0001127602-21-021887.txt : 20210713 0001127602-21-021887.hdr.sgml : 20210713 20210713165053 ACCESSION NUMBER: 0001127602-21-021887 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210709 FILED AS OF DATE: 20210713 DATE AS OF CHANGE: 20210713 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gomez Jorge M CENTRAL INDEX KEY: 0001726653 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16211 FILM NUMBER: 211088417 MAIL ADDRESS: STREET 1: C/O DENTSPLY SIRONA INC STREET 2: 13320 BALLANTYNE CORPORATE PLACE CITY: CHARLOTTE STATE: NC ZIP: 28277 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DENTSPLY SIRONA Inc. CENTRAL INDEX KEY: 0000818479 STANDARD INDUSTRIAL CLASSIFICATION: DENTAL EQUIPMENT & SUPPLIES [3843] IRS NUMBER: 391434669 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 13320 BALLANTYNE CORPORATE PLACE CITY: CHARLOTTE STATE: NC ZIP: 28277-3607 BUSINESS PHONE: 844-546-3722 MAIL ADDRESS: STREET 1: 13320 BALLANTYNE CORPORATE PLACE CITY: CHARLOTTE STATE: NC ZIP: 28277-3607 FORMER COMPANY: FORMER CONFORMED NAME: DENTSPLY INTERNATIONAL INC /DE/ DATE OF NAME CHANGE: 19930630 FORMER COMPANY: FORMER CONFORMED NAME: GENDEX CORP DATE OF NAME CHANGE: 19920703 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2021-07-09 0000818479 DENTSPLY SIRONA Inc. XRAY 0001726653 Gomez Jorge M 13320 BALLANTYNE CORPORATE PLACE CHARLOTTE NC 28277 1 EVP, CFO Common Stock 2021-07-09 4 A 0 107.506 64.18 A 99763.421 D Phantom Stock (Supplemental Executive Retirement Plan) SERP 2021-07-09 4 A 0 3.0076 62.57 A Common Stock 3.0076 1713.7645 D Represents dividends on restricted stock units (RSUs) awarded to the Reporting Person in the form of additional RSUs and are subject to the same vesting terms as the underlying awards. The dividends vest simultaneously with the RSUs to which they relate. Each RSU converts to common stock on a 1:1 basis. Each share of phantom stock is the economic equivalent of one share of common stock. The shares of phantom stock become payable in common stock upon the reporting persons termination of employment. Comprised of phantom stock acquired as a result of accrued dividends. Dane Baumgardner, Attorney-In-Fact for Jorge M. Gomez 2021-07-13