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  5. BRENNAN ORTHODONTICS, INC.

BRENNAN ORTHODONTICS, INC.

Company Details

Name: BRENNAN ORTHODONTICS, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 27 Feb 1974 (51 years ago)
Identification Number: 000002797
ZIP code: 02888
County: Kent County
Principal Address: 1434 WARWICK AVENUE, WARWICK, RI, 02888, USA
Purpose: PRACTICE OF DENTISTRY AND ORTHODONTICS
NAICS: 621210 - Offices of Dentists
Historical names: DR. WILLIAM BRENNAN, INC.
WILLIAM F. BRENNAN, D.M.D., Inc.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1336208511 2006-12-06 2020-08-22 1434 WARWICK AVE, WARWICK, RI, 028885026, US 1434 WARWICK AVE, WARWICK, RI, 028885026, US

Contacts
Phone +1 401-463-6350
Fax 4014635130

Authorized person
Name DR. WILLIAM BRENNAN
Role PRESIDENT
Phone 4014636350

Taxonomy
Taxonomy Code 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
License Number DEN02587
State RI
Is Primary Yes

Other Provider Identifiers
Issuer UNITED CONCORDIA
Number 139-741
State RI
Issuer BLUE CROSS OF MA
Number RG0069
State RI
Issuer BLUE CROSS
Number 8037-4
State RI
Issuer MEDICAID
Number WB01101
State RI
Issuer UNITED HEALTHCARE
Number 41-00012
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BRENNAN ORTHODONTICS INC 401(K) PROFIT SHARING PLAN 2012 050379171 2013-10-09 BRENNAN ORTHODONTICS INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC DEFINED BENEFIT PENSION PLAN 2011 050379171 2012-10-15 BRENNAN ORTHODONTICS INC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1977-06-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC 401(K) PROFIT SHARING PLAN 2011 050379171 2012-10-12 BRENNAN ORTHODONTICS INC. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC.
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC 401(K) PROFIT SHARING PLAN 2010 050379171 2011-10-17 BRENNAN ORTHODONTICS INC. 22
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC.
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC 401(K) PROFIT SHARING PLAN 2010 050379171 2012-01-12 BRENNAN ORTHODONTICS INC. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC.
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2012-01-12
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC DEFINED BENEFIT PENSION PLAN 2010 050379171 2011-10-17 BRENNAN ORTHODONTICS INC 24
Three-digit plan number (PN) 001
Effective date of plan 1977-06-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC 401(K) PROFIT SHARING PLAN 2009 050379171 2010-10-15 BRENNAN ORTHODONTICS INC. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC.
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02886
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature
BRENNAN ORTHODONTICS INC DEFINED BENEFIT PENSION PLAN 2009 050379171 2010-10-15 BRENNAN ORTHODONTICS INC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1977-06-01
Business code 621210
Sponsor’s telephone number 4014636350
Plan sponsor’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888

Plan administrator’s name and address
Administrator’s EIN 050379171
Plan administrator’s name BRENNAN ORTHODONTICS INC
Plan administrator’s address 1434 WARWICK AVENUE, WARWICK, RI, 02888
Administrator’s telephone number 4014636350

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing THOMAS FECTEAU
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARYANNE BEVANS, ESQ. Agent 797 BALD HILL ROAD, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
MATTHEW M BRENNAN PRESIDENT 1434 WARWICK AVENUE WARWICK, RI 02888 USA

Events

Type Date Old Value New Value
Name Change 2002-06-25 WILLIAM F. BRENNAN, D.M.D., Inc. BRENNAN ORTHODONTICS, INC.
Name Change 1984-05-08 DR. WILLIAM BRENNAN, INC. WILLIAM F. BRENNAN, D.M.D., Inc.

Filings

Number Name File Date
202449390500 Annual Report 2024-03-26
202332396530 Annual Report 2023-04-05
202211923590 Annual Report 2022-03-02
202196164760 Statement of Change of Registered/Resident Agent 2021-05-03
202186005200 Annual Report 2021-01-13
202034112690 Annual Report 2020-02-10
201985854390 Annual Report 2019-02-01
201858151270 Annual Report 2018-02-13
201734072260 Annual Report 2017-02-14
201692383820 Annual Report 2016-02-12

Related by officers

MARYANNE BEVANS, ESQ.

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Related by address

1434 WARWICK AVENUE, WARWICK, RI, 02888, USA

1434 WARWICK AVENUE, LLC

Date of last update: 05 Oct 2024

Sources: Rhode Island Department of State

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