DELTA DENTAL OF VIRGINIA FOUNDATION INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF VIRGINIA FOUNDATION INC (EIN 45-3230862)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-12
- IRS object ID
- 202013179349305706
- Schema version
- 2019v5.1
- 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 | 2020-11-12T13:43:06-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 540504608 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROWN EDWARDS & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 319 MCCLANAHAN STREET SW | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24014 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453230862 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF VIRGINIA FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELT | BusinessNameControlTxt |
| Phone | 5409898000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4818 STARKEY ROAD | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24018 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRANK L LUCIA | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 5409898000 | PhoneNum |
| Signature | 2020-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | M C WINGFIELD | PreparerPersonNm |
| PTIN | P00005971 | PTIN |
| Phone | 5403450936 | PhoneNum |
| Preparation | 2020-11-09 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 206.248.228.130 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-09 | IPDt |
| IP Tm | 09:02:24 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B8F3A42E1E02DCEFCA8852D9E0619B3AA9DB5E86 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 99D0D1F6CFEB3F355FC0DB60138D01BD9869373F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRANK L LUCIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4818 STARKEY ROAD | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24018 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $420,586 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DELTADENTALVA.COM/DDVAFOUNDATION.ASPX | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE PUBLIC'S ORAL HEALTH IN THE COMMONWEALTH OF VIRGINIA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $562,052 | PYContributionsGrantsAmt |
| CY Contributions Grants | $420,586 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $562,052 | PYTotalRevenueAmt |
| CY Total Revenue | $420,586 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $546,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $409,865 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,712 | PYOtherExpensesAmt |
| CY Other Expenses | $42,793 | CYOtherExpensesAmt |
| PY Total Expenses | $574,212 | PYTotalExpensesAmt |
| CY Total Expenses | $452,658 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,160 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$32,072 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $520,838 | TotalAssetsBOYAmt |
| Total Assets EOY | $352,792 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $135,974 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $384,864 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $352,792 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE FOUNDATION WORKS TO IMPROVE THE ORAL HEALTH OF ALL VIRGINIANS THROUGH FINANCIAL SUPPORT OF RESEARCH AND EDUCATION INITIATIVES AND PROGRAMS THAT PROVIDE ACCESS TO CARE FOR THE UNDERSERVED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $409,865 | ExpenseAmt |
| Grant | $409,865 | GrantAmt |
| Desc | PROMOTION OF ORAL HEALTH CARE THROUGH EDUCATION, RESEARCH AND INCREASED ACCESS TO ORAL HEALTH CARE IN THE COMMONWEALTH OF VIRGINIA. | Desc |
| Total Program Service Expenses | $409,865 | 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 | 0 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| 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 | 0 | EmployeeCnt |
| 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 0 | 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 | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | 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 | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RJAMES BARKER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5409898000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4818 STARKEY ROAD | AddressLine1Txt |
| City | ROANOKE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24018 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| DR HAROLD J BARRETT JR | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $24,407 | $0 | ||
| DR LEZLEY P MCILVEEN | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $28,138 | $0 | ||
| DR A CAROLE PRATT | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $26,050 | $0 | ||
| MR JAN S SESSOR | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $27,450 | $0 | ||
| MR FRANK L LUCIA | ||||||||
| PRESIDENT & CEO | 1.00 | 41.00 | Yes (X) | $0 | $1,072,199 | $25,206 | Yes (X) | |
| DR GEORGE A LEVICKI | ||||||||
| FORMER PRESIDENT | 0.00 | 0.00 | $0 | $141,199 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,319,443 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $25,206 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $420,586 | RelatedOrganizationsAmt |
| Total Contributions | $420,586 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $420,586 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,865 | TotalAmt |
| Program Services | $409,865 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,406 | TotalAmt |
| Management And General | $4,406 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,074 | TotalAmt |
| Management And General | $36,074 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DENTAL CLAIMS | Desc |
| Total | $2,313 | TotalAmt |
| Management And General | $2,313 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,658 | TotalAmt |
| Program Services | $409,865 | ProgramServicesAmt |
| Management And General | $42,793 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $520,489 | BOYAmt |
| EOY | $347,224 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349 | BOYAmt |
| EOY | $5,568 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $520,838 | BOYAmt |
| EOY | $352,792 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $974 | BOYAmt |
| EOY | $0 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,974 | BOYAmt |
| EOY | $0 | 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 | $384,864 | BOYAmt |
| EOY | $352,792 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,864 | BOYAmt |
| EOY | $352,792 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $520,838 | BOYAmt |
| EOY | $352,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$32,072 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELTA DENTAL OF VIRGINIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 540844477 | EIN |
| Organization Type | 10 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $409,865 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $409,865 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | Yes (1) | SupportedOrgSectionC456Ind |
| Supported Org Qualified | Yes (1) | SupportedOrgQualifiedInd |
| Suprt Exclusively Sec170c2 B | Yes (1) | SuprtExclusivelySec170c2BInd |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART IV, LINE 3B | DELTA DENTAL OF VIRGINIA FOUNDATION ANNUALLY REQUESTS FROM DELTA DENTAL A PRO FORMA FORM 990 SCHEDULE A TO VERIFY IT MEETS THE SECTION 509(A)(2) PUBLIC SUPPORT TEST FOR ITS MOST RECENT TAX YEAR. |
| SCHEDULE A, PART IV, LINE 3C | DELTA DENTAL OF VIRGINIA FOUNDATION HAS PROCEDURES IN PLACE TO ENSURE THAT ITS SUPPORT IS USED SOLELY FOR CHARITABLE PURPOSES. THE FOUNDATION MONITORS ALL GRANT MONIES AWARDED BY REQUIRING END-OF-YEAR UPDATES DETAILING HOW THE GRANT MONIES WERE USED. |
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) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $420,586 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $420,586 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $420,586 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $452,658 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $452,658 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $452,658 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (51 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| ARLINGTON FREE CLINIC | ||||||||
| 2921 11TH ST SOUTH | ARLINGTON | VA | 22204 | 541671883 | 501(C)(3) | $5,000 | DENTIST SALARY | |
| BLAND MINISTRY CENTER AND DENTAL CLINIC | ||||||||
| 65 SEDDON STREET | BLAND | VA | 24315 | 541556134 | 501(C)(3) | $15,000 | DENTAL EQUIPMENT | |
| BOYS & GIRLS CLUBS OF SOUTHWEST VIRGINIA | ||||||||
| 1714 9TH STREET SE | ROANOKE | VA | 24013 | 541867366 | 501(C)(3) | $5,000 | STAFF SUPPORT | |
| BOYS & GIRLS CLUBS OF THE VIRGINIA PENINSULA | ||||||||
| 11825 ROCK LANDING DRIVE CHESAPEAKE | NEWPORT NEWS | VA | 23606 | 540538202 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | BUILDING |
| BRADLEY FREE CLINIC | ||||||||
| 1240 THIRD STREET SW | ROANOKE | VA | 24016 | 237380491 | 501(C)(3) | $20,000 | DENTAL STUDENTS | |
| CENTRAL VIRGINIA HEALTH SERVICES INC | ||||||||
| 25892 N JAMES MADISON HWY | NEW CANTON | VA | 23123 | 540887287 | 501(C)(3) | $7,500 | DENTAL EQUIPMENT | |
| CHARLOTTESVILLE FREE CLINIC | ||||||||
| 1138 ROSE HILL DRIVE SUITE 200 | CHARLOTTESVILLE | VA | 22903 | 541610405 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| CHESAPEAKE CARE INC | ||||||||
| 2145 S MILITARY HIGHWAY | CHESAPEAKE | VA | 23320 | 541642754 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| CHIP OF ROANOKE VALLEY | ||||||||
| 1201 THIRD STREET SW | ROANOKE | VA | 24016 | 541566451 | 501(C)(3) | $5,000 | EDUCATION | |
| CROSS-OVER MINISTRY INC | ||||||||
| 8600 QUIOCCASIN ROAD STE 101 | RICHMOND | VA | 23229 | 541371067 | 501(C)(3) | $5,000 | STAFF SUPPORT | |
| DANVILLE-PITTSYLVANIA COMMUNITY SERVICES | ||||||||
| 245 HAIRSTON STREET | DANVILLE | VA | 24540 | 540937279 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| DENTAL CLINIC OF NORTHERN SHENANDOAH VALLEY INC | ||||||||
| 301 NORTH CAMERON STREET SUITE 200 | WINCHESTER | VA | 22601 | 450573607 | 501(C)(3) | $5,000 | SUPPORT STAFF | |
| DR RICHARD F CLARK HELP CLINICS | ||||||||
| 1320 LASALLE AVENUE | HAMPTON | VA | 23669 | 541209213 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| EASTERN SHORE RURAL HEALTH SYSTEM INC | ||||||||
| 20280 MARKET STREET | ONANCOCK | VA | 23417 | 510196935 | 501(C)(3) | $10,000 | DENTAL EQUIPMENT | |
| FREE CLINIC OF POWHATAN | ||||||||
| 3908 OLD BUCKINGHAM ROAD | POWHATAN | VA | 23139 | 261275136 | 501(C)(3) | $10,000 | DENTAL EQUIPMENT | |
| GLOUCESTER MATHEWS CARE CLINIC | ||||||||
| 6031 INDUSTRIAL DRIVE | GLOUCESTER | VA | 23061 | 541875619 | 501(C)(3) | $10,000 | DENTAL PROVIDER SUPPORT | |
| GOOCHLAND CARES | ||||||||
| 2999 RIVER ROAD WEST | GOOCHLAND | VA | 23063 | 541967650 | 501(C)(3) | $5,000 | MATERIALS/SUPPLIES | |
| GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER | ||||||||
| 4379 RIDGEWOOD CENTER DRIVE | WOODBRIDGE | VA | 22192 | 830435138 | 501(C)(3) | $7,500 | DENTAL EQUIPMENT | |
| HAMPTON ROADS COMMUNITY HEALTH CENTER | ||||||||
| 664 LINCOLN STREET | PORTSMOUTH | VA | 23704 | 541626757 | 501(C)(3) | $10,000 | DENTAL EQUIPMENT | |
| HANOVER INTERFAITH FREE CLINICS | ||||||||
| 125 BEVERLY ROAD PO BOX 117 | ASHLAND | VA | 23005 | 412214314 | 501(C)(3) | $7,500 | DENTAL APPLIANCES | |
| HEALING HANDS HEALTH CENTER | ||||||||
| 245 MIDWAY MEDICAL PARK | BRISTOL | TN | 37620 | 621677000 | 501(C)(3) | $10,000 | DENTAL SUPPLIES | |
| HIGHLAND MEDICAL CENTER | ||||||||
| 120 JACKSON RIVER ROAD PO BOX 490 | MONTEREY | VA | 24465 | 541652356 | 501(C)(3) | $7,800 | DENTAL EQUIPMENT | |
| LACKEY CLINIC | ||||||||
| 1620 OLD WILLIAMSBURG ROAD | YORKTOWN | VA | 23690 | 541850915 | 501(C)(3) | $10,000 | DENTAL PROVIDER SUPPORT | |
| LEWIS GALE FOUNDATION DBA HEALTH FOCUS OF SOUTHWEST VIRGINIA | ||||||||
| PO BOX 4692 | ROANOKE | VA | 24015 | 546051298 | 501(C)(3) | $5,000 | SCHOLARSHIPS | |
| LLOYD F MOSS FREE CLINIC | ||||||||
| 1301 SAM PERRY BOULEVARD STE 100 | FREDERICKSBURG | VA | 22401 | 541677934 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| LUCY CORR FOUNDATION | ||||||||
| 6800 LUCY CORR BOULEVARD | CHESTERFIELD | VA | 23832 | 542010957 | 501(C)(3) | $10,000 | STAFF SUPPORT | |
| MADISON FREE CLINIC | ||||||||
| 410 NORTH MAIN STREET PO BOX 914 | MADISON | VA | 22727 | 311654015 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| MEDICAL CARE FOR CHILDREN PARTNERSHIP FOUNDATION | ||||||||
| 6699 SPRINGFIELD CENTER DRIVE 303 | SPRINGFIELD | VA | 22150 | 261756738 | 501(C)(3) | $5,000 | SPECIAL NEEDS DENTAL | |
| MEDICAL COLLEGE OF VIRGINIA FOUNDATION | ||||||||
| 1228 E BROAD STREET | RICHMOND | VA | 23284 | 546053660 | 501(C)(3) | $10,000 | GEORGE A. LEVICKI, D.D.S. ENDOWED SCHOLARSHIP FUND | |
| MEL LEAMAN FREE CLINIC | ||||||||
| 601 RADIO HILL ROAD | MARION | VA | 24354 | 541993876 | 501(C)(3) | $5,000 | STAFF SUPPORT | |
| MISSION DENTAL VIRGINIA INC | ||||||||
| 15325 LEE HIGHWAY | BRISTOL | VA | 24202 | 833820038 | 501(C)(3) | $15,000 | DENTAL SUPPLIES | |
| NORTHERN NECK - MIDDLESEX FREE HEALTH CLINIC INC | ||||||||
| 51 WILLIAM B GRAHAM COURT | KILMARNOCK | VA | 22482 | 541679279 | 501(C)(3) | $7,500 | DENTAL STUDENTS | |
| NORTHERN VIRGINIA COMMUNITY COLLEGE EDUCATIONAL FOUNDATION | ||||||||
| 4001 WAKEFIELD CHAPEL ROAD | ANNANDALE | VA | 22003 | 510249730 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| NORTHERN VIRGINIA DENTAL CLINIC INC | ||||||||
| 8221 WILLOW OAKS CORPORATE DRIVE | FAIRFAX | VA | 22031 | 541646071 | 501(C)(3) | $7,500 | DENTAL PROVIDER SUPPORT | SUITE 450 |
| OLD DOMINION UNIVERSITY EDUCATIONAL FOUNDATION | ||||||||
| 4417 MONARCH WAY 4TH FLOOR | NORFOLK | VA | 23529 | 541850915 | 501(C)(3) | $4,000 | DENTAL SUPPLIES | |
| PARK PLACE HEALTH AND DENTAL CLINIC | ||||||||
| 606 WEST 29TH STREET | NORFOLK | VA | 23508 | 542026502 | 501(C)(3) | $5,000 | DENTAL STUDENTS | |
| PIEDMONT REGIONAL DENTAL CLINIC | ||||||||
| 13296 JAMES MADISON HIGHWAY | ORANGE | VA | 22960 | 270625764 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT FOR MOBILE | |
| PIEDMONT VIRGINIA DENTAL HEALTH FOUNDATION | ||||||||
| 407 STARLING AVENUE | MARTINSVILLE | VA | 24112 | 541626757 | 501(C)(3) | $10,000 | DENTAL SUPPLIES | |
| PRINCE WILLIAM AREA FREE CLINIC | ||||||||
| 13900 CHURCH HILL DRIVE | WOODBRIDGE | VA | 22191 | 541619202 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| RESCUE MISSION OF ROANOKE INC | ||||||||
| P O BOX 11525 | ROANOKE | VA | 24022 | 540573900 | 501(C)(3) | $10,000 | DENTAL PROVIDER SUPPORT | |
| SOUTHEASTERN VIRGINIA HEALTH SYSTEM | ||||||||
| 10330 28TH STREET 2ND FLOOR | NEWPORT NEWS | VA | 23607 | 541083954 | 501(C)(3) | $4,500 | DENTAL SUPPLIES | |
| ST LUKE'S COMMUNITY CLINIC | ||||||||
| 316 NORTH ROYAL AVENUE | FRONT ROYAL | VA | 22630 | 541801220 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT | |
| THE FENWICK FOUNDATION | ||||||||
| 23 N FENWICK STREET | ARLINGTON | VA | 22201 | 541013637 | 501(C)(3) | $5,000 | MOBILE CLINIC | |
| THE LAMB CENTER | ||||||||
| 3160 CAMPBELL DRIVE | FAIRFAX | VA | 22031 | 412222581 | 501(C)(3) | $3,000 | DENTAL SUPPLIES | |
| THE VIRGINIA HEALTH CARE FOUNDATION | ||||||||
| 707 EAST MAIN STREET STE 1350 | RICHMOND | VA | 23219 | 541639924 | 501(C)(3) | $45,000 | DENTAL PROVIDER SUPPORT | |
| TOTAL ACTION AGAINST POVERTY | ||||||||
| 302 2ND STREET SW | ROANOKE | VA | 24011 | 541639924 | 501(C)(3) | $5,000 | DENTAL PROVIDER SUPPORT | |
| VIRGINIA DENTAL ASSOCIATION FOUNDATION | ||||||||
| 3460 MAYLAND COURT SUITE 110 | RICHMOND | VA | 23233 | 541821602 | 501(C)(3) | $15,000 | MOBILE CLINIC | |
| VIRGINIA HEALTH CATALYST | ||||||||
| 4200 INNSLAKE DRIVE STE 103 | GLEN ALLEN | VA | 23060 | 274082359 | 501(C)(3) | $7,500 | EDUCATION | |
| VIRGINIA WESTERN COMMUNITY COLLEGE EDUCATIONAL FOUNDATION INC | ||||||||
| 3093 COLONIAL AVE | ROANOKE | VA | 24015 | 541268273 | 501(C)(3) | $10,000 | EDUCATION | |
| WESTERN TIDEWATER FREE CLINIC | ||||||||
| 2019 MEADE PARKWAY | SUFFOLK | VA | 23434 | 263302837 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| WILLIAMSBURG AREA MEDICAL ASSIST CORP DBA OLDE TOWN MEDICAL & DENTAL | ||||||||
| 5249 OLDE TOWNE ROAD SUITE D | WILLIAMSBURG | VA | 23188 | 541663905 | 501(C)(3) | $5,565 | DENTAL SUPPLIES AND EQUIPMENT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 51 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION REQUESTS A YEAR-END UPDATE OF HOW THE GRANT FUNDS WERE USED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MR FRANK L LUCIA | ||||||||||||||
| PRESIDENT & CEO | $0 | $638,542 | $0 | $416,478 | $0 | $17,179 | $0 | $0 | $0 | $25,206 | $0 | $1,097,405 | $0 | $0 |
| DR GEORGE A LEVICKI | ||||||||||||||
| FORMER PRESIDENT | $0 | $0 | $0 | $0 | $0 | $141,199 | $0 | $0 | $0 | $0 | $0 | $141,199 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1B | NOT APPLICABLE |
| PART I, LINE 4B | THE FOLLOWING LUMP SUM PAYMENT BY A RELATED ORGANIZATION HAS BEEN INCLUDED IN COLUMN B-III OF SCHEDULE J, PART II. THE LUMP SUM PAYMENT IN 2019 WAS EARNED OVER A PRECEDING MULTI-YEAR PERIOD. THIS PLAN WAS ESTABLISHED VIA THE RELATED ORGANIZATION'S MANAGEMENT DEVELOPMENT & COMPENSATION COMMITTEE'S COMPENSATION AND BENEFIT REVIEW WHICH IS IN ACCORDANCE WITH THE PROCESS OUTLINED BY THE IRS FOR SETTING REASONABLE COMPENSATION. THIS PLAN IS IN ACCORDANCE WITH SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS AS PER IRS SECTION 409(A). THE FOLLOWING AMOUNT WAS PAID FROM A RELATED ORGANIZATION IN 2019: EMPLOYEE AMOUNT DR. GEORGE A. LEVICKI $141,199 RELATED ORG. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO THE ARTICLES OF INCORPORATION, THE FOUNDATION'S BOARD OF DIRECTORS ARE APPOINTED BY THE BOARD OF THE SUPPORTED ORGANIZATION, DELTA DENTAL OF VIRGINIA. |
| FORM 990, PART VI, SECTION B, LINE 11B | MEMBERS OF THE BOARD OF DIRECTORS WILL REVIEW THE DOCUMENT AND THE REVIEW WILL BE DOCUMENTED AT THE SUBSEQUENT BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DELTA DENTAL OF VIRGINIA FOUNDATION REQUIRES CORPORATE OFFICERS AND EACH DIRECTOR ON THE BOARD OF DIRECTORS TO COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT THAT IS BASED ON IRS GUIDANCE. IN ADDITION, THE CONFLICT OF INTEREST POLICY REQUIRES DISCLOSURE OF ALL CONFLICTS, POTENTIAL CONFLICTS, OR ANY MATTER THAT MAY GIVE RISE TO THE APPEARANCE OF A CONFLICT. THE FORMS ARE REVIEWED BY THE COMPLIANCE OFFICER AND REPORTED TO THE CEO AND THE APPROPRIATE COMMITTEE(S) OF THE BOARD. THE FORMS ARE FURTHER AVAILABLE TO, AND REVIEWED BY, OUR AUDITORS AND THE BOI. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE APPLICABLE FORMS ARE AVAILABLE FOR PUBLIC INSPECTION VIA REQUEST AND REGULATORY FILINGS. |
| FORM 990, PART XII, LINE 2C | THERE HAVE BEEN NO CHANGES TO DELTA DENTAL OF VIRGINIA FOUNDATION'S OVERSIGHT PROCESS OF THE AUDIT OR ITS SELECTION OF AN INDEPENDENT AUDITOR. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| DELTA DENTAL OF VIRGINIA | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | 540844477 | ADVANCE PUBLIC'S ORAL HEALTH BY PROVIDING QUALITY DENTAL BENEFITS. | VA | 501(C)(4) | CORVESTA INC | 0 |
| CORVESTA INC | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | 205945158 | HOLDING COMPANY | VA | 501(C)(4) | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| REVOLV INC | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | 271018474 | PROVIDES TPA SERVICES TO DENTAL INSURANCE COMPANIES | VA | N/A | C | 0 |
| STRYDEN INC | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | 352637734 | PROVIDES VISION CARE INSURANCE | VA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | 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 |