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MODERN KIDS DENTISTRY OF NICHOLASVILLE, PLLC

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Company Details

Name: MODERN KIDS DENTISTRY OF NICHOLASVILLE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 08 May 2017 (8 years ago)
Organization Date: 08 May 2017 (8 years ago)
Last Annual Report: 18 Feb 2025 (4 months ago)
Managed By: Managers
Organization Number: 0984824
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40356
City: Nicholasville
Primary County: Jessamine County
Principal Office: 611 N Main St, Nicholasville, KY 40356
Place of Formation: KENTUCKY

Shareholder

Name Role
AMANDA GRACE Shareholder
JUSTIN RAYBOULD Shareholder

Incorporator

Name Role
STEPHEN R CUSTER Incorporator

Organizer

Name Role
JUSTIN RAYBOULD Organizer

Registered Agent

Name Role
JUSTIN RAYBOULD Registered Agent
JUSTIN M. RAYBOULD Registered Agent

Manager

Name Role
Justin Raybould Manager

Member

Name Role
Amanda Grace Member

National Provider Identifier

NPI Number:
1851821854

Authorized Person:

Name:
DR. JUSTIN MICHAEL RAYBOULD
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes

Contacts:

Former Company Names

Name Action
MODERN KIDS DENTISTRY OF NICHOLASVILLE, PSC Type Conversion

Filings

Name File Date
Annual Report 2025-02-18
Annual Report 2024-03-26
Annual Report 2023-08-15
Annual Report 2022-08-08
Articles of Organization (LLC) 2021-03-25

USAspending Awards / Financial Assistance

Date:
2021-02-04
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:
62221.00
Total Face Value Of Loan:
62221.00
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:
91100.00
Total Face Value Of Loan:
91100.00
Date:
2020-04-24
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
6000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-14
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:
-91100.00
Total Face Value Of Loan:
0.00
Date:
2019-09-16
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:
500000.00
Total Face Value Of Loan:
500000.00

Paycheck Protection Program

Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
91100
Current Approval Amount:
91100
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Veteran
Forgiveness Amount:
91766.4
Date Approved:
2021-02-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
62221
Current Approval Amount:
62221
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Veteran
Forgiveness Amount:
62577.28

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Sources: Kentucky Secretary of State