| Name: | Distinctive Dentistry Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 15 Jul 2008 (17 years ago) |
| Date of Dissolution: | 26 Oct 2016 (8 years ago) |
| Date of Status Change: | 26 Oct 2016 (8 years ago) |
| Identification Number: | 000484586 |
| ZIP code: | 02917 |
| County: | Providence County |
| Principal Address: | 41 SANDERSON ROAD SUITE 106, SMITHFIELD, RI, 02917, USA |
| Purpose: | DENTISTRY |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063649549 | 2009-06-11 | 2011-05-26 | 595 PUTNAM PIKE, GREENVILLE, RI, 028282137, US | 595 PUTNAM PIKE, GREENVILLE, RI, 028282137, US | |||||||||||||||||||||
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| Phone | +1 401-949-1420 |
| Fax | 4019495494 |
Authorized person
| Name | DR. DEREK E HATHAWAY |
| Role | PRESIDENT |
| Phone | 4019491420 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | DI83209 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DISTINCTIVE DENTISTRY, INC. 401(K) PROFIT SHARING PLAN | 2015 | 262883958 | 2016-02-24 | DISTINCTIVE DENTISTRY, INC. | 9 | |||||||||||||
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| DISTINCTIVE DENTISTRY, INC. 401(K) PROFIT SHARING PLAN | 2014 | 262883958 | 2015-03-26 | DISTINCTIVE DENTISTRY, INC. | 11 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| BRIAN LAPLANTE, ESQ. | Agent | 272 WEST EXCHANGE STREET, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| DEREK HATHAWAY | PRESIDENT | 41 SANDERSON ROAD, SUITE 106 SMITHFIELD, RI 02917 USA |
| Number | Name | File Date |
|---|---|---|
| 201611053890 | Revocation Certificate For Failure to File the Annual Report for the Year | 2016-10-26 |
| 201601509930 | Revocation Notice For Failure to File An Annual Report | 2016-07-07 |
| 201560947880 | Annual Report | 2015-04-14 |
| 201552946910 | Statement of Change of Registered Office by the Registered Agent | 2015-01-07 |
| 201437719200 | Annual Report | 2014-03-25 |
| 201314031230 | Annual Report | 2013-03-18 |
| 201289837260 | Annual Report | 2012-02-17 |
| 201176104440 | Annual Report | 2011-02-28 |
| 201059624140 | Annual Report | 2010-03-01 |
| 201059641390 | Statement of Change of Registered/Resident Agent | 2010-03-01 |
Date of last update: 13 Oct 2024
Sources: Rhode Island Department of State
