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ELEMENT DENTAL

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Company Details

Name: ELEMENT DENTAL
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 28 Apr 2017 (8 years ago)
Entity Number: 585776
Place of Formation: IDAHO
File Number: 0000585776
ZIP code: 83835
County: Kootenai County
Mailing Address: 1683 E MILES AVE HAYDEN, ID 83835

National Provider Identifier

NPI Number:
1275802068

Authorized Person:

Name:
DR. RACHEL FEHLING
Role:
MANAGING DENTIST
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
453909395
Plan Year:
2019
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
6
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Initial Filing 0000585776 2017-04-28

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Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State