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  5. CHILDREN'S DENTISTRY OF WESTERLY, LLC

CHILDREN'S DENTISTRY OF WESTERLY, LLC

Company Details

Name: CHILDREN'S DENTISTRY OF WESTERLY, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Dissolved
Date of Organization in Rhode Island: 07 May 2009 (16 years ago)
Date of Dissolution: 29 Mar 2024 (a year ago)
Date of Status Change: 29 Mar 2024 (a year ago)
Identification Number: 000506680
ZIP code: 02891
County: Washington County
Principal Address: 130 GRANITE STREET, WESTERLY, RI, 02891, USA
Purpose: PRACTICE OF DENTISTRY AND SPECIALIZING IN PEDIATRIC DENTISTRY
Fictitious names: Children's Dentistry of Westerly & Wakefield (trading name, 2013-09-17 - )

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

Companies doing Offices of dentists

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHILDRENS DENTISTRY OF WESTERLY, LLC 401(K) PROFIT SHARING PLAN 2021 270230155 2022-05-25 CHILDREN'S DENTISTRY OF WESTERLY, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing ANNA CAPALBO
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC 401(K) PROFIT SHARING PLAN 2021 270230155 2022-08-31 CHILDREN'S DENTISTRY OF WESTERLY, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2022-08-31
Name of individual signing ANNA CAPALBO
Valid signature Filed with authorized/valid electronic signature
CHILDRENS DENTISTRY OF WESTERLY, LLC 401(K) PROFIT SHARING PLAN 2020 270230155 2021-07-07 CHILDREN'S DENTISTRY OF WESTERLY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2021-07-07
Name of individual signing ANNA CAPALBO
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC CASH BALANCE PLAN 2020 270230155 2021-07-15 CHILDREN'S DENTISTRY OF WESTERLY, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing ANNA CAPALBO
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC CASH BALANCE PLAN 2020 270230155 2021-10-06 CHILDREN'S DENTISTRY OF WESTERLY, LLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing ANNA CAPALBO
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC CASH BALANCE PLAN 2019 270230155 2020-10-15 CHILDREN'S DENTISTRY OF WESTERLY, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
CHILDRENS DENTISTRY OF WESTERLY, LLC 401(K) PROFIT SHARING PLAN 2019 270230155 2020-10-15 CHILDREN'S DENTISTRY OF WESTERLY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing BRIAN P. SHANNON, D.D.S.
Valid signature Filed with authorized/valid electronic signature
CHILDRENS DENTISTRY OF WESTERLY, LLC 401(K) PROFIT SHARING PLAN 2018 270230155 2019-07-29 CHILDREN'S DENTISTRY OF WESTERLY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing BRIAN P. SHANNON, D.D.S.
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC CASH BALANCE PLAN 2018 270230155 2019-07-29 CHILDREN'S DENTISTRY OF WESTERLY, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
CHILDREN'S DENTISTRY OF WESTERLY, LLC CASH BALANCE PLAN 2017 270230155 2018-07-16 CHILDREN'S DENTISTRY OF WESTERLY, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2018-07-16
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-16
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/16/20180716105951P040066240529001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2018-07-16
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-16
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/02/20171002095204P030169257607001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2017-10-02
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-02
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/28/20170728075151P030062211143001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-28
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/10/20161010111242P030012135421001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/10/20161010142203P040019334705001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/23/20150723100651P040107638999001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2015-07-22
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/23/20150723085715P040107469911001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2015-07-22
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-22
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/25/20140725071213P040018018959001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/28/20140728124918P040025611341001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/18/20130718101109P040392846129001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-07-18
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/24/20130724135406P030406330161001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621210
Sponsor’s telephone number 4015968720
Plan sponsor’s address 130C GRANITE STREET, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-07-24
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-24
Name of individual signing BRIAN SHANNON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JASON P. MARSHALL, ESQ. Agent 300 CENTERVILLE ROAD SUMMIT WEST SUITE 204, WARWICK, RI, 02886, USA

Filings

Number Name File Date
202449745760 Articles of Dissolution 2024-03-29
202335553570 Annual Report 2023-05-11
202217473800 Annual Report 2022-05-18
202105358220 Annual Report 2021-11-24
202188121890 Annual Report - Amended 2021-01-28
202071873600 Annual Report 2020-10-29
201926895660 Annual Report 2019-11-04
201925095250 Statement of Change of Registered/Resident Agent Office 2019-10-23
201878199690 Annual Report 2018-09-21
201750127490 Annual Report 2017-09-20

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2843097301 2020-04-29 0165 PPP 130-c GRANITE ST, WESTERLY, RI, 02891-2461
Loan Status Date 2021-08-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 166612
Loan Approval Amount (current) 166612
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WESTERLY, WASHINGTON, RI, 02891-2461
Project Congressional District RI-02
Number of Employees 18
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 15793
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address Bridgeport, CT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 168529.18
Forgiveness Paid Date 2021-06-30

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JASON P. MARSHALL, ESQ.

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Related by address

130 GRANITE STREET, WESTERLY, RI, 02891, USA

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Date of last update: 14 Oct 2024

Sources: Rhode Island Department of State

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