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 DentistsThis 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
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
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1952590424 | 2007-10-19 | 2007-10-19 | 1351 SMITH ST, NORTH PROVIDENCE, RI, 029113340, US | 1351 SMITH ST, NORTH PROVIDENCE, RI, 029113340, US | |||||||||||||||||||||||||||||||||||||||||||
|
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 |
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 | |||||||||||||||||||||||||||||||||
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JOSEPH A. IZZI, M.D, INC. PROFIT SHARING PLAN | 2014 | 050346567 | 2015-07-30 | JOSEPH A. IZZI, M.D., INC. | 2 | |||||||||||||||||||||||||||||||||
|
Role | Plan administrator |
Date | 2015-07-30 |
Name of individual signing | JOSEPH A.IZZI |
Valid signature | Filed with authorized/valid electronic signature |
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 |
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 |
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 |
Name | Role | Address |
---|---|---|
JONATHAN V. KALANDER, ESQ. | Agent | 931 JEFFERSON BOULEVARD SUITE 2004, WARWICK, RI, 02886, USA |
Name | Role | Address |
---|---|---|
JOSEPH A. IZZI, SR. | PRESIDENT | 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA |
Name | Role | Address |
---|---|---|
JOSEPH A. IZZI, SR. | TREASURER | 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA |
Name | Role | Address |
---|---|---|
JOSEPH A. IZZI, SR. | SECRETARY | 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA |
Name | Role | Address |
---|---|---|
JOSEPH A. IZZI, SR. | VICE PRESIDENT | 1351 SMITH STREET NORTH PROVIDENCE, RI 02911 USA |
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 |
Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State