| Name: | John S. Kacewicz, D.M.D., Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revocation |
| Date of Organization in Rhode Island: | 24 Sep 2002 (23 years ago) |
| Date of Dissolution: | 13 Mar 2025 (a month ago) |
| Date of Status Change: | 13 Mar 2025 (a month ago) |
| Identification Number: | 000127177 |
| ZIP code: | 02818 |
| County: | Kent County |
| Principal Address: | 990 MAIN STREET, EAST GREENWICH, RI, 02818, USA |
| Purpose: | TO PROVIDE ORTHODONTIC SERVICES TO PATIENTS REQUESTING SUCH SERVICES |
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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396468013 | 2022-09-20 | 2022-09-20 | 990 MAIN ST, EAST GREENWICH, RI, 028183182, US | 990 MAIN ST, EAST GREENWICH, RI, 028183182, US | |||||||||||||||
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| Phone | +1 401-884-6500 |
| Fax | 4018864432 |
Authorized person
| Name | ANNE DESOUSA |
| Role | OFFICE MANAGER |
| Phone | 4018846500 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN S. KACEWICZ, D.M.D. 401(K) PROFIT SHARING PLAN | 2009 | 050395040 | 2010-07-14 | JOHN S. KACEWICZ, D.M.D. | 12 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 050395040 |
| Plan administrator’s name | JOHN S. KACEWICZ, D.M.D. |
| Plan administrator’s address | 990 MAIN STREET, EAST GREENWICH, RI, 02818 |
| Administrator’s telephone number | 4018846500 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-14 |
| Name of individual signing | JOHN S. KACEWICZ, D.M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MICHAEL S. KACEWICZ DMD | PRESIDENT | 990 MAIN STREET EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL S. KACEWICZ DMD | TREASURER | 990 MAIN STREET EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL S. KACEWICZ DMD | SECRETARY | 990 MAIN STREET EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL S. KACEWICZ DMD | VICE PRESIDENT | 990 MAIN STREET EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL S. KACEWICZ DMD | DIRECTOR | 990 MAIN STREET EAST GREENWICH, RI 02818 USA |
| Number | Name | File Date |
|---|---|---|
| 202448473060 | Annual Report | 2024-03-12 |
| 202331230510 | Annual Report - Amended | 2023-03-21 |
| 202331228120 | Annual Report | 2023-03-21 |
| 202224128430 | Statement of Change of Registered/Resident Agent | 2022-10-14 |
| 202222149220 | Revocation Notice For Failure to Maintain a Registered Agent | 2022-08-15 |
| 202220819710 | Agent Resigned | 2022-06-30 |
| 202213871420 | Annual Report | 2022-04-03 |
| 202193469390 | Annual Report | 2021-03-02 |
| 202078818550 | Statement of Change of Registered Office by the Registered Agent | 2020-12-07 |
| 202036817700 | Annual Report | 2020-03-26 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
