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  5. PEDIATRIC DENTISTRY AND INTERCEPTIVE ORTHODONTICS, P.C.

PEDIATRIC DENTISTRY AND INTERCEPTIVE ORTHODONTICS, P.C.

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Company Details

Name: PEDIATRIC DENTISTRY AND INTERCEPTIVE ORTHODONTICS, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 03 Oct 1978 (47 years ago)
Entity Number: 513973
ZIP code: 13066
County: Onondaga
Place of Formation: New York
Address: 8016 E. GENESEE ST., FAYETTEVILLE, NY, United States, 13066

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
ANDREW ARCURI, DDS MS Chief Executive Officer 8016 E. GENESEE ST., FAYETTEVILLE, NY, United States, 13066

DOS Process Agent

Name Role Address
ANDREW ARCURI, DDS MS DOS Process Agent 8016 E. GENESEE ST., FAYETTEVILLE, NY, United States, 13066

National Provider Identifier

NPI Number:
1346300209
Link:
View on NPI website

Authorized Person:

Name:
DR. EDWARD ROBISON
Role:
TREASURER
Phone:
3156376961

Taxonomy:

Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
No
Selected Taxonomy:
1223P0221X - Pediatric Dentist
Is Primary:
No
Selected Taxonomy:
1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist
Is Primary:
No

Contacts:

Phone:
+1 315-637-6961
Fax:
3156370169

Form 5500 Series

Employer Identification Number (EIN):
161113992
Plan Year:
2023
Number Of Participants:
81
Sponsors Telephone Number:
3156376961
File:
View File
Plan Year:
2022
Number Of Participants:
74
Sponsors Telephone Number:
3156376961
File:
View File
Plan Year:
2021
Number Of Participants:
61
Sponsors Telephone Number:
3156376961
File:
View File
Plan Year:
2020
Number Of Participants:
58
Sponsors Telephone Number:
3156376961
File:
View File
Plan Year:
2019
Number Of Participants:
66
Sponsors Telephone Number:
3156376961
File:
View File

History

Start date End date Type Value
2025-06-09 2025-06-09 Address 5538 N. BURDICK ST., FAYETTEVILLE, NY, 13066, USA (Type of address: Chief Executive Officer)
2025-06-09 2025-06-09 Address 8016 E. GENESEE ST., FAYETTEVILLE, NY, 13066, 8600, USA (Type of address: Chief Executive Officer)
2020-11-13 2025-06-09 Address 8016 E. GENESEE ST., FAYETTEVILLE, NY, 13066, 8600, USA (Type of address: Chief Executive Officer)
2020-11-13 2025-06-09 Address 8016 E. GENESEE ST., FAYETTEVILLE, NY, 13066, 8600, USA (Type of address: Service of Process)
2008-10-06 2020-11-13 Address 8016 E. GENESEE ST., FAYETTEVILLE, NY, 13066, 8600, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
250609003461 2025-06-09 BIENNIAL STATEMENT 2025-06-09
201113060127 2020-11-13 BIENNIAL STATEMENT 2020-10-01
20150304101 2015-03-04 ASSUMED NAME CORP INITIAL FILING 2015-03-04
141010006513 2014-10-10 BIENNIAL STATEMENT 2014-10-01
121011002345 2012-10-11 BIENNIAL STATEMENT 2012-10-01

USAspending Awards / Financial Assistance

Date:
2021-03-17
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
450000.00
Total Face Value Of Loan:
450000.00
Date:
2020-04-13
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
388150.00
Total Face Value Of Loan:
388150.00

Paycheck Protection Program

Jobs Reported:
45
Initial Approval Amount:
$388,150
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$388,150
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$392,690.82
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $388,150
Jobs Reported:
45
Initial Approval Amount:
$450,000
Date Approved:
2021-03-17
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$450,000
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$455,116.44
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $450,000

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Date of last update: 18 Mar 2025

Sources: New York Secretary of State

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