

Authorized Person:

Name:
CHARLOTTE V DASCH
Role:
DIRECTOR OF CREDENTIALING
Phone:

Taxonomy:

Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006283867 2025-05-27
Annual Report 0006224900 2025-04-30
Annual Report 0005629351 2024-03-04
Initial Filing 0005207160 2023-04-20

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Date of last update: 10 Jul 2025

Sources: Idaho Secretary of State