FORM 1023-EZ for THE AMERICAN INSTITUTE OF DENTAL PUBLIC HEALTH
| Field | Data |
|---|---|
| EIN | 84-2850098 |
| Case Number | EO-2019357-000184 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE AMERICAN INSTITUTE OF DENTAL PUBLIC HEALTH |
| Organization’s Mailing Address | 10650 CULEBRA RD 104 PMB109 |
| City | SAN ANTONIO |
| State | TX |
| ZIP | 78251-4949 |
| Accounting period End | 12 |
| Primary contact name | ANNALIESE COTHRON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DAVID CAPPELLI
CHAIR
9693 TREELINE RUN AVE
LAS VEGAS NV 89166-3801
Officer/Director/Trustee Two
RAUL GARCIA
TREASURER
983 MEMORIAL DR APT 302
CAMBRIDGE MA 02138-5742
Officer/Director/Trustee Three
CASWELL EVANS
SECRETARY
15107 ANITA LANE
LAKESIDE MI 49116-9720
Officer/Director/Trustee Four
STEVEN GEIERMANN
MEMBER AT LARGE
5218 N WINTHROP AVE 3N
CHICAGO IL 60640-6929
Officer/Director/Trustee Five
ANDREA HIGHT
MEMBER AT LARGE
31M ST APT 302
SALT LAKE CITY UT 84103-3844
| Organization’s website | WWW.AIDPH.ORG |
|---|---|
| Organization’s email | PROGRAMS@AIDPH.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/22/2019 |
| Organization Incorporation State | TX |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | A03 - Professional Societies, Associations |
| Organization’s purpose | Charitable: No Religious: No 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 | 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 | No |
| One Third Support Gifts | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | DAVID CAPPELLI |
| Signature Title | CHAIR |
| Signature Date | 12/19/2019 |
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