0001562180-18-003086.txt : 20180622 0001562180-18-003086.hdr.sgml : 20180622 20180622173126 ACCESSION NUMBER: 0001562180-18-003086 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180620 FILED AS OF DATE: 20180622 DATE AS OF CHANGE: 20180622 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tirpak Bradley M CENTRAL INDEX KEY: 0001484439 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23367 FILM NUMBER: 18915405 MAIL ADDRESS: STREET 1: 50 ORCHARD ST. CITY: NEW YORK STATE: NY ZIP: 10002 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIRNER DENTAL MANAGEMENT SERVICES INC CENTRAL INDEX KEY: 0000948072 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HEALTH SERVICES [8000] IRS NUMBER: 841307044 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1777 S. HARRISON STREET, STREET 2: SUITE 1400 CITY: DENVER STATE: CO ZIP: 80210 BUSINESS PHONE: 3036910680 MAIL ADDRESS: STREET 1: 1777 S. HARRISON STREET, STREET 2: SUITE 1400 CITY: DENVER STATE: CO ZIP: 80210 4 1 primarydocument.xml PRIMARY DOCUMENT X0306 4 2018-06-20 false 0000948072 BIRNER DENTAL MANAGEMENT SERVICES INC BDMS 0001484439 Tirpak Bradley M C/O PALM VENTURES LLC 19 WEST ELM STREET GREENWICH CT 06830 true false false false Common Stock 2018-06-20 4 A false 2000.00 0.00 A 2000.00 D Restricted stock that vests in two equal installments on June 20, 2019 and June 20, 2020 On January 3, 2018, Palm Management (US) LLC, Palm Global Small Cap Master Fund LP (the "Fund"), Palm Active Dental, LLC (the "LLC"), the Reporting Person and certain other individuals filed a Schedule 13D regarding the Company under which the Fund and the LLC reported holding an aggregate of 1,000,000 shares of Common Stock issuable upon the conversion of certain securities of the Company into Common Stock. The Reporting Person disclaims beneficial ownership of these securities. /s/ Bradley M. Tirpak 2018-06-22