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LYON FAMILY DENTAL, PLLC

Company Details

Name: LYON FAMILY DENTAL, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 11 Oct 2019 (6 years ago)
Organization Date: 10 Oct 2019 (6 years ago)
Last Annual Report: 24 Sep 2024 (8 months ago)
Managed By: Members
Organization Number: 1074198
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42038
City: Eddyville
Primary County: Lyon County
Principal Office: 252 COMMERCE STREET, EDDYVILLE, KY 42038
Place of Formation: KENTUCKY

Registered Agent

Name Role
DOMINIQUE R. RIVERA Registered Agent

Member

Name Role
Dominique Rey Rivera Member

Organizer

Name Role
GEORGE L FLETCHER Organizer

National Provider Identifier

NPI Number:
1841816824
Certification Date:
2020-06-24

Authorized Person:

Name:
DR. DOMINIQUE RIVERA
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
843520792
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:

Filings

Name File Date
Reinstatement Certificate of Existence 2024-09-24
Reinstatement Approval Letter Revenue 2024-09-24
Reinstatement 2024-09-24
Administrative Dissolution 2023-10-04
Registered Agent name/address change 2022-06-30

Sources: Kentucky Secretary of State