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Asciolla Family Dentistry, Inc.

Company Details

Name: Asciolla Family Dentistry, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 31 Dec 1985 (39 years ago)
Date of Dissolution: 21 Mar 2022 (3 years ago)
Date of Status Change: 21 Mar 2022 (3 years ago)
Identification Number: 000036959
ZIP code: 02835
County: Newport County
Principal Address: 455 DAVIT AVENUE PO BOX 6, JAMESTOWN, RI, 02835, USA
Purpose: DENTAL PRACTICE
NAICS: 621210 - Offices of Dentists
Historical names: John V. Puleo, D.D.S.,Inc.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629353552 2011-10-11 2011-10-11 880 MAIN ST, EAST GREENWICH, RI, 028183113, US 880 MAIN ST, EAST GREENWICH, RI, 028183113, US

Contacts

Phone +1 401-884-5242
Fax 4018849464

Authorized person

Name PAMELA J KORUS
Role OFFICE MANAGER
Phone 4018845242

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 02460
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2015 050418381 2016-05-11 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2015 050418381 2016-04-06 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113

Plan administrator’s name and address

Administrator’s EIN 050418381
Plan administrator’s name ASCIOLLA FAMILY DENTISTRY, INC.
Plan administrator’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
Administrator’s telephone number 4018845242
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2014 050418381 2015-10-05 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113

Plan administrator’s name and address

Administrator’s EIN 050418381
Plan administrator’s name ASCIOLLA FAMILY DENTISTRY, INC.
Plan administrator’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
Administrator’s telephone number 4018845242

Signature of

Role Plan administrator
Date 2015-10-05
Name of individual signing MARIA ASCIOLLA
Valid signature Filed with authorized/valid electronic signature
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2013 050418381 2014-07-08 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113

Plan administrator’s name and address

Administrator’s EIN 050418381
Plan administrator’s name ASCIOLLA FAMILY DENTISTRY, INC.
Plan administrator’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
Administrator’s telephone number 4018845242

Signature of

Role Plan administrator
Date 2014-07-08
Name of individual signing MARIA ASCIOLLA
Valid signature Filed with authorized/valid electronic signature
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2012 050418381 2013-07-26 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113

Plan administrator’s name and address

Administrator’s EIN 050418381
Plan administrator’s name ASCIOLLA FAMILY DENTISTRY, INC.
Plan administrator’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
Administrator’s telephone number 4018845242

Signature of

Role Plan administrator
Date 2013-07-26
Name of individual signing MARIA ASCIOLLA
Valid signature Filed with authorized/valid electronic signature
ASCIOLLA FAMILY DENTISTRY, INC. 401K PROFIT SHARING PLAN 2011 050418381 2012-04-16 ASCIOLLA FAMILY DENTISTRY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 4018845242
Plan sponsor’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113

Plan administrator’s name and address

Administrator’s EIN 050418381
Plan administrator’s name ASCIOLLA FAMILY DENTISTRY, INC.
Plan administrator’s address 880 MAIN STREET, EAST GREENWICH, RI, 028183113
Administrator’s telephone number 4018845242

Signature of

Role Plan administrator
Date 2012-04-16
Name of individual signing MARIA ASCIOLLA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARIA ASCIOLLA Agent 455 DAUIT AVENUE/PO BOX 6, JAMESTOWN, RI, 02835, USA

PRESIDENT

Name Role Address
MARIA ASCIOLLA PRESIDENT 455 DAVOT AVE, PO BOX 6 JAMESTOWN, RI 02835 USA

Events

Type Date Old Value New Value
Name Change 2000-12-12 John V. Puleo, D.D.S.,Inc. Asciolla Family Dentistry, Inc.

Filings

Number Name File Date
202213240730 Articles of Dissolution 2022-03-21
202210990070 Annual Report 2022-02-15
202195447170 Annual Report 2021-04-01
202047626740 Statement of Change of Registered/Resident Agent 2020-08-03
202045842160 Annual Report 2020-07-20
201908894450 Annual Report 2019-08-01
201906967930 Revocation Notice For Failure to File An Annual Report 2019-07-24
201880850730 Annual Report 2018-11-06
201875431450 Revocation Notice For Failure to File An Annual Report 2018-08-24
201746747640 Annual Report 2017-06-29

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State