PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST (EIN 34-2012430)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-09-04
- IRS object ID
- 202312479349300306
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-09-04T13:16:02-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 205824233 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVE V JOHN LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4788 WEST COMMERCIAL BLVD | AddressLine1Txt |
| City | TAMARAC | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33319 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 342012430 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TARA GOOD-YOUNG | InCareOfNm |
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 7078376560 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1380 19TH HOLE DRIVE | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95492 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TARA GOOD-YOUNG | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7078386560 | PhoneNum |
| Signature | 2023-09-04 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TARA | PersonFirstNm |
| Person Last | GOOD-YOUNG | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVE V JOHN | PreparerPersonNm |
| PTIN | P00063077 | PTIN |
| Phone | 9547358855 | PhoneNum |
| Preparation | 2023-09-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST IN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1380 19TH ST HOLE DRIVE | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95492 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,098,725 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 31 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $793,573 | PYContributionsGrantsAmt |
| CY Contributions Grants | $829,893 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,434,649 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,214,438 | CYProgramServiceRevenueAmt |
| PY Investment Income | $122,801 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,394 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,751 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,402,774 | PYTotalRevenueAmt |
| CY Total Revenue | $5,098,725 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,526,934 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,584,727 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $168,384 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,511,665 | PYOtherExpensesAmt |
| CY Other Expenses | $2,857,417 | CYOtherExpensesAmt |
| PY Total Expenses | $4,038,599 | PYTotalExpensesAmt |
| CY Total Expenses | $4,442,144 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $364,175 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $656,581 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,988,064 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,302,132 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $577,200 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $664,828 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,410,864 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,637,304 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO DELIVER SAFE, HIGH QUALITY, AND SPECIALIZED DENTAL TREATMENT TO UNDERSERVE YOUTH AND PROMOTE ORAL HEALTH THROUGH EDUCATION TO COMMUNITIES OF NORTH CALIFORNIA | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,941,012 | ExpenseAmt |
| Revenue | $4,268,832 | RevenueAmt |
| Desc | SEE SCHEDULE "O" | Desc |
| Total Program Service Expenses | $3,941,012 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 31 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC DENTAL INITIATIVE OF THE NORTH COAST IN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7078378833 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1380 19TH ST HOLE DRIVE | AddressLine1Txt |
| City | WINDSOR | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95492 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| JULIE TUCKER | |||||||
| DIR OF CLINICAL SVCS | 40.00 | Yes (X) | $170,955 | $0 | $0 | ||
| JEN STASCH | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $0 | $0 | $0 | Yes (X) | ||
| SURANI KWAN | |||||||
| CHAIRMAN | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| ANDREW MCCORMICK | |||||||
| TREASURER | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| KRISTEN JOHNSON | |||||||
| DIRECTOR | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| ANTONIO PEREZLICEA | |||||||
| DIRECTOR | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| LYNNE FAULKS | |||||||
| DIRECTOR | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| HUGO MATA | |||||||
| DIRECTOR | 2.000 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $170,955 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $829,893 | GovernmentGrantsAmt |
| Total Contributions | $829,893 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM FEES | Desc |
| Total Revenue Column | $4,214,438 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,214,438 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,214,438 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,394 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,394 | RelatedOrExemptFuncIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,098,725 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,268,832 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,584,727 | TotalAmt |
| Program Services | $1,314,459 | ProgramServicesAmt |
| Management And General | $165,109 | ManagementAndGeneralAmt |
| Fundraising | $105,159 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,545 | TotalAmt |
| Program Services | $31,554 | ProgramServicesAmt |
| Management And General | $12,887 | ManagementAndGeneralAmt |
| Fundraising | $4,104 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,791 | TotalAmt |
| Program Services | $831 | ProgramServicesAmt |
| Management And General | $4,194 | ManagementAndGeneralAmt |
| Fundraising | $766 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,532 | TotalAmt |
| Program Services | $138,424 | ProgramServicesAmt |
| Management And General | $52,037 | ManagementAndGeneralAmt |
| Fundraising | $45,071 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,168 | TotalAmt |
| Program Services | $176,957 | ProgramServicesAmt |
| Management And General | $25,211 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,893 | TotalAmt |
| Program Services | $6,893 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,180 | TotalAmt |
| Program Services | $6,616 | ProgramServicesAmt |
| Management And General | $35,564 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PROFESSIONAL FEES | $1,653,512 | $1,603,931 | $36,372 | $13,209 |
| REPAIR AND MAINTENANCE | $115,332 | $115,332 | ||
| PROGRAM EXPENSE | $31,796 | $31,721 | $75 | |
| SUPPLIES AND EQUIPMENT | $515,668 | $514,294 | $1,374 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,442,144 | TotalAmt |
| Program Services | $3,941,012 | ProgramServicesAmt |
| Management And General | $332,748 | ManagementAndGeneralAmt |
| Fundraising | $168,384 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,790 | BOYAmt |
| EOY | $1,275,854 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $346,319 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $361,462 | BOYAmt |
| EOY | $351,669 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
| EOY | $25,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,667 | BOYAmt |
| EOY | $116,088 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,486 | BOYAmt |
| EOY | $18,416 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,228,363 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,125,756 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,041 | BOYAmt |
| EOY | $102,607 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,025,472 | BOYAmt |
| EOY | $2,050,235 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,402,827 | BOYAmt |
| EOY | $1,981,600 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $380,663 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,988,064 | BOYAmt |
| EOY | $6,302,132 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,898 | BOYAmt |
| EOY | $286,150 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $294,302 | BOYAmt |
| EOY | $378,678 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $577,200 | BOYAmt |
| EOY | $664,828 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,130,864 | BOYAmt |
| EOY | $3,572,769 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,000 | BOYAmt |
| EOY | $2,064,535 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,410,864 | BOYAmt |
| EOY | $5,637,304 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,988,064 | BOYAmt |
| EOY | $6,302,132 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $656,581 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$430,141 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $569,273 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $548,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $793,573 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $829,893 | CurrentTaxYearAmt |
| Total | $2,890,834 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $569,273 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $548,955 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $149,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $793,573 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $829,893 | CurrentTaxYearAmt |
| Total | $2,890,834 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,890,834 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $51,125 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $61,323 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $79,974 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $68,781 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,394 | CurrentTaxYearAmt |
| Total | $315,597 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,605 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$6,438 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | -$26,272 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $54,020 | CurrentTaxYearMinus1YearAmt |
| Total | $36,915 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,243,346 | TotalSupportAmt |
| Public Support CY170 | 0.89131 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $861,579 | OtherCostOrOtherBasisAmt |
| Depreciation | $861,579 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,188 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,623 | DepreciationAmt |
| Book Value | $16,565 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $308,596 | OtherCostOrOtherBasisAmt |
| Depreciation | $222,554 | DepreciationAmt |
| Book Value | $86,042 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $102,607 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $1,981,600 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,981,600 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OPERATING LEASE RIGHT OF USE ASSETS | $367,707 |
| SECURITY DEPOSIT | $12,956 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $380,663 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITY | Desc |
| Amt | $378,678 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $378,678 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,668,584 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$430,141 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$430,141 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,098,725 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,098,725 | TotalRevenuePerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| P10, Ln 2 | PDI IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER |
| P10, Ln 2 | SECTION 501(C)(3) AND CALIFORNIA FRANCHISE TAX BOARD SECTION |
| P10, Ln 2 | 23701D. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN |
| P10, Ln 2 | MADE IN THE ACCOMPANY FINANCIAL STATEMENTS. IN ADDITION, |
| P10, Ln 2 | THE INTERNAL REVENUE SERVICES HAS DETERMINED PDI IS NOT |
| P10, Ln 2 | A "PRIVATE FOUNDATION" WITHIN THE MEANING OF SECTION 509(A) |
| P10, Ln 2 | OF THE INTERNAL REVENUE CODE. |
| P10, Ln 2 | MANAGEMENT OF PDI CONSIDERS THE LIKELIHOOD OF CHANGES BY |
| P10, Ln 2 | THE TAXING AUTHORITIES IN ITS FILED TAX RETURNS AND |
| P10, Ln 2 | RECOGNIZES A LIABILITY FOR OR DISCLOSES POTENTIAL |
| P10, Ln 2 | SIGNIFICANT IF MANAGEMENT BELIEVES IT IS MORE LIKELY |
| P10, Ln 2 | THAN NOT FOR A CHANGE TO OCCUR, INCLUDING CHNAGES TO PDI'S |
| P10, Ln 2 | STATUS AS A NOT-FOR-PROFIT ENTITY, MANAGEMENT BELIEVES |
| P10, Ln 2 | PDI MET THE REQUIREMENT TO MAINTAIN ITS TAX EXEMPT STATUS |
| P10, Ln 2 | AND HAS NOT INCOME SUBJECT UNRELATED BUSINESS INCOME TAX; |
Schedule G IRS990ScheduleG
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| JULIE TUCKER | ||
| DIR OF CLINICAL SVCS | $170,955 | $170,955 |
| JEN STASCH | ||
| EXECUTIVE DIRECTOR | ||
| SURANI KWAN | ||
| CHAIRMAN | ||
| ANDREW MCCORMICK | ||
| TREASURER | ||
| KRISTEN JOHNSON | ||
| DIRECTOR | ||
| ANTONIO PEREZLICEA | ||
| DIRECTOR | ||
| LYNNE FAULKS | ||
| DIRECTOR | ||
| HUGO MATA | ||
| DIRECTOR | ||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (22 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 11b | SEE SCHEDULE "O" |
| Part VI Line 19 | DOCUMENTS ARE AVAILBLE UPON REQUEST |
| PT111, LINE 4 | TO DELIVER SAFE, HIGH QUALITY , AND SPECIALIZED DENTAL TREATMENT |
| PT111, LINE 4 | TO UNDERSERVED YOUTH AND PROMOTE ORAL HEALTH THROUGH EDUCATION |
| PT111, LINE 4 | TO COMMUNITIES OF NORTHERN CALIFORNIA. |
| PT111, LINE 4 | PDI PROMOTES PROGRAMS WITH THE FOLLOWING GOALS; |
| PT111, LINE 4 | PROVIDE ORAL HEALTH EDUCATION TO NORTHERN CALIFORNIA FAMILIES |
| PT111, LINE 4 | WITH CHILDREN. ENSURE THAT CHILDREN WITH DENTAL DECAY RECEIVE |
| PT111, LINE 4 | PROMPT TREATMENT AND PROVIDE THE PARENTS WITH NECESSARY TOOLS AND |
| PT111, LINE 4 | INFORMATION TO MAINTAIN HEALTHY TEETH AND ASSIST FAMILIES TO FIND A |
| PT111, LINE 4 | DENTAL HOME FOR THEIR CHILDREN. PDI DIRECTLY TREATED 1484 |
| PT111, LINE 4 | CHILDREN. 100% OF THE ORGANIZATION PATIENTS |
| PT111, LINE 4 | COME TO PDI ARE SUFFERING FROM SEVERE TOOTH DECAY, 97% OF THE PATIENTS |
| PT111, LINE 4 | ARE RESIDING IN VEY LOW INCOME HOUSEHOLD, 80% OF THE PATIENTS ARE |
| PT111, LINE 4 | FROM COMMUNITIES OF COLOR, 15% OF THE PATIENTS HAVE SPECIAL NEEDS AND |
| PT111, LINE 4 | AND 9% OF THE PATIENTS ARE FROM INDIGENOUS COMMUNITIES.DURING THE |
| PT111, LINE 4 | YEAR THE ORGANIZATION ASSISTED 5427 PARENTS WITH ORAL HEALTH |
| PT111, LINE 4 | EDUCATION AND RESOURCES, 8048 DENTAL HYGIENE KITS WERE DISTRIBUTED TO |
| PT111, LINE 4 | ADULTS AND CHILDREN IN THE COMMUNITY AND 1438 HEALTHY FOOD BAGS |
| PT111, LINE 4 | WERE GIVEN TO FAMILIES. THE ORGANIZATION DOES NOT TURN AWAY |
| PT111, LINE 4 | ANY CHILD THAT REQUIRES DENTAL TREATMENT OR SURGERY UNDER GENERAL |
| PT111, LINE 4 | ANESTHESIA FOR A FAMILY INABILITY TO PAY. |