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  5. East Bay Oral Surgery, Inc.

East Bay Oral Surgery, Inc.

Company Details

Name: East Bay Oral Surgery, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 14 Mar 2003 (22 years ago)
Identification Number: 000130650
ZIP code: 02914
County: Providence County
Principal Address: 2224 PAWTUCKET AVE, EAST PROVIDENCE, RI, 02914, USA
Purpose: TO ENGAGE IN THE PRACTICE OF DENTISTRY, ORAL AND MAXILLOFACIAL SURGERY
NAICS: 621210 - Offices of Dentists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1285692731 2006-05-03 2008-04-20 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914, US 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914, US

Contacts
Phone +1 401-435-4240
Fax 4014354245

Authorized person
Name DR. STEPHEN NICHOLAS BAKIAS
Role OWNER
Phone 4014354240

Taxonomy
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 1686
State RI
Is Primary Yes
Taxonomy Code 1223S0112X - Oral and Maxillofacial Surgery (Dentist)
License Number 16987
State MA
Is Primary No

Other Provider Identifiers
Issuer BLUE CROSS
Number X11644
State MA
Issuer BLUE CROSS
Number 80301
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2022 043746687 2023-02-10 EAST BAY ORAL SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2022 043746687 2023-10-31 EAST BAY ORAL SURGERY, INC. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2021 043746687 2022-04-01 EAST BAY ORAL SURGERY, INC. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2020 043746687 2021-08-31 EAST BAY ORAL SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2019 043746687 2020-06-05 EAST BAY ORAL SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2018 043746687 2019-04-10 EAST BAY ORAL SURGERY, INC. 4
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2017 043746687 2018-10-04 EAST BAY ORAL SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY, INC. PROFIT SHARING PLAN 2016 043746687 2017-07-07 EAST BAY ORAL SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, #7, EAST PROVIDENCE, RI, 02914
EAST BAY ORAL SURGERY DEFINED BENEFIT PLAN 2014 043746687 2015-10-13 EAST BAY ORAL SURGERY, INC. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
EAST BAY ORAL SURGERY, INC. DEFINED BENEFIT PLAN 2014 043746687 2015-10-13 EAST BAY ORAL SURGERY, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/01/20141001084125P030008918047001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2014-10-01
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015134413P030047537489001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/16/20131016082117P030018257925001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 043746687
Plan administrator’s name EAST BAY ORAL SURGERY, INC.
Plan administrator’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014354240

Signature of
Role Plan administrator
Date 2013-10-16
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 043746687
Plan administrator’s name EAST BAY ORAL SURGERY, INC.
Plan administrator’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014354240

Signature of
Role Plan administrator
Date 2012-09-27
Name of individual signing STEPHEN N. BAKIOS DDS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/27/20110927152429P030138064049001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 043746687
Plan administrator’s name EAST BAY ORAL SURGERY, INC.
Plan administrator’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014354240

Signature of
Role Plan administrator
Date 2011-09-27
Name of individual signing PATRICIA J. CONGER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/14/20101014013008P070026004865001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621210
Sponsor’s telephone number 4014354240
Plan sponsor’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914

Plan administrator’s name and address
Administrator’s EIN 043746687
Plan administrator’s name EAST BAY ORAL SURGERY, INC.
Plan administrator’s address 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI, 02914
Administrator’s telephone number 4014354240

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing PATRICIA J. CONGER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
R. JEFFREY KNISLEY Agent 10 WEYBOSSET STREET SUITE 800, PROVIDENCE, RI, 02903, USA

TREASURER

Name Role Address
STEPHEN N. BAKIOS TREASURER 2224 PAWTUCKET AVENUE EAST PROVIDENCE, RI 02914 USA

SECRETARY

Name Role Address
STEPHEN N. BAKIOS SECRETARY 2224 PAWTUCKET AVENUE EAST PROVIDENCE, RI 02914 USA

PRESIDENT

Name Role Address
STEPHEN N BAKIOS PRESIDENT 2224 PAWTUCKET AVENUE EAST PROVIDENCE, RI 02914- USA

DIRECTOR

Name Role Address
STEPHEN N. BAKIOS DIRECTOR 2224 PAWTUCKET AVENUE EAST PROVIDENCE, RI 02914 USA

Filings

Number Name File Date
202446995870 Annual Report 2024-02-20
202329725840 Annual Report 2023-02-27
202209673490 Annual Report 2022-02-08
202186128530 Annual Report 2021-01-12
201930706310 Annual Report 2019-12-26
201983942620 Annual Report 2019-01-08
201856849700 Annual Report 2018-01-26
201731067520 Annual Report 2017-01-30
201629257800 Statement of Change of Registered/Resident Agent Office 2016-12-30
201690877790 Annual Report 2016-01-20

Related by officers

R. JEFFREY KNISLEY

The Community Connection Traci Ann Gardens, Inc. Private Label Merchandising Corporation Princeton Alumni Association of Rhode Island Creative Capital, LLC AZ-TECH.FORMS, INC. TeleCare Associates, Inc. Goff Architecture, Ltd. parsonsKellogg llc Greater Westerly Fire Alliance

STEPHEN N. BAKIOS

STEPHEN N. BAKIOS, LTD. STEPHEN N. BAKIOS, D.D.S., PROFESSIONAL CORPORATION S N BAKIOS, LLC

STEPHEN N BAKIOS

STEPHEN N. BAKIOS, LTD.

Related by address

2224 PAWTUCKET AVE, EAST PROVIDENCE, RI, 02914, USA

INDEPENDENCE, LLC PRODUCTS FOR INDEPENDENT LIVING

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

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