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  5. KENT UROLOGY INC.

KENT UROLOGY INC.

Company Details

Name: KENT UROLOGY INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 24 Jun 1976 (49 years ago)
Date of Dissolution: 28 Jul 2016 (8 years ago)
Date of Status Change: 28 Jul 2016 (8 years ago)
Identification Number: 000015141
ZIP code: 02818
County: Kent County
Principal Address: C/O ROBERT J. DOBRZYNSKI MD 2 CRYSTAL COURT, EAST GREENWICH, RI, 02818, USA
Purpose: PRACTICE OF MEDICINE AND SURGERY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437376100 2007-04-20 2020-08-22 390 TOLL GATE RD, SUITE 204, WARWICK, RI, 028864326, US 390 TOLL GATE RD, SUITE 204, WARWICK, RI, 028864326, US

Contacts
Phone +1 401-737-5253
Fax 4017374606

Authorized person
Name ROBERT DOBRZYNSKI
Role PRESIDENT
Phone 4017375253

Taxonomy
Taxonomy Code 208800000X - Urology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 9000699
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENT UROLOGY, INC. PROFIT SHARING PLAN 2023 050368247 2024-08-19 KENT UROLOGY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 02886
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2022 050368247 2023-08-28 KENT UROLOGY, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2021 050368247 2022-08-08 KENT UROLOGY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2020 050368247 2021-11-03 KENT UROLOGY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2019 050368247 2021-04-13 KENT UROLOGY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2018 050368247 2019-09-16 KENT UROLOGY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2017 050368247 2018-11-26 KENT UROLOGY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2016 050368247 2017-10-12 KENT UROLOGY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2015 050368247 2016-11-23 KENT UROLOGY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375900
Plan sponsor’s address 615 JEFFERSON BLVD., #2, WARWICK, RI, 02886

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253
KENT UROLOGY, INC. PROFIT SHARING PLAN 2014 050368247 2015-12-08 KENT UROLOGY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375253
Plan sponsor’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253

Signature of
Role Plan administrator
Date 2015-12-08
Name of individual signing ROBERT DOBRZYNSKI
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/03/27/20150327154017P040150292311001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375253
Plan sponsor’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253

Signature of
Role Plan administrator
Date 2015-03-27
Name of individual signing ROBERT DOBRZYNSKI
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/06/20140106155436P040056193749001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375253
Plan sponsor’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253

Signature of
Role Plan administrator
Date 2014-01-06
Name of individual signing ROBERT DOBRZYNSKI
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/11/14/20121114135934P040003064293001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1976-07-01
Business code 621111
Sponsor’s telephone number 4017375253
Plan sponsor’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326

Plan administrator’s name and address
Administrator’s EIN 050368247
Plan administrator’s name KENT UROLOGY, INC.
Plan administrator’s address 390 TOLL GATE ROAD, WARWICK, RI, 028864326
Administrator’s telephone number 4017375253

Signature of
Role Plan administrator
Date 2012-11-14
Name of individual signing ROBERT DOBRZYNSKI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
E. COLBY CAMERON Agent CAMERON & MITTLEMAN LLP 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA

VICE PRESIDENT

Name Role Address
CURTIS T. JONES MD VICE PRESIDENT 390 TOLLGATE ROAD WARWICK, RI 02886 USA

PRESIDENT

Name Role Address
ROBERT J DOBRZYNSKI MD PRESIDENT 390 TOLLGATE ROAD WARWICK, RI 02886 USA

Filings

Number Name File Date
201602694130 Articles of Dissolution 2016-07-28
201602662760 Statement of Change of Registered/Resident Agent 2016-07-27
201602599660 Annual Report 2016-07-25
201601356390 Revocation Notice For Failure to File An Annual Report 2016-07-07
201555932190 Annual Report 2015-02-27
201433686920 Annual Report 2014-01-20
201324045630 Annual Report 2013-06-18
201321779510 Revocation Notice For Failure to File An Annual Report 2013-06-03
201288418280 Annual Report 2012-01-23
201174373910 Annual Report 2011-02-02

Related by officers

E. COLBY CAMERON

Chicago Transparent Products, Inc. Frances P. Conklin, M.D., Ltd. CROWN TRUCK LEASING, INC. KAB ACQUISITION CO. MEDHAT A. KADER, M.D., INC. Khodarahm Khodarahmi, M.D., Ltd. SYNERGY ASSOCIATES, INC. REM REALTY CORP. INTERNATIONAL ELECTRONIC SWITCH COMPANY J.H.F., Inc.

ROBERT J DOBRZYNSKI MD

Diabetes & Endocrinology Associates, Inc.

Related by address

No related companies by address

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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