Home Page
Counties
Kent County
02886
Medicaid/SCHIP Dental Association

Medicaid/SCHIP Dental Association

Company Details

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
Principal Address:	23 BENEFIT STREET UNIT 21, WARWICK, RI, 02886, USA
Purpose:	PROVIDE EDUCATION AND TRAINING TO DENTISTS IN RI
NAICS:	54199 - All Other Professional, Scientific, and Technical Services

Agent

Name	Role	Address
MARTHA DELLAPENNA	Agent	23 BENEFIT STREET #21, WARWICK, RI, 02886, USA

PRESIDENT

Name	Role	Address
LEON BRAGG DDS	PRESIDENT	5609 N. EVEREST AVE. OKLAHOMA CITY, OK 73111 USA

SECRETARY

Name	Role	Address
SARAH FINNE DDS	SECRETARY	129 PLEASANT ST CONCORD, MA 03301 USA

VICE PRESIDENT

Name	Role	Address
JAMES GILLCRIST DDS	VICE PRESIDENT	310 GREAT CIRCLE ROAD NASHVILLE, TN 37243 USA

EXECUTIVE DIRECTOR

Name	Role	Address
MARY FOLEY	EXECUTIVE DIRECTOR	2 GROVE STREET SANDWICH, MA 02563 USA

DIRECTOR

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

Filings

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

Date of last update: 23 Oct 2024

Sources: Rhode Island Department of State