-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, QxEu1UgenTuVdyrCG71G8YIxMoAiF8MVVYiXQSlh1OskHlB4FrM+N19i9lYeCy8D T5dZ2uop1/NPKV0bCVi/kQ== 0001181431-05-059131.txt : 20051102 0001181431-05-059131.hdr.sgml : 20051102 20051102160700 ACCESSION NUMBER: 0001181431-05-059131 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051101 FILED AS OF DATE: 20051102 DATE AS OF CHANGE: 20051102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN DENTAL PARTNERS INC CENTRAL INDEX KEY: 0001028087 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 043297858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 201 EDGEWATER DRIVE STREET 2: SUITE 285 CITY: WAKEFIELD STATE: MA ZIP: 01880-1249 BUSINESS PHONE: 781-224-0880 MAIL ADDRESS: STREET 1: 201 EDGEWATER DRIVE STREET 2: SUITE 285 CITY: WAKEFIELD STATE: MA ZIP: 01880 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: REEVES DERRIL W CENTRAL INDEX KEY: 0001234994 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23363 FILM NUMBER: 051173349 BUSINESS ADDRESS: STREET 1: 201 EDGEWATER DRIVE CITY: WAKEFIELD STATE: MA ZIP: 01880 4 1 rrd96024.xml X0202 4 2005-11-01 0 0001028087 AMERICAN DENTAL PARTNERS INC ADPI 0001234994 REEVES DERRIL W 2000 TYNE BLVD. NASHVILLE TN 37215 1 0 0 0 Common Stock 2005-11-01 4 M 0 10350 8.33 A 4500 D Common Stock 2005-11-01 4 M 0 6000 4.83 A 4500 D Common Stock 2005-11-01 4 M 0 11250 4.63 A 4500 D Common Stock 2005-11-01 4 M 0 11250 5.25 A 4500 D Common Stock 2005-11-01 4 S 0 15350 21.2393 D 4500 D Common Stock 2005-11-01 4 S 0 23500 20.55 D 4500 D Nonqualifed option granted 02/17/1997 (right to buy) 8.33 2005-11-01 4 M 0 10350 0 D 1998-02-17 2007-02-17 Common Stock 10350 70800 D Nonqualifed option granted 02/26/1999 (right to buy) 4.83 2005-11-01 4 M 0 6000 0 D 2000-02-26 2009-02-26 Common Stock 6000 70800 D Nonqualifed option granted 03/08/2000 (right to buy) 4.63 2005-11-01 4 M 0 11250 0 D 2001-03-08 2010-03-08 Common Stock 11250 70800 D Nonqualifed option granted 03/16/2001 (right to buy) 5.25 2005-11-01 4 M 0 11250 0 D 2002-03-16 2011-03-16 Common Stock 11250 70800 D Number of shares reflects the 3-for-2 stock split effected by the issuer in October 2005. Conversion or exercise price reflects the 3-for-2 stock split effected by the issuer in October 2005. Total number of derivative securities beneficially owned (70,800) reflects all options held by reporting person pursuant to employee benefit plans of issuer. Option vested with respect to 25% of shares subject to options on each of the first four anniversaries of the date of grant. Mark W. Vargo, Attorney-in-Fact and Agent 2005-11-02 -----END PRIVACY-ENHANCED MESSAGE-----