SPECIAL DELIVERY DENTAL CARE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SPECIAL DELIVERY DENTAL CARE INC (EIN 93-1071103)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-14
- IRS object ID
- 202122879349301242
- Schema version
- 2020v4.1
- 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 | 2021-10-14T11:03:05-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 800305279 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPSAHL DAWSON PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7701 NE GREENWOOD DRIVE SUITE 200 | AddressLine1Txt |
| City | VANCOUVER | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98662 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931071103 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECIAL DELIVERY DENTAL CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPEC | BusinessNameControlTxt |
| Phone | 2067953358 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6319 SE POWELL BLVD | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY LINDER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5037723677 | PhoneNum |
| Signature | 2021-09-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMY | PersonFirstNm |
| Person Last | LINDER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SAM CHRISTENSEN CPA | PreparerPersonNm |
| PTIN | P01879347 | PTIN |
| Phone | 3607378007 | PhoneNum |
| Preparation | 2021-09-29 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | AMY LINDER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6319 SE POWELL BLVD | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,368,766 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GERIATRICDENTAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE LOWER COST DENTAL CARE TO THE ELDERLY AND DISABLED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $61,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $109,604 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,721,725 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,235,101 | CYProgramServiceRevenueAmt |
| PY Investment Income | $25,104 | PYInvestmentIncomeAmt |
| CY Investment Income | $24,061 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,807,829 | PYTotalRevenueAmt |
| CY Total Revenue | $1,368,766 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $80,822 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $98,986 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,049,295 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $688,826 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $630,294 | PYOtherExpensesAmt |
| CY Other Expenses | $464,672 | CYOtherExpensesAmt |
| PY Total Expenses | $1,760,411 | PYTotalExpensesAmt |
| CY Total Expenses | $1,252,484 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $47,418 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $116,282 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,055,849 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,173,111 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $87,365 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $70,414 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $968,484 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,102,697 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE LOWER COST DENTAL CARE TO THE ELDERLY AND DISABLED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,089,446 | ExpenseAmt |
| Grant | $98,986 | GrantAmt |
| Revenue | $1,220,005 | RevenueAmt |
| Desc | PROVIDED GERIATRIC DENTAL CARE AT NO CHARGE OR BELOW STANDARD FEES TO ELDERLY AND DISABLED INDIVIDUALS IN PORTLAND, OREGON. ESTIMATED FAIR MARKET VALUE OF SERVICES PROVIDED 2,038,750 | Desc |
| Total Program Service Expenses | $1,089,446 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 20 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMY LINDER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5037723677 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 619 SE POWELL BLVD | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97206 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BARBARA YAKOVETZ | ||||||||
| PRESIDENT | 0.10 | 0.10 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAM LINDER | ||||||||
| SECRETARY | 25.00 | 0.10 | Yes (X) | Yes (X) | $26,372 | $0 | $0 | |
| DUANE MCCARDLE | ||||||||
| DIRECTOR | 0.10 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| JUDITH VAUGHT | ||||||||
| DIRECTOR | 0.10 | 0.10 | Yes (X) | $0 | $0 | $0 | ||
| AMY LINDER | ||||||||
| EXECUTIVE DIRECTOR | 20.00 | 25.00 | Yes (X) | Yes (X) | $55,869 | $110,186 | $0 | |
| NAVID KALANTARPOUR | ||||||||
| DENTIST | 5.00 | 40.00 | $15,890 | $139,742 | $0 | Yes (X) | ||
| DR ALEXANDER RUDNITSKI | ||||||||
| DENTAL DIRECTOR - PORTLAND | 40.00 | 0.00 | $177,894 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $276,025 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $249,928 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,104 | RelatedOrganizationsAmt |
| All Other Contributions | $107,500 | AllOtherContributionsAmt |
| Total Contributions | $109,604 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $1,220,005 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,220,005 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,096 | TotalRevenueColumnAmt |
| Exclusion | $15,096 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,235,101 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,061 | TotalRevenueColumnAmt |
| Exclusion | $24,061 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,368,766 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,220,005 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $39,157 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,986 | TotalAmt |
| Program Services | $98,986 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,025 | TotalAmt |
| Program Services | $193,784 | ProgramServicesAmt |
| Management And General | $82,241 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,492 | TotalAmt |
| Program Services | $254,753 | ProgramServicesAmt |
| Management And General | $34,739 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,730 | TotalAmt |
| Program Services | $20,882 | ProgramServicesAmt |
| Management And General | $2,848 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,706 | TotalAmt |
| Program Services | $48,141 | ProgramServicesAmt |
| Management And General | $6,565 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,873 | TotalAmt |
| Program Services | $39,489 | ProgramServicesAmt |
| Management And General | $5,384 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,684 | TotalAmt |
| Management And General | $11,684 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363 | TotalAmt |
| Program Services | $363 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,125 | TotalAmt |
| Program Services | $10,670 | ProgramServicesAmt |
| Management And General | $1,455 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,447 | TotalAmt |
| Program Services | $16,233 | ProgramServicesAmt |
| Management And General | $2,214 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,920 | TotalAmt |
| Program Services | $51,850 | ProgramServicesAmt |
| Management And General | $7,070 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,948 | TotalAmt |
| Program Services | $2,594 | ProgramServicesAmt |
| Management And General | $354 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43 | TotalAmt |
| Program Services | $38 | ProgramServicesAmt |
| Management And General | $5 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,193 | TotalAmt |
| Program Services | $26,193 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,824 | TotalAmt |
| Program Services | $15,685 | ProgramServicesAmt |
| Management And General | $2,139 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| LAB CHARGES | $142,465 | $142,465 | |
| DRUGS AND DENTAL SUPPLI | $103,825 | $103,825 | |
| CASUAL LABOR | $33,516 | $33,516 | |
| CREDIT CARD LEASE | $16,482 | $14,504 | $1,978 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,837 | TotalAmt |
| Program Services | $15,475 | ProgramServicesAmt |
| Management And General | $4,362 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,252,484 | TotalAmt |
| Program Services | $1,089,446 | ProgramServicesAmt |
| Management And General | $163,038 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,617 | BOYAmt |
| EOY | $362,833 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,861 | BOYAmt |
| EOY | $711,187 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $90,772 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466 | BOYAmt |
| EOY | $3,615 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $280,330 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $275,626 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,905 | BOYAmt |
| EOY | $4,704 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,055,849 | BOYAmt |
| EOY | $1,173,111 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,365 | BOYAmt |
| EOY | $70,414 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,365 | BOYAmt |
| EOY | $70,414 | 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 | $967,984 | BOYAmt |
| EOY | $1,102,197 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500 | BOYAmt |
| EOY | $500 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $968,484 | BOYAmt |
| EOY | $1,102,697 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,055,849 | BOYAmt |
| EOY | $1,173,111 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $116,282 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $11,169 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $6,762 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,567 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $37,170 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $78,560 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $61,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $107,500 | CurrentTaxYearAmt |
| Total | $306,797 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,589,784 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,749,855 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,756,256 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,721,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,220,005 | CurrentTaxYearAmt |
| Total | $8,037,625 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,612,351 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,787,025 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,834,816 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,782,725 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,327,505 | CurrentTaxYearAmt |
| Total | $8,344,422 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $8,344,422 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,148 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,432 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,621 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,104 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,061 | CurrentTaxYearAmt |
| Total | $119,366 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,148 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,432 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,621 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,104 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,061 | CurrentTaxYearAmt |
| Total | $119,366 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,635,499 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,812,457 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,856,437 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,807,829 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,351,566 | CurrentTaxYearAmt |
| Total | $8,463,788 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98590 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98490 | PublicSupportPY509Pct |
| Investment Income CY | 0.01410 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01510 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,465 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $244,670 | OtherCostOrOtherBasisAmt |
| Depreciation | $239,966 | DepreciationAmt |
| Book Value | $4,704 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,195 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,195 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,704 | TotalBookValueLandBuildingsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECIAL DELIVERY DENTAL CARE FEDERAL WAY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 728 S 320TH ST SUITE A | AddressLine1Txt |
| City | FEDERAL WAY | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98003 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 364733035 | RecipientEIN |
| Cash Grant | $96,947 | CashGrantAmt |
| Purpose Of Grant | TO HELP COVER EXPENSES OF SPECIAL DELIVERY DENTAL CARE, PC. | PurposeOfGrantTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR ALEXANDER RUDNITSKI | ||||||||||||||
| DENTAL DIRECTOR - PORTLAND | $177,894 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $177,894 | $0 | $0 | $0 |
| AMY LINDER | ||||||||||||||
| EXECUTIVE DIRECTOR | $55,869 | $110,186 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $55,869 | $110,186 | $0 | $0 |
| NAVID KALANTARPOUR | ||||||||||||||
| DENTIST | $15,890 | $139,742 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,890 | $139,742 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | EXECUTIVE DIRECTORS COMPENSATION IS APPROVED BY THE BOARD. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | PAM LINDER AND AMY LINDER HAVE A FAMILY RELATIONSHIP. DUANE MCCARDLE HAS A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 8B | NOT APPLICABLE |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS REVIEWS AND APPROVESS THE TAX RETURN FOR THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH COVERED PERSON RECEIVES A COPY OF THE POLICY AND IS REQUIRED TO FILL OUT THE ANNUAL CONFLICT OF INTEREST QUESTIONAIRE. THE BOARD REVIEWS AND DETERMINES IF A CONFLICT OF INTEREST DOES EXIST. THE BOARD WILL LOOK INTO DEVELOPING ALTERNATIVES TO REMOVE THE CONFLICT FROM THE SITUATION OR WILL PROHIBIT THE COVERED PERSON FROM VOTING ON TRANSACTIONS IN WHICH THEY HAVE A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD RECOMMENDS AND REVIEWS COMPENSATION OF THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SPECIAL DELIVERY DENTAL CARE PLLC | ||||||||||
| 16500 SE 15TH STREET SUITE 150 | VANCOUVER | WA | 98683 | 300874104 | DENTAL CARE | WA | 501(C)(3) | LINE 11 | SPECIAL DELIVERY DENTAL CARE PC | 0 |
| SPECIAL DELIVERY DENTAL CARE PC | ||||||||||
| 728 S 320TH ST SUITE A | FEDERAL WAY | WA | 98003 | 364733035 | DENTAL CARE | WA | 501(C)(3) | LINE 11 | SPECIAL DELIVERY DENTAL CARE INC | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPECIAL DELIVERY DENTAL CARE PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $96,947 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Comments