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  5. Pediatric Dentistry, Ltd.

Pediatric Dentistry, Ltd.

Company Details

Name: Pediatric Dentistry, Ltd.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 03 Jul 1990 (35 years ago)
Identification Number: 000061035
ZIP code: 02920
County: Providence County
Principal Address: 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920, USA
Purpose: THE PRACTICE OF DENTISTRY
NAICS: 621210 - Offices of Dentists
Historical names: Steven D. Lasser, D.M.D., P.C.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1063545143 2007-03-14 2020-08-22 245 LAUREL AVE, PROVIDENCE, RI, 029065730, US 1090 NEW LONDON AVE, CRANSTON, RI, 029203035, US

Contacts
Phone +1 401-943-7535

Authorized person
Name DR. STEVEN DENNIS LASSER
Role PEDIATRIC DENTIST
Phone 4019437535

Taxonomy
Taxonomy Code 1223P0221X - Pediatric Dentist
License Number 1726
State RI
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number PD-00520
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2023 050454320 2024-05-05 PEDIATRIC DENTISTRY LTD 45
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2024-05-05
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2023 050454320 2024-05-05 PEDIATRIC DENTISTRY LTD 45
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2024-05-05
Name of individual signing A1
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2022 050454320 2023-03-09 PEDIATRIC DENTISTRY LTD 49
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2023-03-09
Name of individual signing CRAIG ELICE
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2021 050454320 2022-04-02 PEDIATRIC DENTISTRY LTD 50
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2022-04-02
Name of individual signing PEDIATRIC DENTISTRY, LTD
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2020 050454320 2021-04-02 PEDIATRIC DENTISTRY LTD 43
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2021-04-02
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401(K) PROFIT SHARING PLAN & TRUST 2019 050454320 2020-04-10 PEDIATRIC DENTISTRY LTD 42
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2020-04-10
Name of individual signing CRAIG E. ELICE, DDS
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401 K PROFIT SHARING PLAN TRUST 2018 050454320 2019-03-28 PEDIATRIC DENTISTRY LTD 43
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2019-03-28
Name of individual signing CRAIG E. ELICE, DDS
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY LTD 401 K PROFIT SHARING PLAN TRUST 2017 050454320 2018-06-12 PEDIATRIC DENTISTRY LTD 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1990-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2018-06-12
Name of individual signing CRAIG E. ELICE, DDS, MS
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY, LTD 401 K PROFIT SHARING PLAN TRUST 2016 050454320 2017-06-28 PEDIATRIC DENTISTRY, LTD 40
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVE., CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing CRAIG ELICE
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC DENTISTRY,LTD. 401(K) PROFIT SHARING PLAN 2015 050454320 2016-05-10 PEDIATRIC DENTISTRY, LTD 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/05/05/20150505145158P040062629885001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2015-05-05
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/23/20140623205947P040460065041001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2014-06-23
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/13/20130613094834P030090058069001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2013-06-13
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/26/20120626134003P030004326838001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2012-06-26
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/25/20110425145231P030008054902001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2011-04-25
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726115835P040399078593001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621210
Sponsor’s telephone number 4014635540
Plan sponsor’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 050454320
Plan administrator’s name PEDIATRIC DENTISTRY, LTD
Plan administrator’s address 1090 NEW LONDON AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4014635540

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing CRAIG E. ELICE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CHACE RUTTENBERG & FREEDMAN, LLP Agent ONE PARK ROW SUITE 300, PROVIDENCE, RI, 02903, USA

TREASURER

Name Role Address
STEVEN D LASSER TREASURER 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

SECRETARY

Name Role Address
CRAIG E ELICE SECRETARY 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

PRESIDENT

Name Role Address
STEVEN D LASSER DMD PRESIDENT 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

VICE PRESIDENT

Name Role Address
CRAIG E. ELICE VICE PRESIDENT 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

DIRECTOR

Name Role Address
CRAIG E ELICE DIRECTOR 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA
STEVEN D LASSER DIRECTOR 1090 NEW LONDON AVENUE CRANSTON, RI 02920 USA

Events

Type Date Old Value New Value
Name Change 1993-11-10 Steven D. Lasser, D.M.D., P.C. Pediatric Dentistry, Ltd.

Filings

Number Name File Date
202453575900 Annual Report 2024-05-01
202332372110 Annual Report 2023-04-05
202209719620 Annual Report 2022-02-08
202191917910 Annual Report 2021-02-18
202038649930 Statement of Change of Registered/Resident Agent 2020-04-24
202033126300 Annual Report 2020-01-27
201985321900 Annual Report 2019-01-29
201857576100 Annual Report 2018-02-05
201733769350 Annual Report 2017-02-08
201691674640 Annual Report 2016-02-03

Related by officers

CHACE RUTTENBERG & FREEDMAN, LLP

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CRAIG E ELICE

Rhode Island Academy of Pediatric Dentistry

Related by address

1090 NEW LONDON AVENUE, CRANSTON, RI, 02920, USA

Advanced Cosmetic Dentistry, Ltd. SOUTHERN NEW ENGLAND TREATMENT CENTER, INC. Rhode Island Academy of Pediatric Dentistry PEDIATRIC DENTISTRY PROPERTIES, LLC LMT REALTY, LLC

Date of last update: 07 Oct 2024

Sources: Rhode Island Department of State

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