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NORTH SHORE PERIODONTICS P.C.

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Company Details

Name: NORTH SHORE PERIODONTICS P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Sep 2006 (19 years ago)
Entity Number: 3416137
ZIP code: 11042
County: Nassau
Place of Formation: New York
Address: 2001 MARCUS AVE, SUITE E244, LAKE SUCCESS, NY, United States, 11042

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
NORTH SHORE PERIODONTICS P.C. DOS Process Agent 2001 MARCUS AVE, SUITE E244, LAKE SUCCESS, NY, United States, 11042

Chief Executive Officer

Name Role Address
GREGORY DAVIS Chief Executive Officer 325 MEETING HOUSE LANE, SOUTHAMPTON, NY, United States, 11968

National Provider Identifier

NPI Number:
1679753669

Authorized Person:

Name:
DR. GREGORY DAVIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
1223P0300X - Periodontist
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2006-09-22 2021-05-12 Address 325 MEETING HOUSE LANE, SOUTHAMPTON, NY, 11968, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210512060026 2021-05-12 BIENNIAL STATEMENT 2018-09-01
180426000045 2018-04-26 ANNULMENT OF DISSOLUTION 2018-04-26
DP-2015193 2011-07-27 DISSOLUTION BY PROCLAMATION 2011-07-27
060922000693 2006-09-22 CERTIFICATE OF INCORPORATION 2006-09-22

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$52,750
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$52,750
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$53,051.85
Servicing Lender:
Valley National Bank
Use of Proceeds:
Payroll: $52,744
Utilities: $1
Jobs Reported:
6
Initial Approval Amount:
$34,672
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$34,672
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$35,002.35
Servicing Lender:
Valley National Bank
Use of Proceeds:
Payroll: $34,672

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State