| 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 |
| NAICS: | 621210 - Offices of Dentists |
| Fictitious names: |
Providence Pediatric Dentistry (trading name, 2017-11-15 - ) |
| 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: 09 Oct 2024
Sources: Rhode Island Department of State
