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Jacob Werba, DDS, Ltd.

Company Details

Name: Jacob Werba, DDS, Ltd.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 20 Jan 2004 (21 years ago)
Identification Number: 000137371
ZIP code: 02903
County: Providence County
Principal Address: 655 BROAD STREET, PROVIDENCE, RI, 02903, USA
Purpose: TO ENGAGE IN THE PRACTICE OF GENERAL DENTISTRY

Industry & Business Activity

NAICS

621210 Offices of Dentists

This 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

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871705418 2007-05-04 2020-08-22 655 BROAD ST, PROVIDENCE, RI, 029071444, US 655 BROAD ST, PROVIDENCE, RI, 029071444, US

Contacts

Phone +1 401-751-9050
Fax 4018610873

Authorized person

Name DR. JACOB DAVID WERBA
Role OWNER
Phone 4017519050

Taxonomy

Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DEN01863
State RI
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number JW57856
State RI

Agent

Name Role Address
J. RICHARD RATCLIFFE, ESQ. Agent 40 WESTMINSTER STREET SUITE 700, PROVIDENCE, RI, 02903, USA

TREASURER

Name Role Address
JACOB WERBA TREASURER 655 BROAD STREET PROVIDENCE, RI 02907 USA

SECRETARY

Name Role Address
JACOB WERBA SECRETARY 655 BROAD STREET PROVIDENCE, RI 02907 USA

PRESIDENT

Name Role Address
JACOB WERBA PRESIDENT 655 BROAD STREET PROVIDENCE, RI 02907- USA

DIRECTOR

Name Role Address
JACOB WERBA DIRECTOR 655 BROAD STREET PROVIDENCE, RI 02907 USA

Filings

Number Name File Date
202451686590 Annual Report 2024-04-19
202338846660 Annual Report 2023-06-28
202338067380 Revocation Notice For Failure to File An Annual Report 2023-06-19
202215448350 Annual Report 2022-04-22
202193955280 Annual Report 2021-03-16
202039510950 Annual Report 2020-05-08
202038763780 Statement of Change of Registered/Resident Agent 2020-04-27
201987575680 Annual Report 2019-02-26
201855578070 Annual Report 2018-01-03
201730947760 Annual Report 2017-01-27

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5305937703 2020-05-01 0165 PPP 655 BROAD ST, PROVIDENCE, RI, 02907-1444
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 18421
Loan Approval Amount (current) 34897
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description New Business or 2 years or less
Project Address PROVIDENCE, PROVIDENCE, RI, 02907-1444
Project Congressional District RI-01
Number of Employees 6
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 35263.18
Forgiveness Paid Date 2021-05-20
5246328300 2021-01-25 0165 PPS 655 Broad St, Providence, RI, 02907-1444
Loan Status Date 2021-11-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 34336
Loan Approval Amount (current) 34336
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Providence, PROVIDENCE, RI, 02907-1444
Project Congressional District RI-01
Number of Employees 7
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 34587.17
Forgiveness Paid Date 2021-10-20

Date of last update: 11 Apr 2025

Sources: Rhode Island Department of State