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  5. Joseph A. Izzi, M.D. Inc.

Joseph A. Izzi, M.D. Inc.

Company Details

Name: Joseph A. Izzi, M.D. Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 22 Oct 1971 (53 years ago)
Date of Dissolution: 23 Jan 2020 (5 years ago)
Date of Status Change: 23 Jan 2020 (5 years ago)
Identification Number: 000020879
ZIP code: 02911
County: Providence County
Principal Address: 1351 SMITH STREET, NORTH PROVIDENCE, RI, 02911, USA
Purpose: MEDICAL PRACTICE
NAICS: 621210 - Offices of Dentists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952590424 2007-10-19 2007-10-19 1351 SMITH ST, NORTH PROVIDENCE, RI, 029113340, US 1351 SMITH ST, NORTH PROVIDENCE, RI, 029113340, US

Contacts
Phone +1 401-353-5550
Fax 4013532909

Authorized person
Name DR. JOSEPH ANTHONY IZZI SR.
Role ORTHOPAEDIC SURGEON
Phone 4013535550

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 3690
State RI
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CHIP
Number 001100
State RI
Issuer UNITED HEALTH
Number 09-00203
State RI
Issuer BLUE CROSS
Number 0000002052
State RI
Issuer STATE LICENSE
Number 3690
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN 2015 050346567 2016-07-26 JOSEPH A. IZZI, M.D., INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-10-01
Business code 621111
Sponsor’s telephone number 4013535550
Plan sponsor’s DBA name C
Plan sponsor’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340
JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN 2014 050346567 2015-07-30 JOSEPH A. IZZI, M.D., INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-10-01
Business code 621111
Sponsor’s telephone number 4013535550
Plan sponsor’s DBA name C
Plan sponsor’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing JOSEPH A.IZZI
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN 2013 050346567 2014-05-05 JOSEPH A. IZZI, M.D., INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-10-01
Business code 621111
Sponsor’s telephone number 4013535550
Plan sponsor’s DBA name C
Plan sponsor’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340

Signature of
Role Plan administrator
Date 2014-05-05
Name of individual signing JOSEPH A.IZZI
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN 2012 050346567 2013-08-22 JOSEPH A. IZZI, M.D., INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-10-01
Business code 621111
Sponsor’s telephone number 4013535550
Plan sponsor’s DBA name C
Plan sponsor’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340

Signature of
Role Plan administrator
Date 2013-08-22
Name of individual signing JOSEPH A.IZZI
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN 2011 050346567 2013-02-14 JOSEPH A. IZZI, M.D., INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-10-01
Business code 621111
Sponsor’s telephone number 4013535550
Plan sponsor’s DBA name C
Plan sponsor’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340

Plan administrator’s name and address
Administrator’s EIN 050346567
Plan administrator’s name JOSEPH A. IZZI, M.D., INC.
Plan administrator’s address 1351 SMITH STREET, NORTH PROVIDENCE, RI, 029113340
Administrator’s telephone number 4013535550

Signature of
Role Plan administrator
Date 2013-02-14
Name of individual signing JOSEPH IZZI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JONATHAN V. KALANDER, ESQ. Agent 931 JEFFERSON BOULEVARD SUITE 2004, WARWICK, RI, 02886, USA

PRESIDENT

Name Role Address
JOSEPH A. IZZI, SR. PRESIDENT 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA

TREASURER

Name Role Address
JOSEPH A. IZZI, SR. TREASURER 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA

SECRETARY

Name Role Address
JOSEPH A. IZZI, SR. SECRETARY 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA

VICE PRESIDENT

Name Role Address
JOSEPH A. IZZI, SR. VICE PRESIDENT 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA

Filings

Number Name File Date
202032906390 Articles of Dissolution 2020-01-23
201882582440 Annual Report 2018-12-13
201859303920 Annual Report 2018-02-28
201734817960 Annual Report 2017-02-27
201695356100 Annual Report 2016-03-29
201557892500 Annual Report 2015-03-21
201435553220 Annual Report 2014-02-13
201313543040 Annual Report 2013-03-05
201290788630 Annual Report 2012-03-08
201175345150 Annual Report 2011-02-21

Related by officers

JONATHAN V. KALANDER, ESQ.

C & D, Inc. DPM Investments, Inc. Everson Construction, Inc. ERNEST P. MENNILLO, M.D., INC. GOODWIN REALTY, INC. EXETER COUNTRY CLUB, INC. HARMONY PATTERN & CASTING CO., INC. Systems Resource Management, Inc. R.I. REFRIGERATION SUPPLY CO., INC. Perry-McStay Funeral Home, Inc.

Related by address

1351 SMITH STREET, NORTH PROVIDENCE, RI, 02911, USA

JOBAR MANAGEMENT, L.L.C. Castle Dent Realty, LLC

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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