FORM 1023-EZ for SPECIAL CARE FOR SPECIAL NEEDS DENTISTRY

Field Data
EIN 82-1464302
Case Number EO-2017137-000389
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SPECIAL CARE FOR SPECIAL NEEDS DENTISTRY
Organization’s Mailing Address 4645 NANNIE HELEN BURROUGHS AVE NE
City WASHINGTON
State DC
ZIP 20019
Accounting period End 12
Primary contact name NEKIA STALEY- NEITHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NEKIA STALEY-NEITHER
PRESIDENT
PO BOX 6078
CAPITAL HEIGHTS MD 20791

Officer/Director/Trustee Two

TONIE LEWIS
TREASURER
7100 QUISINBERRY WAY
BOWIE MD 20720

Officer/Director/Trustee Three

DEVON BANKS
SECRETARY
10439 BEACON RIDGE DRIVE
BOWIE MD 20721

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/14/2015
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E20 - Hospitals and Related Primary Medical Care Facilities
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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