DELTA DENTAL OF VIRGINIA FOUNDATION INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- DELTA DENTAL OF VIRGINIA FOUNDATION INC (EIN 45-3230862)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-12
- IRS object ID
- 201943169349301884
- Schema version
- 2018v3.1
- 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 | 2019-11-12T09:34:37-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | 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 | 2018-01-01 | 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 | 2019-11-08 | 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 | 2019-11-08 | 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 | 2019-11-08 | IPDt |
| IP Tm | 15:33:18 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C6B7EFC27ADC1D591699B7D67A64703C90C79A72 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D0156BD46B4B1FE921C9503B1D7FFBF99E37DBAB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | 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 | $562,052 | 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 | $459,868 | PYContributionsGrantsAmt |
| CY Contributions Grants | $562,052 | 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 | $459,868 | PYTotalRevenueAmt |
| CY Total Revenue | $562,052 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $370,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $546,500 | 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 | $33,498 | PYOtherExpensesAmt |
| CY Other Expenses | $27,712 | CYOtherExpensesAmt |
| PY Total Expenses | $403,998 | PYTotalExpensesAmt |
| CY Total Expenses | $574,212 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $55,870 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$12,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $397,024 | TotalAssetsBOYAmt |
| Total Assets EOY | $520,838 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $135,974 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $397,024 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $384,864 | 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 | $546,500 | ExpenseAmt |
| Grant | $546,500 | 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 | $546,500 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 (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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| MR LYNDELL B BROOKS | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $32,092 | $0 | |
| DR BARRY WOLFE | ||||||||
| SECRETARY | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $36,256 | $0 | |
| DR HAROLD J BARRETT JR | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $24,915 | $0 | ||
| MR GORDON L GENTRY JR | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $27,256 | $0 | ||
| MR FRANK L LUCIA | ||||||||
| PRESIDENT & CEO | 1.00 | 41.00 | Yes (X) | Yes (X) | $0 | $956,368 | $31,106 | |
| DR GEORGE A LEVICKI | ||||||||
| FORMER PRESIDENT | 0.00 | 40.00 | $0 | $763,409 | $60,038 | Yes (X) | ||
| DR EMANUEL W MICHAELS | ||||||||
| FORMER DIRECTOR | 0.00 | 0.00 | $0 | $22,500 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,862,796 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $91,144 | 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 | $562,052 | RelatedOrganizationsAmt |
| Total Contributions | $562,052 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $562,052 | 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 | $546,500 | TotalAmt |
| Program Services | $546,500 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,742 | TotalAmt |
| Management And General | $1,742 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,619 | TotalAmt |
| Management And General | $19,619 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DENTAL CLAIMS | Desc |
| Total | $6,351 | TotalAmt |
| Management And General | $6,351 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $574,212 | TotalAmt |
| Program Services | $546,500 | ProgramServicesAmt |
| Management And General | $27,712 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,371 | BOYAmt |
| EOY | $520,489 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,653 | BOYAmt |
| EOY | $349 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,024 | BOYAmt |
| EOY | $520,838 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $974 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $135,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $135,974 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,024 | BOYAmt |
| EOY | $384,864 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,024 | BOYAmt |
| EOY | $384,864 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,024 | BOYAmt |
| EOY | $520,838 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$12,160 | 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 | $546,500 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $546,500 | 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 | $562,052 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $562,052 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $562,052 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $574,212 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $574,212 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $574,212 | 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, 2018 AND 2017. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (52 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| CHILD HEALTH INVESTMENT PARTNERSHIP OF ROANOKE VALLEY | ||||||||
| 1201 THIRD STREET SW | ROANOKE | VA | 24016 | 541566451 | 501(C)(3) | $5,000 | SUPPORT TO PROVIDE FLUORIDE VARNISH TREATMENTS AND CONDUCT DENTAL FAIRS | |
| BRADLEY FREE CLINIC | ||||||||
| 1240 THIRD STREET SW | ROANOKE | VA | 24016 | 237380491 | 501(C)(3) | $15,000 | SPONSOR VCU DENTAL STUDENTS PROVIDING SERVICES AT THE CLINIC | |
| OLIVET MEDICAL MINISTRY INC AKA LACKEY FREE CLINIC | ||||||||
| 1620 OLD WILLIAMSBURG ROAD | YORKTOWN | VA | 23690 | 541850915 | 501(C)(3) | $10,000 | EXPANSION OF DENTAL TREATMENT | |
| PIEDMONT REGIONAL DENTAL CLINIC INC | ||||||||
| 13296 JAMES MADISON HWY STE B | ORANGE | VA | 22960 | 270625764 | 501(C)(3) | $5,000 | SUPPORT SENIOR SMILE TIME PROGRAM FOR SENIORS | |
| BRADLEY FREE CLINIC | ||||||||
| 1240 THIRD STREET SW | ROANOKE | VA | 24016 | 237380491 | 501(C)(3) | $5,000 | SUPPLIES FOR ACCESS TO DENTAL DAYS EVENTS | |
| VIRGINIA HEALTH CARE FOUNDATION | ||||||||
| 707 EAST MAIN STREET STE 1350 | RICHMOND | VA | 23219 | 541639924 | 501(C)(3) | $45,000 | DENTAL OPPORTUNITIES CHAMPION (DOC) | |
| BOYS & GIRLS CLUBS OF THE VIRGINIA PENINSULA | ||||||||
| 11825 ROCK LANDING DRIVE | NEWPORT NEWS | VA | 23606 | 540538202 | 501(C)(3) | $5,000 | SUPPORT OF THE SMART SMILES AT THE DENTIST PROGRAM | |
| CROSSOVER HEALTHCARE MINISTRY | ||||||||
| 8600 QUIOCCASIN ROAD SUITE 102 | RICHMOND | VA | 23229 | 541371067 | 501(C)(3) | $5,000 | SALARY SUPPORT AND PUERCHASE ESSENTIAL DENTAL SUPPLIESSALARY SUPPORT AND PURCHASE ESSENTIAL DENTAL SUPPLIES | |
| NORTHERN NECK-MIDDLESEX FREE HEALTH CLINIC | ||||||||
| PO BOX 1694 | KILMARNOCK | VA | 22482 | 541679279 | 501(C)(3) | $7,500 | SUPPORT OF VCU DENTAL STUDENTS PROVIDING SERVICES AT THE CLINIC | |
| WILLIAMSBURG AREA MEDICAL ASSISTANCE DBA OLDE TOWNE MEDICAL & DENTAL CTR | ||||||||
| 5249 OLDE TOWNE ROAD | WILLIAMSBURG | VA | 23188 | 541663905 | 501(C)(3) | $5,000 | DENTAL SUPPLIES AND EQUIPMENT | |
| VIRGINIA ORAL HEALTH COALITION | ||||||||
| 4200 INNSLAKE DRIVE STE 103 | GLEN ALLEN | VA | 23060 | 274082359 | 501(C)(3) | $7,500 | EDUCATE MEDICAL & DENTAL PROVIDERS ABOUT THE SAFETY, EFFICACY & IMPORTANCE OF DENTAL CARE DURING PREGNANCY | |
| BOYS & GIRLS CLUBS OF SOUTHWEST VIRGINIA | ||||||||
| 1714 9TH STREET SE | ROANOKE | VA | 24013 | 541867366 | 501(C)(3) | $5,000 | SUPPORT OF THE SMART SMILES AT THE DENTIST PROGRAM | |
| CHARLOTTESVILLE FREE CLINIC | ||||||||
| 1138 ROSE HILL DRIVE SUITE 200 | CHARLOTTESVILLE | VA | 22903 | 541610405 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| CRAIG COUNTY RURAL HEALTH CARE CORPORATION | ||||||||
| 230 MARKET STREET-BASEMENT | NEW CASTLE | VA | 24127 | 562569389 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT | |
| DANVILLE PITTSYLVANIA COMMUNITY SERVICES | ||||||||
| 245 HAIRSTON STREET | DANVILLE | VA | 24540 | 540937279 | 501(C)(3) | $5,000 | PROVIDE DENTAL EXAMS FOR ADULTS WITH BEHAVIORAL DISORDERS | |
| LUCY CORR FOUNDATION INC | ||||||||
| 6800 LUCY CORR BOULEVARD | CHESTERFIELD | VA | 23832 | 542010957 | 501(C)(3) | $10,000 | EXPAND DENTAL CARE TO ELDERLY IN THE RICHMOND AREA | |
| NORTHERN VIRGINIA DENTAL CLINIC INC | ||||||||
| 8221 WILLOW OAKS CORPORATE DR NO | FAIRFAX | VA | 22031 | 541646071 | 501(C)(3) | $7,500 | DENTAL EQUIPMENT | 450 |
| PARK PLACE DENTAL CLINIC INC | ||||||||
| 606 W 29TH STREET | NORFOLK | VA | 23508 | 453086608 | 501(C)(3) | $5,000 | SUPPORT VCU DENTAL STUDENTS | |
| PIEDMONT VIRGINIA DENTAL HEALTH FOUNDATION | ||||||||
| 407 STARLING AVE | MARTINSVILLE | VA | 24112 | 201468244 | 501(C)(3) | $10,000 | DENTAL SERVICES | |
| HANOVER INTERFAITH FREE CLINICS | ||||||||
| 125 BEVERLY ROAD PO BOX 117 | ASHLAND | VA | 23005 | 412214314 | 501(C)(3) | $7,500 | DENTURES FOR LOW INCOME RESIDENTS | |
| VIRGINIA DENTAL ASSOCIATION FOUNDATION | ||||||||
| 3460 MAYLAND COURT SUITE 110 | HENRICO | VA | 23233 | 541821602 | 501(C)(3) | $15,000 | EXPAND ACCESS TO CARE | |
| WESTERN TIDEWATER FREE CLINIC | ||||||||
| 2019 MEADE PARKWAY | SUFFOLK | VA | 23434 | 263302837 | 501(C)(3) | $5,000 | DENTAL SUPPLIES | |
| ARLINGTON FREE CLINIC | ||||||||
| 2921 11TH STREET SOUTH | ARLINGTON | VA | 22204 | 541671883 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT | |
| CENTRAL VIRGINIA HEALTH SERVICES | ||||||||
| PO BOX 220 25892 N JAMES MADISON | NEW CANTON | VA | 23123 | 540887287 | 501(C)(3) | $7,500 | DENTAL EQUIPMENT | HWY |
| CHRISTIAN FREE CLINIC OF BOTETOURT | ||||||||
| 7330 ROANOKE ROAD | FINCASTLE | VA | 24090 | 204342697 | 501(C)(3) | $2,000 | DENTAL EQUIPMENT | |
| HEALING HANDS HEALTH CENTER INC | ||||||||
| 245 MIDWAY MEDICAL PARK | BRISTOL | TN | 37620 | 621677000 | 501(C)(3) | $10,000 | DENTAL SERVICES | |
| LEWIS-GALE FOUNDATION DBA HEALTH FOCUS OF SOUTHWEST VA | ||||||||
| 1902 BRAEBURN DRIVE | SALEM | VA | 24153 | 546051298 | 501(C)(3) | $5,000 | SUPPORT DELTA DENTAL SCHOLARSHIP ENDOWMENT | |
| PRINCE WILLIAM AREA FREE CLINIC | ||||||||
| 13900 CHURCH HILL DRIVE | WOODBRIDGE | VA | 22191 | 541619202 | 501(C)(3) | $7,500 | DENTAL SERVICES | |
| THE FENWICK FOUNDATION | ||||||||
| 23 N FENWICK STREET | ARLINGTON | VA | 22201 | 274879033 | 501(C)(3) | $5,000 | PROVIDE DENTAL SERVICES TO LOW-INCOME PATIENTS | |
| VIRGINIA TECH-CARILION SCHOOL OF MEDICINE | ||||||||
| TWO RIVERSIDE CIRCLE | ROANOKE | VA | 24016 | 264556177 | 501(C)(3) | $50,000 | 2ND YEAR OF PILOT PROGRAM (SMART SMILES AT THE DOCTOR) INTEGRATING ORAL HEALTH EXAMS & FLUORIDE VARNISHING FOR CHILDREN INTO FAMILY MEDICINE & PEDIATRIC PRACTICES | |
| VIRGINIA WESTERN COMMUNITY COLLEGE EDUCATIONAL FOUNDATION INC | ||||||||
| 3093 COLONIAL AVENUE | ROANOKE | VA | 24015 | 521200913 | 501(C)(3) | $10,000 | DENTAL HYGIENE PROGRAM AND THE SERVICES PROVIDED THROUGH THE FREE COMMUNITY CLINICS | |
| AUGUSTA REGIONAL FREE CLINIC | ||||||||
| 342 MULE ACADEMY ROAD | FISHERSVILLE | VA | 22939 | 541651896 | 501(C)(3) | $10,000 | SUPPORT FOR AND ADDITIONAL DENTIST AT CLINIC | |
| BLAND MINISTRY CENTER AND DENTAL CLINIC | ||||||||
| 65 SEDDON STREET | BLAND | VA | 24315 | 541556134 | 501(C)(3) | $5,000 | DENTAL TREATMENT | |
| CHESAPEAKE CARE INC | ||||||||
| 2145 S MILITARY HIGHWAY | CHESAPEAKE | VA | 23320 | 541642754 | 501(C)(3) | $5,000 | SUPPORT PART-TIME HYGIENIST | |
| DENTAL CLINIC OF NORTHERN SHENANDOAH VALLEY INC | ||||||||
| 301 NORTH CAMERON STREET SUITE 200 | WINCHESTER | VA | 22601 | 540573607 | 501(C)(3) | $5,000 | EXPANSION OF DENTAL SERVICES | |
| HAMPTON ECUMENICAL LODGING & PROVISIONS (AKA DR RICHARD CLARK HELP CLINIC) | ||||||||
| 1320 LASALLE AVENUE | HAMPTON | VA | 23669 | 541209213 | 501(C)(3) | $5,000 | EXPANSION OF DENTAL SERVICES | |
| FREE CLINIC OF CENTRAL VIRGINIA | ||||||||
| 1016 MAIN STREET | LYNCHBURG | VA | 24504 | 541420756 | 501(C)(3) | $10,000 | EXPANSION OF DENTAL SERVICES | |
| FREE CLINIC OF CULPEPER DBA CULPEPER WELLNESS FOUNDATION | ||||||||
| 311 S EAST STREET SUITE 100 | CULPEPER | VA | 22701 | 521366700 | 501(C)(3) | $3,000 | DENTAL SERVICES | |
| FREE CLINIC OF THE NEW RIVER VALLEYINC -DBA COMMUNITY HEALTH CENTER OF NRV | ||||||||
| 215 ROANOKE STREET | CHRISTIANSBURG | VA | 24073 | 510247098 | 501(C)(3) | $10,000 | DENTAL EQUIPMENT | |
| GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER | ||||||||
| 4379 RIDGEWOOD CENTER DRIVE STE 102 | WOODBRIDGE | VA | 22192 | 830435138 | 501(C)(3) | $7,500 | DENTAL EQUIPMENT | |
| MADISON FREE CLINIC | ||||||||
| 410 NORTH MAIN STEET | MADISON | VA | 22727 | 311654015 | 501(C)(3) | $5,000 | DENTAL SERVICES | |
| NORTHERN VIRGINIA COMMUNITY COLLEGE EDUCATIONAL FOUNDATION | ||||||||
| 4001 WAKEFIELD CHAPEL ROAD | ANNANDALE | VA | 22003 | 510249730 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT | |
| OLD DOMINION UNIVERSITY EDUCATIONAL FOUNDATION | ||||||||
| 4417 MONARCH WAY 4TH FLOOR | NORFOLK | VA | 23529 | 546052014 | 501(C)(3) | $4,000 | DENTAL EQUIPMENT FOR ODU SCHOOL OF HYGIENE | |
| PIEDMONT ACCESS TO HEALTH SERVICES INC(PATHS) | ||||||||
| 705 MAIN STREET | DANVILLE | VA | 24541 | 542026502 | 501(C)(3) | $5,000 | DENTAL EQUIPMENT | |
| PORTSMOUTH COMMUNITY HEALTH CENTER-DBA HAMPTON ROADS COMMUNITY HEALTH CTR | ||||||||
| 664 LINCOLN STREET | PORTSMOUTH | VA | 23704 | 541626757 | 501(C)(3) | $10,000 | DENTAL SERVICES | |
| RESCUE MISSION OF ROANOKE INC | ||||||||
| 402 4TH STREET SE | ROANOKE | VA | 24014 | 540573900 | 501(C)(3) | $10,000 | DENTAL EQUIPMENT | |
| SPECIAL OLYMPICS VIRGINIA INC | ||||||||
| 3212 SKIPWITH ROAD SUITE 100 | RICHMOND | VA | 23294 | 541013637 | 501(C)(3) | $5,000 | SUPPORT SPECIAL SMILES CLINIC | |
| VALLEY AREA COMMUNITY SUPPORT INC | ||||||||
| 418 DUPONT AVENUE PO BOX 1907 | STAUNTON | VA | 24401 | 270132429 | 501(C)(3) | $5,000 | SUPPORT ACCESS TO CARE FOR LOW-INCOME ADULTS | |
| 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 - ACCRUED AT 12/31/18 & PAID ON 5/29/19 | |
| VIRGINIA ORAL HEALTH COALITION INC | ||||||||
| 4200 INNSLAKE DRIVE STE 103 | GLEN ALLEN | VA | 23060 | 274082359 | 501(C)(3) | $25,000 | FALLON PARK PROJECT FOR HEALTH & WELLNESS CLINIC - ACCRUED AT 12/31/18 & PAID ON 1/31/19 | |
| FREEDOM FIRST ENTERPRISE - LIFT | ||||||||
| 5240 VALLEYPARK DRIVE | ROANOKE | VA | 24019 | 813904720 | 501(C)(3) | $100,000 | FALLON PARK PROJECT FOR HEALTH & WELLNESS CLINIC - ACCRUED AT 12/31/18 & PAID ON 8/15/19 | |
| FREDERICKSBURG AREA REGNAL HEALTH COUNCIL INC DBA LLOYD F MOSS FREE CLINIC | ||||||||
| 1301 SAM PERRY BOULEVARD STE 100 | FREDERICKSBURG | VA | 22401 | 541677834 | 501(C)(3) | $5,000 | EXPANSION OF DENTAL SERVICES | |
| 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MR FRANK L LUCIA | ||||||||||||||
| PRESIDENT & CEO | $0 | $612,471 | $0 | $282,510 | $0 | $61,387 | $0 | $5,500 | $0 | $25,606 | $0 | $987,474 | $0 | $0 |
| DR GEORGE A LEVICKI | ||||||||||||||
| FORMER PRESIDENT | $0 | $201,693 | $0 | $446,095 | $0 | $115,621 | $0 | $55,000 | $0 | $5,038 | $0 | $823,447 | $0 | $0 |
| DR EMANUEL W MICHAELS | ||||||||||||||
| FORMER DIRECTOR | $0 | $22,500 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $22,500 | $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 2018 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 NONQUALIFIED DEFERRED COMPENSATION PLANS AS PER IRS SECTION 457(F). THE FOLLOWING AMOUNT WAS PAID FROM A RELATED ORGANIZATION IN 2018: EMPLOYEE AMOUNT DR. GEORGE A. LEVICKI $111,915 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 (3 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 |
| CORVESTA LIFE INSURANCE COMPANY INC | |||||||||
| 4818 STARKEY ROAD | ROANOKE | VA | 24018 | 860201136 | PROVIDES LIFE INSURANCE POLICIES | AZ | 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 |