PARK PLACE HEALTH & DENTAL CLINIC INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PARK PLACE HEALTH & DENTAL CLINIC INC (EIN 45-3086608)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-08-16
- IRS object ID
- 202222289349301452
- Schema version
- 2021v4.0
- 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 | 2022-08-16T13:07:47-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200221868 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARNES BROCK CORNWELL & PAINTER PLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 908 EDEN WAY N STE 201 | AddressLine1Txt |
| City | CHESAPEAKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 233202640 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453086608 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARK PLACE HEALTH & DENTAL CLINIC | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PARK | BusinessNameControlTxt |
| Phone | 7573903288 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 W 29TH ST | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23508 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL B STOUT | PersonNm |
| Person Title | CHAIRMAN | PersonTitleTxt |
| Phone | 7573903288 | PhoneNum |
| Signature | 2022-08-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL B | PersonFirstNm |
| Person Last | STOUT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 888008888 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY C PAINTER CPA | PreparerPersonNm |
| PTIN | P00294115 | PTIN |
| Phone | 7579615017 | PhoneNum |
| Preparation | 2022-08-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL B STOUT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 606 W 29TH ST | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $131,010 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PARKPLACECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | MISSION OF THE CLINIC IS TO PROVIDE EXCELLENT DENTAL CARE IN THE AREAS OF EXTRACTIONS, FILLINGS AND CLEANINGS TO THE HOMELESS, LOW-INCOME AND UNDERSERVED RESIDENTS OF THE CITY OF NORFOLK. AN ADDED MANDATE IS ALSO TO PROVIDE GREAT COMMUNITY IMPACT CLASSES TO RESIDENTS OF NORFOLK PARK PLACE HEALTH & DENTAL CLINIC SEEKS TO BE A POSITIVE IMPACT IN THE COMMUNITY THROUGH DENTAL SERVICES AND COMMUNITY INVOLVEMENT. OUR MISSION MOTTO IS THAT WE "CHANGE LIVES, ONE SMILE AT A TIME." | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 3 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $157,187 | PYContributionsGrantsAmt |
| CY Contributions Grants | $129,460 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,525 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,550 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $163,712 | PYTotalRevenueAmt |
| CY Total Revenue | $131,010 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $96,487 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $89,716 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $6,280 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,540 | PYOtherExpensesAmt |
| CY Other Expenses | $30,177 | CYOtherExpensesAmt |
| PY Total Expenses | $130,027 | PYTotalExpensesAmt |
| CY Total Expenses | $119,893 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $33,685 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,117 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $153,078 | TotalAssetsBOYAmt |
| Total Assets EOY | $144,292 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,763 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,860 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $128,315 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $139,432 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MISSION OF THE CLINIC IS TO PROVIDE EXCELLENT DENTAL CARE IN THE AREAS OF EXTRACTIONS, FILLINGS AND CLEANINGS TO THE HOMELESS, LOW-INCOME AND UNDERSERVED RESIDENTS OF THE CITY OF NORFOLK. AN ADDED MANDATE IS ALSO TO PROVIDE GREAT COMMUNITY IMPACT CLASSES TO RESIDENTS OF NORFOLK PARK PLACE HEALTH & DENTAL CLINIC SEEKS TO BE A POSITIVE IMPACT IN THE COMMUNITY THROUGH DENTAL SERVICES AND COMMUNITY INVOLVEMENT. OUR MISSION MOTTO IS THAT WE "CHANGE LIVES, ONE SMILE AT A TIME." | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $102,097 | ExpenseAmt |
| Desc | PARK PLACE HEALTH AND DENTAL IS A FREE STANDING NON-PROFIT LOCATED IN DOWNTOWN NORFOLK, VA. PARK PLACE HEALTH AND DENTAL SEES THOSE WHO ARE UNINSURED AND WHO ARE LOW INCOME. EACH PATIENT MUST COMPLETE AN APPLICATION ANNUALLY IN ORDER TO QUALITY. OUR CLINIC PROVIDES SERVICES SUCH AS FILINGS, CLEANINGS, EXTRACTIONS, DENTURES AND PARTIALS FOR A VERY LOW FEE. WE ARE ABLE TO DO SO WITH THE HELP OF OUR VOLUNTEERS. IN ADDITION TO OUR IN-HOUSE CLINICAL SERVICES, WE ALSO PARTICIPATE IN A WIDE VARIETY OF COMMUNITY ACTIVITIES. | Desc |
| Total Program Service Expenses | $102,097 | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | 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 | Yes (true) | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 3 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOCUMENT MANAGEMENT COMPANY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7574950829 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 LORD DUNMORE DRIVE | AddressLine1Txt |
| City | VIRGINIA BEACH | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23464 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| JENNIFER TOMAR | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $43,900 | $0 | $0 | |
| MICHAEL B STOUT | ||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MARK HORNING | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| D BARRY IACONO | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DR GREG HORNING | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR LEE MELVIN DDS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ALVIN SAMUELS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR EDWARD J WEISBERG | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CAROL WALSH | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MEG LEMASTER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SUSAN OWEN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR FRITZ OCHAVE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $43,900 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $21,500 | GovernmentGrantsAmt |
| All Other Contributions | $107,960 | AllOtherContributionsAmt |
| Total Contributions | $129,460 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Total Revenue Column | $1,550 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,550 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,550 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $131,010 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,550 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,900 | TotalAmt |
| Program Services | $36,437 | ProgramServicesAmt |
| Management And General | $4,390 | ManagementAndGeneralAmt |
| Fundraising | $3,073 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,154 | TotalAmt |
| Program Services | $31,668 | ProgramServicesAmt |
| Management And General | $3,815 | ManagementAndGeneralAmt |
| Fundraising | $2,671 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,662 | TotalAmt |
| Program Services | $6,360 | ProgramServicesAmt |
| Management And General | $766 | ManagementAndGeneralAmt |
| Fundraising | $536 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,132 | TotalAmt |
| Program Services | $3,719 | ProgramServicesAmt |
| Management And General | $413 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660 | TotalAmt |
| Program Services | $594 | ProgramServicesAmt |
| Management And General | $66 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138 | TotalAmt |
| Program Services | $124 | ProgramServicesAmt |
| Management And General | $14 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,459 | TotalAmt |
| Program Services | $6,713 | ProgramServicesAmt |
| Management And General | $746 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,308 | TotalAmt |
| Program Services | $3,308 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,127 | TotalAmt |
| Program Services | $1,914 | ProgramServicesAmt |
| Management And General | $213 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES AND SUBSCRIPTIONS | $5,330 | $4,797 | $533 |
| INTERNET | $1,530 | $1,377 | $153 |
| REPAIRS AND MAINTENANCE | $1,410 | $1,269 | $141 |
| PROGRAM EXPENSE | $988 | $988 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,095 | TotalAmt |
| Program Services | $2,829 | ProgramServicesAmt |
| Management And General | $266 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,893 | TotalAmt |
| Program Services | $102,097 | ProgramServicesAmt |
| Management And General | $11,516 | ManagementAndGeneralAmt |
| Fundraising | $6,280 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,577 | BOYAmt |
| EOY | $99,778 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,101 | BOYAmt |
| EOY | $40,910 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,239 | BOYAmt |
| EOY | $908 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $42,633 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,937 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,004 | BOYAmt |
| EOY | $2,696 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,078 | BOYAmt |
| EOY | $144,292 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $467 | BOYAmt |
| EOY | $1,328 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,500 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,796 | BOYAmt |
| EOY | $3,532 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,763 | BOYAmt |
| EOY | $4,860 | 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 | $64,214 | BOYAmt |
| EOY | $139,432 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,101 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,315 | BOYAmt |
| EOY | $139,432 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,078 | BOYAmt |
| EOY | $144,292 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,117 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| 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 | $109,527 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $78,114 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $159,962 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $157,187 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $129,460 | CurrentTaxYearAmt |
| Total | $634,250 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $109,527 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $78,114 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $159,962 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $157,187 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $129,460 | CurrentTaxYearAmt |
| Total | $634,250 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $634,250 | PublicSupportTotal170Amt |
| Total Support | $634,250 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $105,165 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,633 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,937 | DepreciationAmt |
| Book Value | $2,696 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,696 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUED PAYROLL | Desc |
| Amt | $3,532 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,532 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $151,323 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $20,313 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $20,313 | RevenueNotReportedAmt |
| Revenue Subtotal | $131,010 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $131,010 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $140,206 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $20,313 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $20,313 | ExpensesNotReportedAmt |
| Expenses Subtotal | $119,893 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $119,893 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 FOOTNOTE: THE ORGANIZATION ADOPTED THE RECOGNITION REQUIREMENTS FOR UNCERTAIN INCOME TAX POSITIONS AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, WITH NO CUMULATIVE EFFECT ADJUSTMENT REQUIRED. INCOME TAX BENEFITS ARE RECOGNIZED FOR INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A RETURN, ONLY WHEN IT IS DETERMINED THAT THE INCOME TAX POSITION WILL MORE- LIKELY-THAN-NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE ORGANIZATION HAS ANALYZED THE TAX POSITIONS TAKEN IN ITS FILINGS WITH THE INTERNAL REVENUE SERVICE. THE ORGANIZATION BELIEVES THAT ITS INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE AFFECT ON THE ORGANIZATION'S FINANCIAL CONDITION, RESULTS OF OPERATIONS OR CASH FLOWS. ACCORDINGLY, THE ORGANIZATION HAS NOT RECORDED ANY RESERVES, OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS AT DECEMBER 31, 2021. |
| SCHEDULE D, PAGE 4, PART XIII | THE ORGANIZATION'S FEDERAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) FOR 2021, 2020, 2019, AND 2018 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY, FOR THREE YEARS AFTER THEY WERE FILED. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOCUMENT MANAGEMENT COMPANY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ACCOUNTING SRV | RelationshipDescriptionTxt |
| Transaction | BOOKKEEPING | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | MISSION OF THE CLINIC IS TO PROVIDE EXCELLENT DENTAL CARE IN THE AREAS OF EXTRACTIONS, FILLINGS AND CLEANINGS TO THE HOMELESS, LOW-INCOME AND UNDERSERVED RESIDENTS OF THE CITY OF NORFOLK. AN ADDED MANDATE IS ALSO TO PROVIDE GREAT COMMUNITY IMPACT CLASSES TO RESIDENTS OF NORFOLK PARK PLACE HEALTH & DENTAL CLINIC SEEKS TO BE A POSITIVE IMPACT IN THE COMMUNITY THROUGH DENTAL SERVICES AND COMMUNITY INVOLVEMENT. OUR MISSION MOTTO IS THAT WE "CHANGE LIVES, ONE SMILE AT A TIME." |
| FORM 990, PAGE 6, PART VI, LINE 2 | MICHAEL STOUT MARK HORNING CHAIRMAN SECRETARY FATHER IN LAW MARK HORNING GREG HORNING SECRETARY DIRECTOR SON |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE GOVERNING BODY RECEIVED A DRAFT OF THE TAX RETURN TO APPROVE BEFORE FINAL PROCESSING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUALLY THE CONFLICT OF INTEREST POLICY IS REVIEWED WITH THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUAL REVIEW AND APPROVAL BY THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 15B | ANNUAL REVIEW AND APPROVAL BY THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |