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  5. Shaghalian Family Dental, LLC

Shaghalian Family Dental, LLC

Company Details

Name: Shaghalian Family Dental, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Dissolved
Date of Organization in Rhode Island: 16 Mar 2016 (9 years ago)
Date of Dissolution: 14 Dec 2022 (2 years ago)
Date of Status Change: 14 Dec 2022 (2 years ago)
Identification Number: 001661411
ZIP code: 02916
County: Providence County
Principal Address: 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916, USA
Purpose: DENTAL PRACTICE

Industry & Business Activity

NAICS

621210 Offices of Dentists

This 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

Companies doing Offices of dentists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1568904571 2016-11-08 2016-11-08 1002 PAWTUCKET AVE, RUMFORD, RI, 029161704, US 1002 PAWTUCKET AVE, RUMFORD, RI, 029161704, US

Contacts
Phone +1 401-438-4964
Fax 4014346021

Authorized person
Name DR. JUSTIN W SHAGHALIAN
Role DENTIST/OWNER
Phone 4014384964

Taxonomy
Taxonomy Code 122300000X - Dentist
License Number DEN02886
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2021 811868515 2022-04-25 SHAGHALIAN FAMILY DENTAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2022-04-25
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-25
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2021 811868515 2022-03-04 SHAGHALIAN FAMILY DENTAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2022-03-04
Name of individual signing DAVID SYNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-03-04
Name of individual signing DAVID SYNER
Valid signature Filed with authorized/valid electronic signature
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2020 811868515 2021-04-21 SHAGHALIAN FAMILY DENTAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2021-04-18
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-18
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2019 811868515 2020-02-28 SHAGHALIAN FAMILY DENTAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2020-02-28
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-28
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2018 811868515 2019-02-27 SHAGHALIAN FAMILY DENTAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2019-02-27
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-27
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
SHAGHALIAN FAMILY DENTAL, LLC 401(K) PLAN 2017 811868515 2018-03-28 SHAGHALIAN FAMILY DENTAL, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 4014384964
Plan sponsor’s address 1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916

Signature of
Role Plan administrator
Date 2018-03-28
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-03-28
Name of individual signing JUSTIN SHAGHALIAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ORSON AND BRUSINI LTD. Agent 211 QUAKER LANE SUITE 201, WEST WARWICK, RI, 02893, USA

MANAGER

Name Role Address
JUSTIN W. SHAGHALIAN, DMD MANAGER 1002 PAWTUCKET AVENUE RUMFORD, RI 02916 USA

Filings

Number Name File Date
202225178650 Articles of Dissolution 2022-12-14
202224399380 Statement of Change of Registered/Resident Agent Office 2022-10-21
202212287330 Annual Report 2022-03-02
202102265990 Annual Report 2021-09-28
202064877310 Annual Report 2020-10-08
201921951370 Annual Report 2019-09-30
201878208040 Annual Report 2018-09-24
201751458700 Annual Report 2017-10-12
201694749200 Articles of Organization 2016-03-16

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5889087101 2020-04-14 0165 PPP 1002 Pawtucket Ave, RUMFORD, RI, 02916
Loan Status Date 2021-01-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 52410
Loan Approval Amount (current) 52410
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Unanswered
Project Address RUMFORD, PROVIDENCE, RI, 02916-0551
Project Congressional District RI-01
Number of Employees 5
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 52756.49
Forgiveness Paid Date 2020-12-21
4151058403 2021-02-06 0165 PPS 1002 Pawtucket Ave, Rumford, RI, 02916-1704
Loan Status Date 2021-11-20
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 52092
Loan Approval Amount (current) 52092
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Rumford, PROVIDENCE, RI, 02916-1704
Project Congressional District RI-01
Number of Employees 5
NAICS code 621210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 52450.86
Forgiveness Paid Date 2021-10-25

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Related by address

1002 PAWTUCKET AVENUE, RUMFORD, RI, 02916, USA

1002 Pawtucket Avenue, LLC

Date of last update: 26 Oct 2024

Sources: Rhode Island Department of State

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