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KENTUCKY DENTAL ANESTHESIA SERVICES PLLC

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Company Details

Name: KENTUCKY DENTAL ANESTHESIA SERVICES PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 02 Jul 2023 (2 years ago)
Organization Date: 02 Jul 2023 (2 years ago)
Last Annual Report: 07 Mar 2025 (5 months ago)
Managed By: Members
Organization Number: 1291944
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40403
City: Berea
Primary County: Madison County
Principal Office: 1006 Ace Dr, Berea, KY 40403
Place of Formation: KENTUCKY

Registered Agent

Name Role
Eric Jacobson Registered Agent

Member

Name Role
Eric Jacobson Member

Organizer

Name Role
Eric Jacobson Organizer

National Provider Identifier

NPI Number:
1013696723
Certification Date:
2024-10-30

Authorized Person:

Name:
ERIC JACOBSON
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207LP3000X - Pediatric Anesthesiology Physician
Is Primary:
No
Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
No
Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Filings

Name File Date
Annual Report 2025-03-07
Annual Report 2024-08-05
Articles of Organization 2023-07-02

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Sources: Kentucky Secretary of State