| Name: | CITY DENTAL OF WOONSOCKET, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 01 Oct 2009 (16 years ago) |
| Date of Dissolution: | 22 Jul 2019 (6 years ago) |
| Date of Status Change: | 22 Jul 2019 (6 years ago) |
| Identification Number: | 000513350 |
| ZIP code: | 02895 |
| County: | Providence County |
| Place of Formation: | DELAWARE |
| Principal Address: | 515 SOCIAL STREET, WOONSOCKET, RI, 02895, USA |
| Purpose: | DENTAL OFFICE ANNUAL REPORT 2017 |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265759567 | 2010-04-26 | 2010-04-26 | 515 SOCIAL ST, WOONSOCKET, RI, 028952043, US | 515 SOCIAL ST, WOONSOCKET, RI, 028952043, US | |||||||||||||||||||
|
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| Phone | +1 401-597-5920 |
Authorized person
| Name | MRS. JOSEPHINE ROCA |
| Role | OFFICE MANAGER |
| Phone | 4015975920 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NP INDIVIDUAL |
| Number | 1548321235 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| ITALO A. LOZADA, DMD | Agent | 515 SOCIAL STREET, WOONSOCKET, RI, 02895, USA |
| Name | Role | Address |
|---|---|---|
| ITALO A LOZADA DMD | MANAGER | 515 SOCIAL STREET WOONSOCKET, RI 02895 USA |
| Number | Name | File Date |
|---|---|---|
| 201906337120 | Revocation Certificate For Failure to File the Annual Report for the Year | 2019-07-22 |
| 201992923410 | Revocation Notice For Failure to File An Annual Report | 2019-05-13 |
| 201863220400 | Annual Report | 2018-05-01 |
| 201628553020 | Annual Report | 2016-12-06 |
| 201558317570 | Annual Report | 2015-04-17 |
| 201558318270 | Annual Report | 2015-04-02 |
| 201557598060 | Revocation Notice For Failure to File An Annual Report | 2015-03-16 |
| 201327558650 | Annual Report | 2013-09-03 |
| 201309721760 | Annual Report | 2013-01-14 |
| 201308473660 | Revocation Notice For Failure to File An Annual Report | 2013-01-09 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
