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  5. HODOSH DENTAL ASSOCIATES, INC.

HODOSH DENTAL ASSOCIATES, INC.

Company Details

Name: HODOSH DENTAL ASSOCIATES, INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 31 Dec 1971 (53 years ago)
Identification Number: 000017190
ZIP code: 02907
County: Providence County
Principal Address: 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907, USA
Purpose: PROVIDING DENTAL SERVICES AS DEFINED IN SECTION 7-5.1 OF THE RHODE ISLAND GENERAL LAWS AS AMENDED
Historical names: MILTON HODOSH, D.M.D., INC.

Industry & Business Activity

NAICS

621210 Offices of Dentists

This industry comprises establishments of health practitioners having the degree of D.M.D. (Doctor of Dental Medicine), D.D.S. (Doctor of Dental Surgery), or D.D.Sc. (Doctor of Dental Science) primarily engaged in the independent practice of general or specialized dentistry or dental surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. They can provide either comprehensive preventive, cosmetic, or emergency care, or specialize in a single field of dentistry. Learn more at the U.S. Census Bureau

Companies doing Offices of dentists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1679634109 2006-12-12 2009-05-26 243 ELMWOOD AVE, PROVIDENCE, RI, 029071547, US 243 ELMWOOD AVE, PROVIDENCE, RI, 029071547, US

Contacts
Phone +1 401-467-4600
Fax 4017819854

Authorized person
Name DR. ALEX HODOSH
Role DR. -MANAGER
Phone 4014674600

Taxonomy
Taxonomy Code 1223E0200X - Endodontist
License Number 2280
State RI
Is Primary Yes
Taxonomy Code 1223E0200X - Endodontist
License Number 1854
State RI
Is Primary No
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 2280
State RI
Is Primary No
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 1854
State RI
Is Primary No
Taxonomy Code 1223P0106X - Oral and Maxillofacial Pathology Dentist
License Number 2280
State RI
Is Primary No
Taxonomy Code 1223P0300X - Periodontist
License Number 2280
State RI
Is Primary No
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 2280
State RI
Is Primary No
Taxonomy Code 122400000X - Denturist
License Number 2280
State RI
Is Primary No

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD RI
Number 8982-7
State RI
Issuer MASHENTUCKET-PEQUOT
Number DEN999
State RI
Issuer BLUE CROSS BLUE SHEILD MA
Number RG0053
State MA
Issuer UNITED CONCORDIA
Number 780979
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HODOSH DENTAL ASSOCIATES, INC. 401(K) PLAN 2023 050346651 2024-07-24 HODOSH DENTAL ASSOCIATES, INC. 14
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2024-07-24
Name of individual signing ALEX J. HODOSH
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. CASH BALANCE PLAN 2023 050346651 2024-10-02 HODOSH DENTAL ASSOCIATES, INC. 9
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing ALEX J. HODOSH D.M.D.
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. 401(K) PLAN 2022 050346651 2023-10-02 HODOSH DENTAL ASSOCIATES, INC. 15
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2023-10-02
Name of individual signing ALEX J. HODOSH
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. CASH BALANCE PLAN 2022 050346651 2023-07-13 HODOSH DENTAL ASSOCIATES, INC. 9
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2023-07-13
Name of individual signing ALEX J. HODOSH D.M.D.
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. 401(K) PLAN 2021 050346651 2022-10-10 HODOSH DENTAL ASSOCIATES, INC. 12
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing ALEX J. HODOSH
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. CASH BALANCE PLAN 2021 050346651 2022-09-22 HODOSH DENTAL ASSOCIATES, INC. 7
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02904

Signature of
Role Plan administrator
Date 2022-09-22
Name of individual signing ALEX J. HODOSH D.M.D.
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. 401(K) PLAN 2020 050346651 2021-09-30 HODOSH DENTAL ASSOCIATES, INC. 12
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2021-09-30
Name of individual signing ALEX J. HODOSH
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. CASH BALANCE PLAN 2020 050346651 2021-09-27 HODOSH DENTAL ASSOCIATES, INC. 8
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2021-09-27
Name of individual signing ALEX J. HODOSH D.M.D.
Valid signature Filed with authorized/valid electronic signature
HODOSH DENTAL ASSOCIATES, INC. CASH BALANCE PLAN 2019 050346651 2020-10-02 HODOSH DENTAL ASSOCIATES, INC. 7
File View Page
Three-digit plan number (PN) 005
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
HODOSH DENTAL ASSOCIATES, INC. 401(K) PLAN 2019 050346651 2020-10-05 HODOSH DENTAL ASSOCIATES, INC. 10
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4014674600
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/04/03/20190403072049P040000193328001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/08/13/20180813093542P040056910191001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/08/08/20170808083218P040068777533001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/05/19/20160519132752P040075824263001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/13/20151013075645P040040624727001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing ALEX J. HODOSH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/11/20140711124222P040011440799001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547

Signature of
Role Plan administrator
Date 2014-07-11
Name of individual signing ALEX J. HODOSH DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/08/20131008124601P030025167923001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547

Plan administrator’s name and address
Administrator’s EIN 050346651
Plan administrator’s name HODOSH DENTAL ASSOCIATES, INC.
Plan administrator’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547
Administrator’s telephone number 4017813591

Signature of
Role Plan administrator
Date 2013-10-08
Name of individual signing ALEX J. HODOSH DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/28/20120628133845P030004451414001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547

Plan administrator’s name and address
Administrator’s EIN 050346651
Plan administrator’s name HODOSH DENTAL ASSOCIATES, INC.
Plan administrator’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547
Administrator’s telephone number 4017813591

Signature of
Role Plan administrator
Date 2012-06-28
Name of individual signing ALEX J. HODOSH DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/05/25/20110525201025P040303196544001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547

Plan administrator’s name and address
Administrator’s EIN 050346651
Plan administrator’s name HODOSH DENTAL ASSOCIATES, INC.
Plan administrator’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547
Administrator’s telephone number 4017813591

Signature of
Role Plan administrator
Date 2011-05-25
Name of individual signing ALEX J. HODOSH, DMD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/27/20100727081041P040015097541001.pdf
Three-digit plan number (PN) 004
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 4017813591
Plan sponsor’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547

Plan administrator’s name and address
Administrator’s EIN 050346651
Plan administrator’s name HODOSH DENTAL ASSOCIATES, INC.
Plan administrator’s address 243 ELMWOOD AVENUE, PROVIDENCE, RI, 029071547
Administrator’s telephone number 4017813591

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing ALEX J. HODOSH, DMD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ALEX J. HODOSH Agent 243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907, USA

PRESIDENT

Name Role Address
ALEX J. HODOSH PRESIDENT 243 ELMWOOD AVENUE PROVIDENCE, RI 02907 USA

Events

Type Date Old Value New Value
Name Change 1996-11-07 MILTON HODOSH, D.M.D., INC. HODOSH DENTAL ASSOCIATES, INC.

Filings

Number Name File Date
202445725810 Annual Report 2024-02-06
202327245520 Annual Report 2023-02-02
202209288720 Annual Report 2022-02-03
202185973050 Annual Report 2021-01-13
202031205430 Annual Report 2020-01-07
201988632030 Annual Report 2019-03-14
201988631330 Statement of Change of Registered/Resident Agent 2019-03-14
201859583700 Annual Report 2018-03-01
201734511020 Annual Report 2017-02-21
201691227350 Annual Report 2016-01-25

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2922987110 2020-04-11 0165 PPP 243 ELMWOOD AVE, PROVIDENCE, RI, 02907-1547
Loan Status Date 2021-06-30
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 133902
Loan Approval Amount (current) 133902
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address PROVIDENCE, PROVIDENCE, RI, 02907-1547
Project Congressional District RI-01
Number of Employees 11
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 135255.9
Forgiveness Paid Date 2021-04-21
4245018403 2021-02-06 0165 PPS 243 Elmwood Ave, Providence, RI, 02907-1547
Loan Status Date 2022-01-21
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 133902
Loan Approval Amount (current) 133902
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Providence, PROVIDENCE, RI, 02907-1547
Project Congressional District RI-01
Number of Employees 11
NAICS code 621210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 134995.53
Forgiveness Paid Date 2021-12-08

Related by officers

No related officers

Related by address

243 ELMWOOD AVENUE, PROVIDENCE, RI, 02907, USA

WHITMARSH REALTY CORP.

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State

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