2012-09-10T15:20:37-05:00 2011-12-31 954895294 R SHANE CHANCE CPA PC PO BOX 341 AZTEC NM 874100341 990 2011-01-01 850397883 NIZHONI SMILES INC NIZH 5053685626 PO BOX 3449 SHIPROCK NM 87420 JAMES M TUTT 5053685626 2012-09-10 1 R SHANE CHANCE P00170250 5053344375 2012-09-10 2011 2016-02-24 21:20:13Z JAMES M TUTT PO BOX 3449 SHIPROCK NM 87420 2410502 0 X NIZHONISMILES.COM X 1992 NM TO PROVIDE DENTAL AND ORTHODONTIC SERVICES TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA 5 5 37 0 0 0 133327 0 2674393 2161087 1 -787 187698 243527 2995419 2403827 0 0 0 0 824819 745147 0 0 0 2095786 1856022 2920605 2601169 74814 -197342 6049060 5441400 4865043 4454725 1184017 986675 TO PROVIDE DENTAL AND ORTHODONTIC SERVICES TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA 0 0 2353186 0 2403827 ORTHODONTIC AND DENTAL SERVICES PROVIDED TO INDIVIDUALS LIVING ON THE NAVAJO RESERVATION IN NW NEW MEXICO AND NE ARIZONA 2353186 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 37 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 NM X NIZHONI SMILES INC 5053685626 US HWY 491 N SHIPROCK NM 87420 PEGGY SUE NEZ 1.00 X X 0 0 1250 THOMAS TODACHEENEY 1.00 X X 0 0 1250 HARRY SLOAN JR 1.00 X X 0 0 1000 CORINNE CLAUSCHEE 1.00 X X 0 0 1250 DR MICHAEL BECK 3.00 X 16375 0 750 JAMES TUTT 40.00 X 69992 0 0 86367 0 5500 0 0 0 0 DR SAM CARROLL DMD PO BOX 443 ST MICHAELS AZ 86511 DENTAL 200755 DR HELLEN BUSH MDS 3107 ASPEN DR FARMINGTON NM 87401 ORTHODONTICS 192750 CRAIG LAYTON DBA FOUR CORNERS DENTAL CON 6601 TENNYSON ST NE APT 11205 ALBUQUERQUE NM 87111 DENTAL 140270 3 REVENUE ORTHO-DENTAL S 621110 2046221 2046221 REVENUE-PRODUCTS &SERV 621110 114866 114866 2161087 243527 0 243527 243527 243527 5888 6675 -787 -787 -787 2403827 2403827 0 0 86367 16375 69992 586281 411447 174834 11095 4123 6972 9722 9620 102 51682 33777 17905 306 306 10775 10775 641033 678950 -37917 2189 2189 140876 140876 54664 54664 110792 110792 12511 3358 9153 166905 165713 1192 346632 346632 45368 45368 BAD DEBT EXPENSE 215220 215220 LABORATORY 46588 46588 CREDIT CARD SERVICE CHA 33087 33087 FURNITURE AND EQUIPMENT 18383 18383 10693 4942 5751 2601169 2353186 247984 0 12960 2248 455551 452543 53579 36884 5829 450 6283850 1932907 4691469 4350943 829672 598332 6049060 5441400 157952 216711 829672 598332 120667 3662685 3413779 30110 30300 184624 74936 4865043 4454725 X 1184017 986675 1184017 986675 6049060 5441400 -197342 0 X 1 0 0 X 0 X 133327 133327 3539559 3631581 3423465 2674393 2160683 15429681 3539559 3631581 3423465 2807720 2160683 15563008 0 0 0 15563008 1198 27 7 1 1233 1198 27 7 1 1233 175211 178831 184901 187698 243527 970168 3715968 3810439 3608373 2995419 2404210 16534409 0.94120 0.94770 0.00010 0.00030 X 146199 146199 4266598 572343 3694255 1871053 1360564 510489 4350943 L-T ORTHO CONTRACTS RECEIVABLE 598332 598332 ACCOUNTS PAYABLE TO RELATED PARTIES 48094 ROUNDING -2 TENANT SECURITY DEPOSIT 26844 74936 DR MICHAEL BECK TEMPORARY WORKING CAPITAL ADVANCE X 30000 30000 0 1 1 MR JAMES TUTT TEMPORARY WORKING CAPITAL ADANCE X 4000 4000 0 1 1 DR MICHAEL BECK INSTALLMENT PAYOUT CEO FEES ACCRUED IN PRIOR YEARS X 86667 86667 0 1 1 120667 FORM 990, PART VI, SECTION B, LINE 11 ORGANIZATION PRESENTS COPY OF FORM 990 TO ITS BOARD OF DIRECTORS FOR REVIEW, COMMENT AND APPROVAL AT REGUALAR BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURE STATEMENT FORMS ARE PREPARED BY OFFICERS, DIRECTORS AND KEY EMPLOYEES ON AN ANNUAL BASIS WHICH ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. COPIES OF THE FORMS ARE MAINTAINED IN THE ORGANIZATIONS RECORDS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF OFFICERS, DIRECTORS, MANAGEMENT AND KEY EMPLOYEES IS BASED ON THE RESULTS OF ANNUAL PERFORMANCE EVALUATIONS AND COMPARATIVE REGIONAL COMPENSATION WHICH IS APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE MINUTES OF MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAINTAINS ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AT ITS CORPORATE OFFICES IN SHIPROCK, NEW MEXICO. ALL SUCH DOCUMENTS ARE AVAILABLE FOR PUBLIC REVIEW AT THAT LOCATION.