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AMERICAN DENTAL ASSOCIATION

Company Details

Entity Name: AMERICAN DENTAL ASSOCIATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 19 Jun 1922
Company Number: CORP_16587486
File Number: 16587486
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FLL6M6KYSPH6 2025-02-06 211 E CHICAGO AVE FL 19, CHICAGO, IL, 60611, 2637, USA 211 E CHICAGO AVE, CHICAGO, IL, 60611, 2637, USA

Business Information

URL http://www.ada.org
Division Name AMERICAN DENTAL ASSOCIATION
Congressional District 05
State/Country of Incorporation IL, USA
Activation Date 2024-02-09
Initial Registration Date 2001-02-15
Entity Start Date 1922-01-01
Fiscal Year End Close Date Dec 31

Service Classifications

NAICS Codes 813910
Product and Service Codes 6520

Points of Contacts

Electronic Business
Title PRIMARY POC
Name DIANE BUSHEMI
Address 211 E CHICAGO AVE, CHICAGO, IL, 60611, USA
Title ALTERNATE POC
Name CHRISTINE MACKEY
Address 211 E CHICAGO AVE, CHICAGO, IL, 60611, USA
Government Business
Title PRIMARY POC
Name ROBERT ZINN
Address 211 E CHICAGO AVE, CHICAGO, IL, 60611, USA
Title ALTERNATE POC
Name JOSIELEN CALLOWAY
Address 211 E CHICAGO AVE, CHICAGO, IL, 60611, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HMO ILLINOIS 2009 360724690 2010-10-13 AMERICAN DENTAL ASSOCIATION 113
File View Page
Three-digit plan number (PN) 509
Effective date of plan 1986-01-01
Business code 813000
Sponsor’s telephone number 3124402538
Plan sponsor’s mailing address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Plan sponsor’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611

Plan administrator’s name and address

Administrator’s EIN 360724690
Plan administrator’s name AMERICAN DENTAL ASSOCIATION
Plan administrator’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Administrator’s telephone number 3124402538

Number of participants as of the end of the plan year

Active participants 119
Retired or separated participants receiving benefits 15
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
KAISER PERMANENTE HMO 2009 360724690 2010-10-13 AMERICAN DENTAL ASSOCIATION 25
File View Page
Three-digit plan number (PN) 507
Effective date of plan 1982-01-01
Business code 813000
Sponsor’s telephone number 3124402538
Plan sponsor’s mailing address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Plan sponsor’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611

Plan administrator’s name and address

Administrator’s EIN 360724690
Plan administrator’s name AMERICAN DENTAL ASSOCIATION
Plan administrator’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Administrator’s telephone number 3124402538

Number of participants as of the end of the plan year

Active participants 19
Retired or separated participants receiving benefits 9
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
COMPREHENSIVE MAJOR MEDICAL PLAN 2009 360724690 2010-10-12 AMERICAN DENTAL ASSOCIATION 304
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1983-03-15
Business code 813000
Sponsor’s telephone number 3124402538
Plan sponsor’s mailing address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Plan sponsor’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611

Plan administrator’s name and address

Administrator’s EIN 360724690
Plan administrator’s name AMERICAN DENTAL ASSOCIATION
Plan administrator’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Administrator’s telephone number 3124402538

Number of participants as of the end of the plan year

Active participants 231
Retired or separated participants receiving benefits 85
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
CAREFIRST HMO 2009 360724690 2010-10-13 AMERICAN DENTAL ASSOCIATION 16
File View Page
Three-digit plan number (PN) 506
Effective date of plan 1987-01-01
Business code 813000
Sponsor’s telephone number 3124402538
Plan sponsor’s mailing address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Plan sponsor’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611

Plan administrator’s name and address

Administrator’s EIN 360724690
Plan administrator’s name AMERICAN DENTAL ASSOCIATION
Plan administrator’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Administrator’s telephone number 3124402538

Number of participants as of the end of the plan year

Active participants 21
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
TRAVEL-ACCIDENT INSURANCE (AD&D INSURANCE) 2009 360724690 2010-10-12 AMERICAN DENTAL ASSOCIATION 473
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1986-01-01
Business code 813000
Sponsor’s telephone number 3124402538
Plan sponsor’s mailing address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Plan sponsor’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611

Plan administrator’s name and address

Administrator’s EIN 360724690
Plan administrator’s name AMERICAN DENTAL ASSOCIATION
Plan administrator’s address 211 EAST CHICAGO AVENUE, CHICAGO, IL, 60611
Administrator’s telephone number 3124402538

Number of participants as of the end of the plan year

Active participants 472
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing PAMELA DISSELHORST
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
C T CORPORATION SYSTEM, 208 SO LASALLE ST, SUITE 814, CHICAGO, 60604, COOK-NOT IN CITY OF CHICAGO Agent 2011-08-02

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PURCHASE ORDER AWARD 75R60224P00026 2024-09-21 2025-09-20 2025-09-20
Unique Award Key CONT_AWD_75R60224P00026_7526_-NONE-_-NONE-
Awarding Agency Department of Health and Human Services
Link View Page

Award Amounts

Obligated Amount 57750.00
Current Award Amount 57750.00
Potential Award Amount 57750.00

Description

Title BHW93 C 5341 DATA PURCHASE-ADA DENTIST FILE
NAICS Code 813910: BUSINESS ASSOCIATIONS
Product and Service Codes U005: EDUCATION/TRAINING- TUITION/REGISTRATION/MEMBERSHIP FEES

Recipient Details

Recipient AMERICAN DENTAL ASSOCIATION
UEI FLL6M6KYSPH6
Recipient Address UNITED STATES, 211 E CHICAGO AVE FL 19, CHICAGO, COOK, ILLINOIS, 606112637
PURCHASE ORDER AWARD HT940824P0005 2024-05-22 2025-05-21 2025-05-21
Unique Award Key CONT_AWD_HT940824P0005_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Award Amounts

Obligated Amount 14700.00
Current Award Amount 14700.00
Potential Award Amount 14700.00

Description

Title AMERICAN DENTAL ASSOCIATION MEMBERSHIP FEE, 6 RESIDENCY PROGRAMS AND 1 FELLOWSHIP PROGRAM
NAICS Code 813920: PROFESSIONAL ORGANIZATIONS
Product and Service Codes U005: EDUCATION/TRAINING- TUITION/REGISTRATION/MEMBERSHIP FEES

Recipient Details

Recipient AMERICAN DENTAL ASSOCIATION
UEI FLL6M6KYSPH6
Recipient Address UNITED STATES, 211 E CHICAGO AVE FL 19, CHICAGO, COOK, ILLINOIS, 606112637
PURCHASE ORDER AWARD HHSD2002018M00126P 2018-04-01 2019-03-31 2019-03-31
Unique Award Key CONT_AWD_HHSD2002018M00126P_7523_-NONE-_-NONE-
Awarding Agency Department of Health and Human Services
Link View Page

Award Amounts

Obligated Amount 0.00
Current Award Amount 6200.00
Potential Award Amount 6200.00

Description

Title SERVICES
NAICS Code 813910: BUSINESS ASSOCIATIONS
Product and Service Codes B529: SPECIAL STUDIES/ANALYSIS- SCIENTIFIC DATA

Recipient Details

Recipient AMERICAN DENTAL ASSOCIATION
UEI FLL6M6KYSPH6
Recipient Address UNITED STATES, 211 E CHICAGO AVE, CHICAGO, COOK, ILLINOIS, 606112637

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State