FORM 1023-EZ for MINISTRY OF DENTISTRY INC

Field Data
EIN 84-1846450
Case Number EO-2020118-000139
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MINISTRY OF DENTISTRY INC
Organization’s Mailing Address 59 E LEXINGTON AVE
City PHOENIX
State AZ
ZIP 85012
Accounting period End 4
Primary contact name JESSICA PETERKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA PETERKIN
OFFICER
59 E LEXINGTON AVE
PHOENIX AZ 85012

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2019
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSICA PETERKIN
Signature Title OFFICER
Signature Date 4/22/2020

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