Select Plan Provider Directory - Dominion Dental Services, Inc.

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SELECT PLAN 1 DENTIST DIRECTORY Dentists listed are under contract as of 10/1/12 Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County Savani Niranjan 001023 A+ Family Dental Care PC 24 South 14th Street Quakertown PA 18951 General Provider Bucks Tantucco Kathleen 001023 A+ Family Dental Care PC 24 South 14th Street Quakertown PA 18951 General Provider Bucks Todd Meredith 001023 A+ Family Dental Care PC 24 South 14th Street Quakertown PA 18951 General Provider Bucks Bandelac Georges 070944 A+ Periodontic Specialty Care PC 24 S 14th St Quakertown PA 18951 Periodontist Bucks Evans Marianna 070944 A+ Periodontic Specialty Care PC 24 S 14th St Quakertown PA 18951 Periodontist Bucks Charkas Ahmad 070952 Allied Orthodontics PC 24 S 14th St Quakertown PA 18951 Orthodontist Bucks Evans Marianna 070952 Allied Orthodontics PC 24 S 14th St Quakertown PA 18951 Orthodontist Bucks Bhatnagar Payal 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Chadha Chandan 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Kim Peter 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Malhotra Swati 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Obaid Michel 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Sambaraju Haritha 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Withanachchi Janatha 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 Endodontist Bucks Yi Tyler 078266 Aspen Dental 90 North West End Blvd Quakertown PA 18951 General Provider Bucks Sayles Erik 000666 Drs. Schwartz & Schelkun Associates Brownstone Office Complex, 853 2nd St. Pke, Ste.A- Richboro PA 18954 Oral Surgeon Bucks Schelkun Paul 000666 Drs. Schwartz & Schelkun Associates Brownstone Office Complex, 853 2nd St. Pke, Ste.A- Richboro PA 18954 Oral Surgeon Bucks Metz August 069529 Apex Smiles LLC 771 2nd St Pike Southampton PA 18966 General Provider Bucks Cichetti Michael 070996 Cichetti & DelliGatti Orthodontics PC 928 Jaymor Rd, Suite 130A Southampton PA 18966 Orthodontist Bucks DelliGatti Steve 070996 Cichetti & DelliGatti Orthodontics PC 928 Jaymor Rd, Suite 130A Southampton PA 18966 Orthodontist Bucks Milewski Michael 070996 Cichetti & DelliGatti Orthodontics PC 928 Jaymor Rd, Suite 130A Southampton PA 18966 Orthodontist Bucks Orozco Jacob 070996 Cichetti & DelliGatti Orthodontics PC 928 Jaymor Rd, Suite 130A Southampton PA 18966 Orthodontist Bucks Bahn Paul 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks D'Agostino Alegra 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Hamilton Sharon 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Kay Lewis 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Quinn Noah 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Rosenbaum Michael 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Thomas Kimberly 070987 Pediatric Dental Associates 928 Jaymor Rd, Suite 130 A Southampton PA 18966 Pedodontist Bucks Sayles Erik 000665 Drs. Schwartz & Schelkun Associates 158 York Road Warminster PA 18974 Oral Surgeon Bucks Schelkun Paul 000665 Drs. Schwartz & Schelkun Associates 158 York Road Warminster PA 18974 Oral Surgeon Bucks Lee Elliot 078283 Warrington Dental Arts 865 Easton Road, Suite 110 Warrington PA 18976 General Provider Bucks Yoo Joo 078283 Warrington Dental Arts 865 Easton Road, Suite 110 Warrington PA 18976 General Provider Bucks Motwani Amit 002576 Warrington Dental PC 1380 Easton Rd Warrington PA 18976 General Provider Bucks Dudhat Dilip 040338 Radiant Smiles at Floral Vale 117 Floral Vale Blvd Yardley PA 19067 General Provider Bucks Hazard Amelia 040338 Radiant Smiles at Floral Vale 117 Floral Vale Blvd Yardley PA 19067 General Provider Bucks Kalanuria Vinita 040338 Radiant Smiles at Floral Vale 117 Floral Vale Blvd Yardley PA 19067 General Provider Bucks Metz August 040338 Radiant Smiles at Floral Vale 117 Floral Vale Blvd Yardley PA 19067 General Provider Bucks Aviso Venice 038072 Smile Today Dental LLC 301 Oxford Valley Rd, Suite 1301 Yardley PA 19067 General Provider Bucks Phan Kathy 038072 Smile Today Dental LLC 301 Oxford Valley Rd, Suite 1301 Yardley PA 19067 General Provider Bucks Ciarallo Robert 037964 Aspen Dental of Butler 256 New Castle Rd Butler PA 16001 Oral Surgeon Butler Garver Eric 037964 Aspen Dental of Butler 256 New Castle Rd Butler PA 16001 General Provider Butler Grinberg Anna 037964 Aspen Dental of Butler 256 New Castle Rd Butler PA 16001 General Provider Butler Laughrey Nathan 037964 Aspen Dental of Butler 256 New Castle Rd Butler PA 16001 General Provider Butler Ruprecht Heather 037964 Aspen Dental of Butler 256 New Castle Rd Butler PA 16001 General Provider Butler Hiras John 001348 Butler Dental Associates 121 South Main Street Butler PA 16001 General Provider Butler Manalo Maria 001348 Butler Dental Associates 121 South Main Street Butler PA 16001 General Provider Butler Terasavage William 001348 Butler Dental Associates 121 South Main Street Butler PA 16001 General Provider Butler Conquest Matthew 002197 Snyder and Dugar Oral and Maxillofacial Surgery 373 Stirling Village Butler PA 16001 Oral Surgeon Butler Dugan Michael 002197 Snyder and Dugar Oral and Maxillofacial Surgery 373 Stirling Village Butler PA 16001 Oral Surgeon Butler Snyder Richard 002197 Snyder and Dugar Oral and Maxillofacial Surgery 373 Stirling Village Butler PA 16001 Oral Surgeon Butler Sweeney Patrick 002197 Snyder and Dugar Oral and Maxillofacial Surgery 373 Stirling Village Butler PA 16001 Oral Surgeon Butler Garver Eric 050865 Aspen Dental 20000 Route 19, Suite 300 Cranberry Township PA 16066 General Provider Butler Grinberg Anna 050865 Aspen Dental 20000 Route 19, Suite 300 Cranberry Township PA 16066 General Provider Butler Laughrey Nathan 050865 Aspen Dental 20000 Route 19, Suite 300 Cranberry Township PA 16066 General Provider Butler Ruprecht Heather 050865 Aspen Dental 20000 Route 19, Suite 300 Cranberry Township PA 16066 General Provider Butler Morrow Bartley 001450 Generational Dental Associates 2610 Rochester Road Cranberry Township PA 16066 General Provider Butler Kampas Ronald 079820 Kampas Orthodontics PC 7011 Crider Rd, Suite 104 Mars PA 16046 Orthodontist Butler Feduska Linda 061408 My Best Smile North 518 Myoma Rd, Suite 200 Mars PA 16046 General Provider Butler Kokai John 061408 My Best Smile North 518 Myoma Rd, Suite 200 Mars PA 16046 General Provider Butler Manalo Alfredo 001298 North Pointe Dental Associates 7031 Crider Road, Suite 200 Mars PA 16046 Oral Surgeon Butler Novotny Greg 037626 Allied Dental Group, Ltd. 234 S. Main St. Slippery Rock PA 16057 General Provider Butler Kampas Ronald 080783 Kampas Orthodontics PC 508 S Main St, Suite 103 Zelienople PA 16063 Orthodontist Butler Conquest Matthew 002198 Snyder and Dugar Oral and Maxillofacial Surgery 506 S. Main Street, Suite 2101 Zelienople PA 16063 Oral Surgeon Butler Dugan Michael 002198 Snyder and Dugar Oral and Maxillofacial Surgery 506 S. Main Street, Suite 2101 Zelienople PA 16063 Oral Surgeon Butler Snyder Richard 002198 Snyder and Dugar Oral and Maxillofacial Surgery 506 S. Main Street, Suite 2101 Zelienople PA 16063 Oral Surgeon Butler * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 20 1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses.
SELECT PLAN 1 DENTIST DIRECTORY Dentists listed are under contract as of 10/1/12 Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County Sweeney Patrick 002198 Snyder and Dugar Oral and Maxillofacial Surgery 506 S. Main Street, Suite 2101 Zelienople PA 16063 Oral Surgeon Butler Check Jennifer 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Ciarallo Robert 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 Oral Surgeon Cambria Cignetti Scott 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Fazio John 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Ferguson III William 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Grinberg Anna 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Malone Matthew 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria McCann Eve 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria McClain Kelly 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Monios George 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Raja Nabila 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Somers Mitchell 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Tam Dominic 002756 Aspen Dental 121 Town Center Dr. Johnstown PA 15904 General Provider Cambria Burnheimer John 002393 John M. Burnheimer, D.M.D., P.C. 336 Bloomfield Street Johnstown PA 15904 Orthodontist Cambria Check Jennifer 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Ciarallo Robert 038064 Aspen Dental 1715 N Atherton St State College PA 16803 Oral Surgeon Centre Cignetti Scott 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Fazio John 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Ferguson III William 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Grinberg Anna 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Malone Matthew 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre McCann Eve 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre McClain Kelly 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Monios George 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Raja Nabila 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Somers Mitchell 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Tam Dominic 038064 Aspen Dental 1715 N Atherton St State College PA 16803 General Provider Centre Gretzula Chad 069563 Absolute Oral Surgery PC 616 E Lancaster Ave Berwyn PA 19312 Oral Surgeon Chester Tran David 085552 A + Oral Surgery Specialty Care PC 479 Thomas Jones Way, Ste 600 Exton PA 19341 Oral Surgeon Chester Bandelac Georges 070948 A+ Periodontic Specialty Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 Periodontist Chester Evans Marianna 070948 A+ Periodontic Specialty Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 Periodontist Chester Charkas Ahmad 070957 Allied Orthodontics PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 Orthodontist Chester Evans Marianna 070957 Allied Orthodontics PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 Orthodontist Chester Agrawal Avanti 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Ahmadzadeh Bijan 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Brown Benjamin 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Dapkute Ingrida 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Derosa Daniel 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Desai Kaushal 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Gombar Anna 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Kim Sunghun 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Kopp Anatoliy 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Merin Jared 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Mitelman Alexandra 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Moriarty Sean 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Nguyen Anna 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Savani Bhaskar 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Savani Bhumi 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Savani Niranjan 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Soliman John 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Todd Meredith 050386 American Family Dental Care PC 479 Thomas Jones Way, Suite 600 Exton PA 19341 General Provider Chester Gorelik Tatyana 002317 Exton Dental Associates, LTD 436 Exton Commons Exton PA 19341 General Provider Chester Hook William 000848 William L. Hook, D.M.D., MSD 358 S. Balderston Drive Exton PA 19341 Orthodontist Chester * Yeung Alan 000510 Alan S Yeung, D.D.S. 250 W Lancaster Ave. #210 Paoli PA 19301 General Provider Chester Babameto Blendi 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 Oral Surgeon Chester Brier Ashley 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 General Provider Chester Ciarallo Robert 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 Oral Surgeon Chester Fellin Michael 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 General Provider Chester Singh Tanvir 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 General Provider Chester Withanachchi Janatha 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 Endodontist Chester Young Donovan 002742 Aspen Dental Associates of NY, PC 1100 Town Square Rd Pottstown PA 19465 General Provider Chester In Andrew 000628 Gentle Dental Thorndale LLC 3307 Lincoln Hwy Thorndale PA 19372 General Provider Chester Chen Thomas 037762 Jiten P. Gohel, DMD 913 E Boot Rd West Chester PA 19380 General Provider Chester Gohel Jiten 037762 Jiten P. Gohel, DMD 913 E Boot Rd West Chester PA 19380 General Provider Chester DeLoache Yvonne 001057 Yvonne DeLoache, D.D.S. 301 S. High Street West Chester PA 19382 General Provider Chester * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 21 1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses.
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Select Plan Provider Directory - Dominion Dental Services, Inc.

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