2023-11-15T18:55:03-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 1111 MICHIGAN AVE STE 100 EAST LANSING MI 48823 990 2022-01-01 383421257 MICHIGAN DENTAL ASSOCIATION FOUNDATION MICH 5173729070 3657 OKEMOS RD 200 OKEMOS MI 48864 DANIEL PETERS DDS PRESIDENT 5173729070 2023-11-15 1 DANIEL PETERS DDS 999009999 1 TINA PETERS P00904574 5173326200 2023-11-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DANIEL PETERS DDS 3657 OKEMOS RD 200 OKEMOS MI 48864 832991 0 X HTTPS://WWW.MICHIGANDENTAL.ORG/FOUNDATION X 1998 MI THE MICHIGAN DENTAL ASSOCIATION FOUNDATION WAS FORMED TO RECEIVE AND ADMINISTER FUNDS FOR EDUCATION IN DENTISTRY AND FOR RESEARCH FELLOWSHIPS AND SCHOLARSHIPS TO OUTSTANDING STUDENTS INTENDING TO PURSUE EDUCATIONAL TRAINING FOR A CAREER IN DENTISTRY OR RELATED FIELDS. THE FOUNDATION IS ALSO PROVIDING FINANCIAL AID TO DENTISTS WHO PRACTICE OR HAVE PRACTICED IN THE STATE OF MICHIGAN AND THEIR DEPENDENTS, WHO, BECAUSE OF MISFORTUNE, AGE, PHYSICAL, OR OTHER DISABLING CONDITIONS, ARE NOT WHOLLY SELF-SUSTAINING. 13 13 0 65 0 0 276496 243165 0 0 203783 64269 0 -17807 480279 289627 93350 109275 0 0 0 0 0 0 30062 284967 234338 378317 343613 101962 -53986 1718386 1388512 37183 41454 1681203 1347058 THE MISSION OF THE MICHIGAN DENTAL ASSOCIATION FOUNDATION IS TO SUPPORT MICHIGAN RESIDENTS' QUALITY OF LIFE THROUGH IMPROVED DENTAL HEALTH. 0 0 92775 92775 PROVIDED 10 ACCESS TO CARE GRANTS TO ORGANIZATIONS THAT HELP PROVIDE DENTAL SERVICES TO THE UNDERSERVED POPULATIONS OF THE STATE OF MICHIGAN. 16500 16500 PROVIDED ASSISTANCE TO 16 STUDENTS FOR DENTAL SCHOOL THROUGH SCHOLARSHIPS 1717 PROVIDED DENTAL SERVICES/ASSISTANCE TO PATIENTS THROUGH THE MISSION OF MERCY EVENT. 110992 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 MI X DONALD WINN 5173469407 3657 OKEMOS ROAD STE 200 OKEMOS MI 48864 DANIEL PETERS DDS PRESIDENT 1.00 0.00 X X 0 0 0 BETH ROSENBURG DDS VICE PRESIDENT 1.00 0.00 X X 0 0 0 TED SCHUMANN II SECRETARY/ TREASURER 1.00 0.00 X X 0 0 0 REEM AL-ABBOUSI DDS DIRECTOR 1.00 0.00 X 0 0 0 CAMERON ELROD DIRECTOR 1.00 0.00 X 0 0 0 ANANTPREET GREWAL DMD DIRECTOR 1.00 0.00 X 0 0 0 NANCY HARMON RDH DIRECTOR 1.00 0.00 X 0 0 0 ELIZABETH KNUDSEN DDS DIRECTOR 1.00 0.00 X 0 0 0 DIANA H ELLIS DDS DIRECTOR 1.00 0.00 X 0 0 0 SHANELLE PEARSE DDS DIRECTOR 1.00 0.00 X 0 0 0 JOHN STANASZEK DIRECTOR 1.00 0.00 X 0 0 0 NICHOLAS VANDERVEEN DIRECTOR 1.00 0.00 X 0 0 0 SUE CARRON DDS MS DIRECTOR 1.00 0.00 X 0 0 0 KAREN BURGESS MDA EXECUTIVE DIRECTOR 1.00 40.00 X 0 309205 38733 ANNE BERQUIST FOUNDATION EXECUTIVE DIRECTOR 40.00 0.00 X 0 44581 6717 DONALD WINN CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 117256 24122 0 471042 69572 0 0 1 0 0 65207 5000 172958 243165 26860 26860 562966 525557 37409 37409 37409 0 65207 17807 -17807 -17807 289627 0 0 46462 92775 92775 16500 16500 106791 106791 8716 8716 30062 30062 20 20 9875 9875 5521 5521 396 396 RETURN OF FUNDS 57092 57092 MISCELLANEOUS 14148 14148 MISSION OF MERCY EXPENS 1717 1717 343613 110992 202559 30062 83807 81727 28522 25235 55043 55142 1551014 1226408 1718386 1388512 37183 41454 37183 41454 X 1389063 1126756 292140 220302 1681203 1347058 1718386 1388512 -53986 -280159 0 X X 0 1 X 1 0 X X 1 MICHIGAN DENTAL ASSOCIATION 381300483 10 1 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 3B: THE FOUNDATION HAS ACCESS TO THE MICHIGAN DENTAL ASSOCIATION'S (MDA) DETERMINATION LETTER. THE MDA ANNUALLY COMPLETES SCHEDULE A, PART III TO CONFIRM IT WOULD MEET THE SECTION 509(A)(2) PUBLIC SUPPORT TEST. PART IV, SECTION A, LINE 3C: THE FOUNDATION DOES NOT PROVIDE MONETARY SUPPORT TO THE MDA. INSTEAD IT RUNS PROGRAMS WHICH SUPPORT THE MEMBERS OF THE MDA. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14 8 37623 2660 80416 12693 195302 434166 1 1 544377 2660 -72320 12693 2858 459166 482205 12574 59515 6830 3087 544377 450619 3500 38807 8500 2221 482205 384518 4000 72014 7000 2913 450619 406754 4200 -15495 8000 2941 384518 0.94555 0.05445 0.00000 0 0 0 PART V, LINE 4: THE PURPOSE OF OUR ENDOWMENTS IS TO SUPPORT THE MISSION OF THE MDA FOUNDATION. ONE FUND SUPPORTS FOCUS AREAS IDENTIFIED BY THE BOARD FOR THE GIVEN YEAR. ONE FUND SUPPORTS ACCESS TO DENTAL CARE INITIATIVES IN MICHIGAN. THE REMAINING SIX FUNDS SUPPORT SCHOLARSHIPS FOR STUDENTS ATTENDING DENTAL, HYGIENE, AND ASSISTING SCHOOLS. SPARKLING SMILES 65207 65207 2500 14952 355 65207 65207 2500 14952 355 17807 -17807 1 HOPE MEDICAL CLINIC 518 HARRIET STREET YPSILANTI MI 48198 382469007 501(C)3 10000 0 N/A N/A TO FUND INTEGRATATION OF PRIMARY AND ORAL HEALTH CARE SYSTEMS TO ENSURE HIGHER QUALITY CARE AND TREATMENT FOR PATIENTS. TRINITY COMMUNITY CARE 47511 VANDYKE AVE SHELBY TWP MI 48317 453723129 501(C)3 10000 0 N/A N/A TO PROVIDE FREE DENTAL AND MEDICAL CARE FOR THOSE WITHOUT INSURANCE. GARY BURNSTEIN CLINIC PONTIAC 7042 DAVENTRY WOODS DR WEST BLOOMFIELD MI 48322 320015321 501(C)3 15000 0 N/A N/A TO PROVIDE DENTAL EDUCATION AND CARE TO SE MICHIGAN UNINSURED. GARY BURNSTEIN CLINIC IS THE ONLY FREE DENTAL CLINIC IN THE NORTH OAKLAND COUNTY AREA. A PATIENT IS NEVER TURNED AWAY FOR SERVICES. THIS GRANT WILL HELP ADD A DENTAL MANAGER TO THE OFFICE TO HELP ORGANIZE, SCHEDULE AND DECREASE PATIENT WAIT TIMES. VICTORS FOR VETERANS 3003 S STATE STREET ANN ARBOR MI 48109 261471172 501(C)3 15000 0 N/A N/A TO PROVIDE FREE DENTAL CARE FOR THOSE WITHOUT INSURANCE. 4 0 SCHOLARSHIPS 16 16500 N/A N/A PART I, LINE 2: SCHOLARSHIP GRANTS, RELIEF GRANTS AND ACCESS TO CARE GRANTS ALL HAVE FORMAL APPLICATION PROCESSES THAT ARE FOLLOWED PRIOR TO THE AWARDING OF THE GRANTS. ALL APPLICATIONS ARE REVIEWED BY COMMITTEE MEMBERS. FORMAL VOTING TAKES PLACE PRIOR TO THE AWARDING OF THE GRANTS. 0 0 0 0 0 0 0 0 0 KAREN BURGESS MDA EXECUTIVE DIRECTOR 0 288019 0 12664 0 8522 0 19134 0 19599 0 347938 0 0 PART I, LINE 3 THE SALARY OF THE EXECUTIVE DIRECTOR IS DETERMINED BY A RELATED ENTITY, MICHIGAN DENTAL ASSOCIATION, USING THE FOLLOWING METHODS: - COMPENSATION COMMITTEE - COMPENSATION SURVEY OR STUDY - INDEPENDENT COMPENSATION CONSULTANT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 RETURN IS PROVIDED TO THE GOVERNING BODY BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY EACH BOARD MEMBER MUST SIGN THE CONFLICT OF INTEREST FORM. MONITORING IS DONE BY THE BOARD PRESIDENT AT EACH MEETING FORM 990, PART VI, SECTION B, LINE 15A THE MICHIGAN DENTAL ASSOCIATION'S 2022 PAY-FOR-PERFORMANCE COMPENSATION PROGRAM, ADMINISTERED BY AN INDEPENDENT COMPENSATION CONSULTANT, WAS UTILIZED TO SET THE SALARY LEVEL FOR THE EXECUTIVE DIRECTOR, DEVELOPMENT DIRECTOR AND DIRECTOR OF FINANCE FOR 2022. THE MICHIGAN DENTAL ASSOCIATION FOUNDATION BOARD OF DIRECTORS PROVIDED THE FINAL APPROVAL FOR THE DEVELOPMENT DIRECTOR'S 2022 SALARY FIGURE. THE EXECUTIVE DIRECTOR ADVISORY COMMITTEE, WHICH IS COMPRISED OF MDA BOARD OF TRUSTEE MEMBERS, PROVIDES OVERSIGHT OF THE EXECUTIVE DIRECTOR'S COMPENSATION. THE EXECUTIVE DIRECTOR PROVIDED THE FINAL APPROVAL FOR THE FINANCE DIRECTOR'S 2022 SALARY FIGURE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. MICHIGAN DENTAL ASSOCIATION 3657 OKEMOS ROAD OKEMOS MI 48864 381300483 MEMBER ASSOCIATION FOR MICHIGAN DENTISTS MI 501(C)(6) N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 MICHIGAN DENTAL ASSOCIATION O 84291 TIME BUDGET MICHIGAN DENTAL ASSOCIATION S 82456 CONTRIBUTIONS COLLECTED