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TRISTA E. POTTENGER, DMD, PLLC

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Company Details

Name: TRISTA E. POTTENGER, DMD, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 16 Jul 2018 (7 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 618828
Place of Formation: IDAHO
File Number: 618828
ZIP code: 83709
County: Ada County
Principal Address: 4370 S COCHEES WAY BOISE, ID 83709
Mailing Address: 12212 W AMITY RD BOISE, ID 83709-5389

Agent

Name Role Address
TRISTA E POTTENGER, DMD Agent 12212 W AMITY RD, BOISE, ID 83709

Manager

Name Role Address Appointed On
Trista E Pottenger Manager 12212 W AMITY RD, BOISE, ID 83709 2021-07-12

National Provider Identifier

NPI Number:
1649935818
Certification Date:
2021-11-03

Authorized Person:

Name:
DR. TRISTA E POTTENGER
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QD0000X - Dental Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2083433818

Form 5500 Series

Employer Identification Number (EIN):
831470698
Plan Year:
2023
Number Of Participants:
11
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0005758059 2024-06-03
Annual Report 0005344349 2023-08-03
Annual Report 0004764608 2022-06-03
Statement of Change of Business Mailing Address 0004475377 2021-11-02
Statement of Change of Business Mailing Address 0004459756 2021-10-25

USAspending Awards / Financial Assistance

Date:
2020-04-28
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:
13700.00
Total Face Value Of Loan:
13700.00

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$13,700
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$13,700
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$13,840.38
Servicing Lender:
Idaho Central CU
Use of Proceeds:
Payroll: $13,700

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Date of last update: 05 Jul 2025

Sources: Idaho Secretary of State