2024-11-08T12:38:48-06:00 2023-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990PF 2023-01-01 860842694 DELTA DENTAL PLAN OF ARIZONA CHARITABLE FOUNDATION AND TRUST DELT 6029383131 14850 NORTH SCOTTSDALE RD SUITE 40 SCOTTSDALE AZ 85254 MARK ANDERSON CFO 6029383131 2024-10-31 1 1 DAVID LOWENTHAL P00378651 3122071040 2024-10-31 2023 2024-10-15 13:58:12Z X X 2352825 X 954458 4491 4491 72839 72839 74392 2099461 74392 1106180 151722 0 0 0 0 0 3000 1500 0 1500 600 300 0 300 1629 0 0 0 4712 0 0 707 234088 3070 0 206196 244029 4870 0 208703 1794964 1794964 2038993 4870 0 2003667 -932813 146852 0 102662 114345 114345 116090 101646 101646 16279 5000 8822 8822 1903311 1348818 1348818 948339 745383 745383 42262 32819 32819 1025 992 992 3134968 2352825 2352825 32845 14514 184 201 33029 14715 X 3101939 2338110 3101939 2338110 3134968 2352825 3101939 -932813 168984 2338110 0 2338110 NORTHERN TRUST - 9601 P 2023-12-31 2099461 2025069 74392 74392 74392 2041 0 2041 0 2041 2661 0 2000 0 4661 0 2620 2620 0 0 0 0 0 0 0 0 0 0 0 1 1 AZ 1 0 0 0 0 1 WWW.DELTADENTALAZ.COM/FOUNDATION MARK ANDERSON 6029383131 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MICHAEL JONES 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 CHAIRMAN 2.00 0 0 0 MELANIE S HULL DDS MAGD 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 SECRETARY/TREASURER 1.00 0 0 0 SHAHARYAR ASHRAF DDS 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 DIRECTOR 1.00 0 0 0 LAILA HISHAW DDS 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 DIRECTOR 1.00 0 0 0 JULIA WACLOFF 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 DIRECTOR 1.00 0 0 0 MONICA VILLALOBOS 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 DIRECTOR 1.00 0 0 0 JESSICA YANOW MPH 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 DIRECTOR 1.00 0 0 0 NONE 0 NONE 0 PROMOTING ORAL HEALTH BY DISTRIBUTING TOOTHBRUSHES, FLOSS, TOOTHPASTE AND EDUCATIONAL MATERIALS. IMPROVES ORAL HEALTH IN THE STATE OF ARIZONA BY GIVING GRANTS, EQUIPMENT AND SUPPLIES FOR NONPROFIT DENTAL CLINICS, SCHOOLS AND ORGANIZATIONS TO HELP UNDER-SERVED POPULATIONS ACCESS DENTAL CARE. ADDITIONALLY, IMPROVING ACCESS TO FOOD FOR UNDERSERVED POPULATIONS ACROSS THE STATE BY FUNDING FOOD BANKS, FOOD PANTRIES, FOOD DISTRIBUTION PROGRAMS AND NUTRITIONAL EDUCATIONAL PROGRAMS. 192536 0 2394016 199765 0 2593781 0 0 2593781 38907 2554874 127744 127744 2041 2041 125703 0 125703 0 125703 2003667 0 2003667 125703 0 0 930845 767593 1543460 1200917 1212203 5655018 2003667 0 0 0 125703 1877964 0 0 7532982 0 0 0 0 0 0 930845 6602137 767593 1543460 1200917 1212203 1877964 BARB KOZUH 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 6025883935 DELTAFOUNDATION@DELTADENTALAZ.COM GUIDELINES ARE PROVIDED ON THE WEBSITE AT DELTADENTALAZ.COM/FOUNDATION AND THE APPLICATION QUESTIONS SHOULD BE ANSWERED IN A WORD DOCUMENT AND ACCOMPANIED BY A 501C3 LETTER OF DETERMINATION, CURRENT ORGANIZATIONAL BUDGET, LIST OF BOARD OF DIRECTORS, CURRENT 990, AND PROJECT BUDGET. SECOND THURSDAY OF OCTOBER NO LATER THAN 5 PM ARIZONA TIME. APPLICANTS MUST BE DOMICILED IN ARIZONA AND SERVE UNDER-SERVED POPULATIONS WITH PROGRAMS/PROJECTS TO IMPROVE ORAL HEALTH WITH DENTAL SERVICES, EDUCATION, SCREENINGS, EXAMS, SEALANTS AND FLUORIDE TREATMENTS. A NEW LEAF 868 E UNIVERSITY MESA AZ 85203 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 AT STILL UNIVERSITY SEALANT PROGRAM 5850 E STILL CIR MESA AZ 85206 MESA AZ 85206 NONE PUBLIC CHARITY COMMUNITY GRANT 13200 ADELANTE HEALTHCARE 500 W THOMAS RD SUITE 870 PHOENIX AZ 85013 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 ARIZONA DENTAL FOUNDATION 3193 N DRINKWATER BLVD SCOTTSDALE AZ 85251 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 ARIZONA PBS 555 N CENTRAL AVE PHOENIX AZ 85004 NONE PUBLIC CHARITY COMMUNITY GRANT 100000 ATSU CEO CLINIC 5850 E STILL CIRCLE MESA AZ 85206 NONE PUBLIC CHARITY COMMUNITY GRANT 30000 AZDA CARES FOUNDATION 3193 N DRINKWATER BLVD SCOTTSDALE AZ 85251 NONE PUBLIC CHARITY COMMUNITY GRANT 60000 BACK TO SCHOOL CLOTHING DRIVE 360 E CORONADO RD 200 PHOENIX AZ 85004 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 BANNER HEALTH FOUNDATION 302 E MCDOWELL RD PHOENIX AZ 85004 NONE PUBLIC CHARITY COMMUNITY GRANT 165000 CHILDREN'S MUSEUM OF PHOENIX 215 N 7TH STREET PHOENIX AZ 85034 NONE PUBLIC CHARITY COMMUNITY GRANT 33875 CHIRICAHUA CHC 1100 F AVE DOUGLAS AZ 85607 NONE PUBLIC CHARITY COMMUNITY GRANT 30000 CITY OF CHANDLER PUBLIC HOUSING 235 S ARIZONA AVE CHANDLER AZ 85225 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 COCONINO COUNTY COOPERATIVE EXTENSION 2304 N 3RD ST FLAGSTAFF AZ 860043605 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 COCONINO COUNTY HEALTH AND HUMAN SERVICES 2625 N KING ST FLAGSTAFF AZ 86004 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 COMMUNITY FOOD BANK OF SOUTHERN ARIZONA 3003 S COUNTRY CLUB RD TUCSON AZ 85713 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 DENTAL CONNECT PROGRAM 4131 N 24TH ST STE B102 PHOENIX AZ 85016 NONE PUBLIC CHARITY COMMUNITY GRANT 275000 DENTAL LIFELINE NETWORK 1800 15TH STREET SUITE 100 DENVER CO 80202 NONE PUBLIC CHARITY COMMUNITY GRANT 18000 DESERT SENITA DENTAL CENTER 410 N MALACATE STREET AJO AZ 85321 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 DIANA GREGORY OUTREACH SERVICES 1934 E CAMELBACK RD PHOENIX AZ 85016 NONE PUBLIC CHARITY COMMUNITY GRANT 7500 DIGNITY HEALTH FOUNDATION 1727 W FRYE ROAD 230 CHANDLER AZ 85224 NONE PUBLIC CHARITY COMMUNITY GRANT 25000 EL RIO HEALTH CENTER FOUNDATION 839 W CONGRESS TUCSON AZ 85745 NONE PUBLIC CHARITY COMMUNITY GRANT 50000 ESPERANCA 1911 W EARLL DRIVE PHOENIX AZ 85015 NONE PUBLIC CHARITY COMMUNITY GRANT 50000 FLAGSTAFF MEDICAL CENTER CHILDREN'S HEALTH CENTER 753 N MAIN ST STE A COTTONWOOD AZ 86326 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 GILA COUNTY HEALTH & EMERGENCY MANAGEMENT 5515 S APACHE AVE SUITE 400 GLOBE AZ 85501 NONE PUBLIC CHARITY COMMUNITY GRANT 30000 GREAT AZ PUPPET THEATER 302 W LATHAM ST PHOENIX AZ 85003 NONE PUBLIC CHARITY COMMUNITY GRANT 50000 KITCHEN ON THE STREET 2650 E MOHAWK LN STE 168 PHOENIX AZ 85050 NONE PUBLIC CHARITY COMMUNITY GRANT 5000 LIVE AND LEARN PROGRAM 326 E CORONADO RD PHOENIX AZ 85004 NONE PUBLIC CHARITY COMMUNITY GRANT 12000 MARANA COMMUNITY HEALTH CENTER 13395 N MARANA MAIN ST MARANA AZ 85653 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 MIDWESTERN UNIVERSITY 19555 N 59TH AVE GLENDALE AZ 85308 NONE PUBLIC CHARITY COMMUNITY GRANT 10000 NATIONAL KIDNEY FOUNDATION ARIZONA 360 E CORONADO RD SUITE 180 PHOENIX AZ 85004 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 NORTH COUNTRY HEALTH CARE PO BOX 3630 FLAGSTAFF AZ 86003 NONE PUBLIC CHARITY COMMUNITY GRANT 25000 PACIFIC DENTAL SERVICES FOUNDATION - SPECIAL NEEDS CLINIC 4550 E BELL RD BUILDING 1 STE 106 PHOENIX AZ 85032 NONE PUBLIC CHARITY COMMUNITY GRANT 50000 PHOENIX CHILDREN'S HOSPITAL 1919 E THOMAS ROAD PHOENIX AZ 85016 NONE PUBLIC CHARITY COMMUNITY GRANT 73389 PRESCOTT COMMUNITY CUPBOARD 777 W HILLSIDE AVE PRESCOTT AZ 86301 NONE PUBLIC CHARITY COMMUNITY GRANT 12000 SOUTHWEST HUMAN DEVELOPMENT 2850 N 24TH STREET PHOENIX AZ 85008 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 ST VINCENT DE PAUL PO BOX 13600 PHOENIX AZ 850023600 NONE PUBLIC CHARITY COMMUNITY GRANT 100000 SUN LIFE FAMILY HEALTH CENTER PO BOX 10097 CASA GRANDE AZ 85130 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 TOOTH BUDDS PO BOX 937 PIMA AZ 85543 NONE PUBLIC CHARITY COMMUNITY GRANT 50000 TUCSON CHILDREN'S MUSEUM 200 S 6TH AVE TUCSON AZ 85701 NONE PUBLIC CHARITY COMMUNITY GRANT 10000 UMOM NEW DAY CENTERS 3333 E VAN BUREN ST PHOENIX AZ 85008 NONE PUBLIC CHARITY COMMUNITY GRANT 20000 UNIVERSITY OF AZ - ORAL HEALTH CURRICULUM 1200 E UNIVERSITY BLVD TUCSON AZ 85721 NONE PUBLIC CHARITY COMMUNITY GRANT 200000 VALLEY OF THE SUN YMCA 1030 E LIBERTY LANE PHOENIX AZ 85048 NONE PUBLIC CHARITY COMMUNITY GRANT 25000 VERDE VALLEY MEDICAL CENTER 269 S CANDY LN COTTONWOOD AZ 86326 NONE PUBLIC CHARITY COMMUNITY GRANT 15000 1794964 0 14 4491 14 72839 18 74392 0 151722 0 151722 0 0 0 0 0 0 0 0 1 1c 343347 ARIZONA DENTAL INSURANCE SERVICE INC ARIZONA DENTAL INSURANCE SERVICE, INC. PROVIDES THE ORGANIZATION FREE USE OF FACILITIES, OFFICE EQUIPMENT AND STAFF. 1 ARIZONA DENTAL INSURANCE SERVICE INC 501(C)(4) UP TO 4 COMMON BOARD MEMBERS AND PRESIDENT/CEO X X 1 DELTA DENTAL OF ARIZONA 14850 NORTH SCOTTSDALE RD SUITE 400 SCOTTSDALE AZ 85254 913661 X ACCOUNTING 3000 1500 0 1500 NORTHERN TRUST - FIXED INCOME FUNDS 745383 745383 NORTHERN TRUST - EQUITIES 1348818 1348818 NORTHERN TRUST - REAL ESTATE FUNDS AT COST 32819 32819 INTEREST RECEIVABLE 1025 992 992 DUES AND SUBSCRIPTIONS 9657 0 0 1680 PROMOTION 905 0 0 905 POSTAGE 136 0 0 136 BANK CHARGES 4393 3070 0 1323 BOARD EXP AND OTHER ADMIN 3929 0 0 0 TRAINING AND SEMINARS 3350 0 0 0 SUPPLIES 2892 0 0 0 DENTAL SUPPLIES DONATION 191677 0 0 191677 ADMIN EXPENSES - ACCRUAL TO CASH 0 0 0 -5692 TELEPHONE 982 0 0 0 VENDOR COSTS 16167 0 0 16167 UNREALIZED GAIN 168984 DUE TO DDAZ - PAYABLE 184 201 OTHER PROFESSIONAL FEES 600 300 0 300 TAXES 1629 0 0 0