0001144204-15-054136.txt : 20150909 0001144204-15-054136.hdr.sgml : 20150909 20150909084208 ACCESSION NUMBER: 0001144204-15-054136 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150904 FILED AS OF DATE: 20150909 DATE AS OF CHANGE: 20150909 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Xtant Medical Holdings, Inc. CENTRAL INDEX KEY: 0001453593 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 205313323 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 BUSINESS PHONE: 406-388-0480 MAIL ADDRESS: STREET 1: 664 CRUISER LANE CITY: BELGRADE STATE: MT ZIP: 59714 FORMER COMPANY: FORMER CONFORMED NAME: Bacterin International Holdings, Inc. DATE OF NAME CHANGE: 20100615 FORMER COMPANY: FORMER CONFORMED NAME: K KITZ INC DATE OF NAME CHANGE: 20090108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Goldberger Daniel S CENTRAL INDEX KEY: 0001382042 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34951 FILM NUMBER: 151098014 MAIL ADDRESS: STREET 1: 11400 W OLYMPIC BLVD STREET 2: SUITE 200 CITY: LOS ANGELES STATE: CA ZIP: 90064 4 1 v419968_form4.xml OWNERSHIP DOCUMENT X0306 4 2015-09-04 0 0001453593 Xtant Medical Holdings, Inc. BONE 0001382042 Goldberger Daniel S 664 CRUISER LANE BELGRADE MT 59714 1 1 0 0 Chief Executive Officer Common Stock 2015-09-04 4 P 0 81522 3.68 A 81522 I By IRA Common Stock 12510 D /s/ Daniel Goldberger 2015-09-08