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  5. LINDSAY R. CASSIDY, DMD, LLC

LINDSAY R. CASSIDY, DMD, LLC

Company Details

Name: LINDSAY R. CASSIDY, DMD, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Activ
Date of Organization in Rhode Island: 14 Aug 2014 (10 years ago)
Identification Number: 000971849
ZIP code: 02878
County: Newport County
Principal Address: 1750 MAIN ROAD UNITS 1 AND 2, TIVERTON, RI, 02878, USA
Purpose: OWN AND RUN A DENTAL OFFICE
NAICS: 621210 - Offices of Dentists
Fictitious names: Stone Bridge Dental Group (trading name, 2020-02-03 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1861647158 2008-12-01 2008-12-01 1750 MAIN RD, TIVERTON, RI, 028784538, US 1750 MAIN RD, TIVERTON, RI, 028784538, US

Contacts
Phone +1 401-624-2375

Authorized person
Name DR. PAUL BAZZONI
Role EMPLOYEE
Phone 4016242375

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number 1864
State RI
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 8931-3
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2023 471590208 2024-06-04 LINDSAY R. CASSIDY, DMD, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2024-06-04
Name of individual signing BETSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2022 471590208 2023-06-01 LINDSAY R. CASSIDY, DMD, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2023-06-01
Name of individual signing BETSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2021 471590208 2023-02-16 LINDSAY R. CASSIDY, DMD, LLC 13
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2023-02-16
Name of individual signing BETSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2021 471590208 2023-04-27 LINDSAY R. CASSIDY, DMD, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2023-04-27
Name of individual signing BETSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2020 471590208 2021-07-22 LINDSAY R. CASSIDY, DMD, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing BETSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2019 471590208 2020-07-16 LINDSAY R. CASSIDY, DMD, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2020-07-16
Name of individual signing LINDSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature
LINDSAY R. CASSIDY, DMD, LLC 401(K) PLAN 2018 471590208 2019-07-09 LINDSAY R. CASSIDY, DMD, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621210
Sponsor’s telephone number 4016242375
Plan sponsor’s address 1750 MAIN ROAD, TIVERTON, RI, 02878

Signature of
Role Plan administrator
Date 2019-07-09
Name of individual signing LINDSEY CASSIDY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JOHN W. WOLFE, ESQ. Agent 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA

Filings

Number Name File Date
202448077060 Annual Report 2024-03-08
202332264730 Annual Report 2023-04-04
202215245210 Annual Report 2022-04-20
202207843110 Statement of Change of Registered/Resident Agent 2022-01-11
202103211860 Annual Report 2021-10-14
202066310680 Annual Report 2020-10-15
202033664000 Fictitious Business Name Statement 2020-02-03
201923637560 Annual Report 2019-10-07
201878415240 Annual Report 2018-09-27
201749744060 Annual Report 2017-09-14

Related by officers

JOHN W. WOLFE, ESQ.

GTS FLEXIBLE MATERIALS, INC. BROWN NEUROLOGY DIAGNOSTIC INFORMATION SYSTEM, INC. Frank J. Jehle, Jr., M.D., Inc. AAD, LLC AMERICAN FRIENDS OF THE HAKLUYT SOCIETY SEASCAPE LAWN CARE INC. Bungo.com, Inc. Wakefield Printing Corp. S. LOME AND SONS JEWELERS, INC.

Related by address

1750 MAIN ROAD UNITS 1 AND 2, TIVERTON, RI, 02878, USA

LMV Holdings, LLC

Date of last update: 19 Oct 2024

Sources: Rhode Island Department of State

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