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SOUTH SHORE PEDIATRIC DENTISTRY, P.C.

SOUTH SHORE PEDIATRIC DENTISTRY, P.C.

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Company Details

Name:	SOUTH SHORE PEDIATRIC DENTISTRY, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	19 Mar 1999 (26 years ago)
Entity Number:	2358229
ZIP code:	11772
County:	Suffolk
Place of Formation:	New York
Address:	285 SILLS ROAD, SUITE 3B, E PATCHOGUE, NY, United States, 11772
Principal Address:	285 SILLS ROAD / SUITE 3B, E PATCHOGUE, NY, United States, 11772

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name	Role	Address
ROSS E. GRUBER	Chief Executive Officer	285 SILLS ROAD / SUITE 3B, E PATCHOGUE, NY, United States, 11772

DOS Process Agent

Name	Role	Address
SOUTH SHORE PEDIATRIC DENTISTRY, P.C.	DOS Process Agent	285 SILLS ROAD, SUITE 3B, E PATCHOGUE, NY, United States, 11772

National Provider Identifier

NPI Number:

1952528341

Link:

View on NPI website

Authorized Person:

Name:

DR. ROSS E GRUBER

Role:

OWNER

Phone:

6312899000

Taxonomy:

Selected Taxonomy:

1223P0221X - Pediatric Dentist

Is Primary:

No

Selected Taxonomy:

1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist

Is Primary:

No

Contacts:

Phone:

+1 631-289-9000

Fax:

6312899009

Form 5500 Series

Employer Identification Number (EIN):

113498409

Plan Year:

2024

Number Of Participants:

10

Sponsors Telephone Number:

6312899000

File:

Plan Year:

2023

Number Of Participants:

11

Sponsors Telephone Number:

6312899000

File:

Plan Year:

2022

Number Of Participants:

11

Sponsors Telephone Number:

6312899000

File:

Plan Year:

2021

Number Of Participants:

13

Sponsors Telephone Number:

6312899000

File:

Plan Year:

2020

Number Of Participants:

13

Sponsors Telephone Number:

6312899000

File:

History

Start date	End date	Type	Value
2013-03-07	2015-03-03	Address	285 SILLS ROAD, E PATCHOGUE, NY, 11772, USA (Type of address: Service of Process)
2007-03-29	2015-03-03	Address	285 SILLS ROAD / SUITE 3B, E PATCHOGUE, NY, 11772, USA (Type of address: Chief Executive Officer)
2007-03-29	2013-03-07	Address	285 SILLS ROAD, E PATCHOGUE, NY, 10541, USA (Type of address: Service of Process)
2001-03-16	2007-03-29	Address	285 SILLS RD SUITE 3B, EAST PATCHOGUE, NY, 11772, USA (Type of address: Chief Executive Officer)
2001-03-16	2007-03-29	Address	285 SILLS RD SUITE 3B, EAST PATCHOGUE, NY, 11772, USA (Type of address: Principal Executive Office)

Filings

Filing Number	Date Filed	Type	Effective Date
210301060209	2021-03-01	BIENNIAL STATEMENT	2021-03-01
150303006701	2015-03-03	BIENNIAL STATEMENT	2015-03-01
130307006440	2013-03-07	BIENNIAL STATEMENT	2013-03-01
110609002528	2011-06-09	BIENNIAL STATEMENT	2011-03-01
090316002264	2009-03-16	BIENNIAL STATEMENT	2009-03-01

Paycheck Protection Program

Jobs Reported:

11

Initial Approval Amount:

$83,895

Date Approved:

2021-02-11

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$83,895

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$84,602.94

Servicing Lender:

Cross River Bank

Use of Proceeds:

Payroll: $83,892
Utilities: $1

Jobs Reported:

10

Initial Approval Amount:

$100,000

Date Approved:

2020-04-29

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$100,000

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$101,050

Servicing Lender:

WebBank

Use of Proceeds:

Payroll: $100,000

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State