Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Providence County
    4. ›
  4. 02864
    5. ›
  5. William B. Chan, D.M.D., Inc.

William B. Chan, D.M.D., Inc.

Company Details

Name: William B. Chan, D.M.D., Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 11 May 1990 (35 years ago)
Date of Dissolution: 25 Nov 2024 (5 months ago)
Date of Status Change: 25 Nov 2024 (5 months ago)
Identification Number: 000060418
ZIP code: 02864
County: Providence County
Principal Address: 2359 MENDON ROAD, CUMBERLAND, RI, 02864, USA
Purpose: PEDIATRIC DENTIST

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

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2020 050453017 2021-10-07 WILLIAM B. CHAN, D.M.D., INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. CASH BALANCE PLAN 2019 050453017 2020-07-20 WILLIAM B. CHAN, D.M.D., INC. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2019 050453017 2020-10-12 WILLIAM B. CHAN, D.M.D., INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2018 050453017 2019-07-24 WILLIAM B. CHAN, D.M.D., INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. CASH BALANCE PLAN 2018 050453017 2019-07-24 WILLIAM B. CHAN, D.M.D., INC. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2017 050453017 2018-08-24 WILLIAM B. CHAN, D.M.D., INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. CASH BALANCE PLAN 2017 050453017 2018-08-24 WILLIAM B. CHAN, D.M.D., INC. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. CASH BALANCE PLAN 2016 050453017 2017-08-21 WILLIAM B. CHAN, D.M.D., INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2016 050453017 2017-08-21 WILLIAM B. CHAN, D.M.D., INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
WILLIAM B. CHAN, D.M.D., INC. RETIREMENT PLAN 2015 050453017 2016-10-13 WILLIAM B. CHAN, D.M.D., INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/13/20161013105734P030025383889001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/21/20150721081702P030125670161001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/21/20150721081301P030108315591001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/30/20140930145450P040009715951001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/30/20140930145232P030008636175001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/08/06/20130806122211P030429853841001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2013-08-06
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-06
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/09/20120409134102P040009476530001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864

Plan administrator’s name and address
Administrator’s EIN 050453017
Plan administrator’s name WILLIAM B. CHAN, D.M.D., INC.
Plan administrator’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
Administrator’s telephone number 4013343070

Signature of
Role Plan administrator
Date 2012-04-09
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-09
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/03/07/20110307094756P030100197840001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864

Plan administrator’s name and address
Administrator’s EIN 050453017
Plan administrator’s name WILLIAM B. CHAN, D.M.D., INC.
Plan administrator’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
Administrator’s telephone number 4013343070

Signature of
Role Plan administrator
Date 2011-03-07
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-07
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864

Plan administrator’s name and address
Administrator’s EIN 050453017
Plan administrator’s name WILLIAM B. CHAN, D.M.D., INC.
Plan administrator’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
Administrator’s telephone number 4013343070

Signature of
Role Plan administrator
Date 2011-03-07
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-07
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/18/20100818165213P070004422040001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1985-01-01
Business code 621210
Sponsor’s telephone number 4013343070
Plan sponsor’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864

Plan administrator’s name and address
Administrator’s EIN 050453017
Plan administrator’s name WILLIAM B. CHAN, D.M.D., INC.
Plan administrator’s address 2359 MENDON ROAD, CUMBERLAND, RI, 02864
Administrator’s telephone number 4013343070

Signature of
Role Plan administrator
Date 2010-08-18
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-18
Name of individual signing WILLIAM CHAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
EDWARD F. YAZBAK Agent 501 GREAT ROAD UNIT 106, NORTH SMITHFIELD, RI, 02896, USA

PRESIDENT

Name Role Address
WILLIAM B CHAN PRESIDENT 2359 MENDON ROAD CUMBERLAND, RI 02864 USA

Filings

Number Name File Date
202444180340 Annual Report 2024-01-18
202327375470 Annual Report 2023-02-03
202219923420 Statement of Change of Registered/Resident Agent 2022-06-23
202212802380 Annual Report 2022-03-07
202198606240 Annual Report 2021-06-22
202196752660 Revocation Notice For Failure to File An Annual Report 2021-05-19
202036301470 Annual Report 2020-03-12
201986910040 Annual Report 2019-02-18
201985939330 Statement of Change of Registered Office by the Registered Agent 2019-02-04
201857563470 Annual Report 2018-02-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3976757209 2020-04-27 0165 PPP 2359 MENDON RD, CUMBERLAND, RI, 02864-3707
Loan Status Date 2021-10-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 197700
Loan Approval Amount (current) 197700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 104771
Servicing Lender Name Navigant CU
Servicing Lender Address 1005 Douglas Pike, SMITHFIELD, RI, 02917-1206
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address CUMBERLAND, PROVIDENCE, RI, 02864-3707
Project Congressional District RI-01
Number of Employees 17
NAICS code 621210
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 104771
Originating Lender Name Navigant CU
Originating Lender Address SMITHFIELD, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 200418.38
Forgiveness Paid Date 2021-09-08

Related by officers

EDWARD F. YAZBAK

BRANCH VILLAGE CONDOMINIUM ASSOCIATION, INC. YAZBAK & COMPANY, LTD. MARCOVICH, YAZBAK & COMPANY, LTD. MENDON REALTY LLC KABRED REALTY LLC 193 KNIGHT STREET LLC Laura D Rau MD LLC Dube's Plumbing, Inc Chan Orthodontic Dentistry, LLC C. Warrington Defense Consulting LLC

WILLIAM B CHAN

B&J REALTY, INC.

Related by address

2359 MENDON ROAD, CUMBERLAND, RI, 02864, USA

2359 Mendon Road, LLC MENDON REALTY LLC Chan Orthodontic Dentistry, LLC Cumberland Dental Specialists, Inc.

Date of last update: 08 Apr 2025

Sources: Rhode Island Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 riorgs.com, Part of Big Data Integrated