| Name: | THOMAS S. MULVEY, D.D.S., L.L.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Nov 2003 (21 years ago) |
| Identification Number: | 000136052 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | 111 POINT STREET SUITE 1, PROVIDENCE, RI, 02903-4715, USA |
| Purpose: | DENTISTRY |
| Fictitious names: |
Providence Pediatric Dentistry (trading name, 2017-11-15 - ) |
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 | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942322458 | 2007-04-04 | 2020-07-30 | P.O. BOX 2608, PROVIDENCE, RI, 02906, US | 111 POINT STREET, SUITE 1, PROVIDENCE, RI, 02903, US | |||||||||||||||||||||||||||
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| Phone | +1 917-566-2652 |
| Fax | 4012723539 |
| Phone | +1 401-272-3443 |
Authorized person
| Name | DR. THOMAS SPENCER MULVEY |
| Role | OWNER |
| Phone | 9175662652 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 2821 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | TM51137 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| THOMAS S. MULVEY, DDS | Agent | 111 POINT STREET SUITE 1, PROVIDENCE, RI, 02903, USA |
| Number | Name | File Date |
|---|---|---|
| 202447675780 | Annual Report | 2024-03-02 |
| 202327119100 | Annual Report | 2023-02-01 |
| 202208996310 | Annual Report | 2022-02-01 |
| 202101314770 | Annual Report | 2021-09-13 |
| 202061366060 | Annual Report | 2020-10-05 |
| 202046682440 | Annual Report | 2020-07-28 |
| 202045608900 | Revocation Notice For Failure to File An Annual Report | 2020-07-20 |
| 201920883140 | Statement of Change of Registered/Resident Agent Office | 2019-09-20 |
| 201918912610 | Revocation Notice For Failure to Maintain a Registered Office | 2019-09-11 |
| 201918507780 | Registered Office Not Maintained | 2019-08-29 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7660468606 | 2021-03-24 | 0165 | PPS | 111 Point St # 1, Providence, RI, 02903-4715 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7451207301 | 2020-04-30 | 0165 | PPP | 111 POINT ST, PROVIDENCE, RI, 02903-4715 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 11 Apr 2025
Sources: Rhode Island Department of State
