| Name: | Access Dental Care, P.C., Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 20 Aug 1997 (28 years ago) |
| Identification Number: | 000096490 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 1234 MINERAL SPRING AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | TO PROVIDE DENTAL CARE. |
| Historical names: |
Geriatric Dental Care, P.C., Inc. |
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 | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992858054 | 2007-01-19 | 2020-08-22 | 1234 MINERAL SPRING AVE, NORTH PROVIDENCE, RI, 029044105, US | 1234 MINERAL SPRING AVE, NORTH PROVIDENCE, RI, 029044105, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-722-5800 |
| Fax | 4017226718 |
Authorized person
| Name | MELANIE GENTRY |
| Role | OFFICE MANAGER |
| Phone | 4017225800 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS MA |
| Number | RG0044 |
| State | MA |
| Issuer | MEDICAID |
| Number | AD24688 |
| State | RI |
| Issuer | BLUE CROSS RI |
| Number | 8767-2 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| MARYANNE PEZZULLO, ESQ. | Agent | PETRARCA AND MCGAIR INC. 797 BALD HILL ROAD, WARWICK, RI, 02886, USA |
| Name | Role | Address |
|---|---|---|
| JOHN MANOUSOS | PRESIDENT | 1234 MINERAL SPRING AVENUE NORTH PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| TARANEH TABATABAIE | VICE PRESIDENT | 1234 MINERAL SPRING AVE NORTH PROVIDENCE, RI 02904 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1997-12-04 | Geriatric Dental Care, P.C., Inc. | Access Dental Care, P.C., Inc. |
| Number | Name | File Date |
|---|---|---|
| 202447336140 | Annual Report | 2024-02-27 |
| 202330161860 | Annual Report | 2023-03-08 |
| 202213876560 | Annual Report | 2022-04-04 |
| 202191841080 | Annual Report | 2021-02-17 |
| 202062049700 | Annual Report | 2020-10-06 |
| 202054997020 | Revocation Notice For Failure to File An Annual Report | 2020-09-16 |
| 201916229350 | Annual Report | 2019-08-29 |
| 201907009710 | Revocation Notice For Failure to File An Annual Report | 2019-07-24 |
| 201859069790 | Annual Report | 2018-02-23 |
| 201737544340 | Annual Report | 2017-03-07 |
Date of last update: 09 Apr 2025
Sources: Rhode Island Department of State
