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PEDIATRIC DENTISTRY OF ALBANY PLLC

Company Details

Name: PEDIATRIC DENTISTRY OF ALBANY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 15 Nov 2012 (13 years ago)
Entity Number: 4320709
ZIP code: 10901
County: Westchester
Place of Formation: New York
Address: 29 N. AIRMONT ROAD, SUITE 22, SUITE22, SUFFERN, NY, United States, 10901

DOS Process Agent

Name Role Address
MARK JACOBS DOS Process Agent 29 N. AIRMONT ROAD, SUITE 22, SUITE22, SUFFERN, NY, United States, 10901

National Provider Identifier

NPI Number:
1174202329
Certification Date:
2023-07-11

Authorized Person:

Name:
DR. BARRY L JACOBSON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
1223D0004X - Dentist Anesthesiologist
Is Primary:
No
Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
Yes
Selected Taxonomy:
1223S0112X - Oral and Maxillofacial Surgery (Dentist)
Is Primary:
No
Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
No

Contacts:

Fax:
8453693183
Fax:
5186217286

History

Start date End date Type Value
2020-11-05 2023-07-14 Address 29 N. AIRMONT ROAD, SUITE 22, SUITE22, SUFFERN, NY, 10901, USA (Type of address: Service of Process)
2012-11-15 2020-11-05 Address 80 BUSINESS PARK DRIVE STE 103, ARMONK, NY, 10504, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230714002706 2023-07-14 BIENNIAL STATEMENT 2022-11-01
201105061369 2020-11-05 BIENNIAL STATEMENT 2020-11-01
181203008584 2018-12-03 BIENNIAL STATEMENT 2018-11-01
141113006119 2014-11-13 BIENNIAL STATEMENT 2014-11-01
130430001205 2013-04-30 CERTIFICATE OF PUBLICATION 2013-04-30

Date of last update: 26 Mar 2025

Sources: New York Secretary of State