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DHDA ProviderCo, PLLC

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Company Details

Name: DHDA ProviderCo, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 04 Feb 2020 (5 years ago)
Organization Date: 04 Feb 2020 (5 years ago)
Last Annual Report: 08 Mar 2025 (3 months ago)
Managed By: Members
Organization Number: 1085966
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 40059
City: Prospect, River Bluff
Primary County: Jefferson County
Principal Office: 13104 W US HWY 42, PROSPECT, KY 40059
Place of Formation: KENTUCKY

Member

Name Role
Paul T Lavelle Member

Registered Agent

Name Role
Timothy Lavelle Registered Agent
TIMOTHY LAVELLE Registered Agent

Organizer

Name Role
Paul Lavelle Organizer

National Provider Identifier

NPI Number:
1902432537
Certification Date:
2020-03-16

Authorized Person:

Name:
PAUL T LAVELLE
Role:
SOLE MEMBER
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
844585626
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
7
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
LAVELLE FAMILY & COSMETIC DENTISTRY Active 2030-02-12
VIE SMILE DESIGN Active 2029-04-16

Filings

Name File Date
Annual Report 2025-03-08
Assumed Name renewal 2025-02-12
Certificate of Assumed Name 2024-04-16
Annual Report 2024-03-19
Registered Agent name/address change 2023-09-19

USAspending Awards / Financial Assistance

Date:
2020-06-05
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:
78542.00
Total Face Value Of Loan:
78542.00

Paycheck Protection Program

Date Approved:
2020-06-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
78542
Current Approval Amount:
78542
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
79253.98

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Sources: Kentucky Secretary of State