Medicaid/SCHIP Dental Association
| Name: | Medicaid/SCHIP Dental Association |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Non-Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 01 May 2015 (10 years ago) |
| Date of Dissolution: | 03 Apr 2019 (6 years ago) |
| Date of Status Change: | 03 Apr 2019 (6 years ago) |
| Identification Number: | 001327201 |
| ZIP code: | 02886 |
| County: | Kent County |
| Purpose: | PROVIDE EDUCATION AND TRAINING TO DENTISTS IN RI |
| Principal Address: |
23 BENEFIT STREET UNIT 21, WARWICK, RI, 02886, USA
|
NAICS
54199 All Other Professional, Scientific, and Technical ServicesSee industry description for 541990. Learn more at the U.S. Census Bureau
| Name | Role | Address |
|---|---|---|
| MARTHA DELLAPENNA | Agent | 23 BENEFIT STREET #21, WARWICK, RI, 02886, USA |
| Name | Role | Address |
|---|---|---|
| LEON BRAGG DDS | PRESIDENT | 5609 N. EVEREST AVE. OKLAHOMA CITY, OK 73111 USA |
| Name | Role | Address |
|---|---|---|
| SARAH FINNE DDS | SECRETARY | 129 PLEASANT ST CONCORD, MA 03301 USA |
| Name | Role | Address |
|---|---|---|
| JAMES GILLCRIST DDS | VICE PRESIDENT | 310 GREAT CIRCLE ROAD NASHVILLE, TN 37243 USA |
| Name | Role | Address |
|---|---|---|
| MARY FOLEY | EXECUTIVE DIRECTOR | 2 GROVE STREET SANDWICH, MA 02563 USA |
| Name | Role | Address |
|---|---|---|
| JODI HULM | DIRECTOR | 600 EST BOULEVARD AVE. BISMARK, ND 58505 USA |
| SCOTT CASHION DDS | DIRECTOR | 402 TURNSTONE TRAIL GREENSBORO, NC 27455 USA |
| MYRA SHOOK | DIRECTOR | 600 E. BORAD ST RICHMOND, VA 23219 USA |
| MICHAEL EXLER DDS | DIRECTOR | 10324 S. DOLFIELD ROAD OWINGS MILLS, MD 21117 USA |
| Number | Name | File Date |
|---|---|---|
| 201989764550 | Revocation Certificate For Failure to File the Annual Report for the Year | 2019-04-03 |
| 201985503180 | Revocation Notice For Failure to File An Annual Report | 2019-01-30 |
| 201744069780 | Annual Report | 2017-06-02 |
| 201699015120 | Annual Report | 2016-05-17 |
| 201561351910 | Application for Certificate of Authority | 2015-05-01 |
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Date of last update: 01 Jun 2025
Sources: Rhode Island Department of State