| Name: | JOANNE C. LEWIS PEDIATRIC DENTISTRY, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 24 May 2010 (15 years ago) |
| Identification Number: | 000540960 |
| ZIP code: | 02818 |
| County: | Kent County |
| Principal Address: | 5700 POST ROAD SUITE 5, EAST GREENWICH, RI, 02818, USA |
| Mailing Address: | 1111 MAIN STREET, HOPE VALLEY, RI, 02832, USA |
| Purpose: | THE PRACTICE OF DENTISTRY |
| NAICS: | 621210 - Offices of Dentists |
| Fictitious names: |
Chariho Children's Dentistry (trading name, 2021-03-12 - ) Childrens Dentistry of East Greenwich (trading name, 2017-09-15 - ) Valley Dental (trading name, 2017-01-10 - ) Childrens Dentistry of Coventry (trading name, 2010-12-02 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780121350 | 2017-01-20 | 2019-02-20 | 5700 POST RD UNIT 5, EAST GREENWICH, RI, 028183455, US | 5700 POST RD UNIT 5, EAST GREENWICH, RI, 028183455, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-285-2500 |
| Fax | 4018231702 |
Authorized person
| Name | AMANDA N JOHNSON |
| Role | PRACTICE MANAGER |
| Phone | 4012852500 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 1497729370 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 1114362506 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 1487644852 |
| Is Primary | Yes |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| License Number | 1053759225 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1912036013 |
| Issuer | NPI |
| Number | 1487644852 |
| Issuer | NPI |
| Number | 1891157145 |
| Name | Role | Address |
|---|---|---|
| JOANNE LEWIS | Agent | 1111 MAIN STREET, HOPE VALLEY, RI, 02832, USA |
| Number | Name | File Date |
|---|---|---|
| 202458802010 | Statement of Change of Registered/Resident Agent Office | 2024-08-13 |
| 202458800890 | Reinstatement | 2024-08-13 |
| 202455519380 | Revocation Certificate For Failure to Maintain a Registered Office | 2024-06-10 |
| 202454658710 | Miscellaneous Filing (No Fee) | 2024-05-21 |
| 202454285970 | Annual Report | 2024-05-14 |
| 202449472260 | Revocation Notice For Failure to Maintain a Registered Office | 2024-03-27 |
| 202447983290 | Registered Office Not Maintained | 2024-02-06 |
| 202327753610 | Annual Report | 2023-02-07 |
| 202209823660 | Annual Report | 2022-02-09 |
| 202101915300 | Annual Report | 2021-09-22 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
