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 Thilak Preetha 002801 American Dental Care, PC 1003 W Baltimore Pike Media PA 19063 General Provider Delaware Weinstein Steven 002801 American Dental Care, PC 1003 W Baltimore Pike Media PA 19063 General Provider Delaware Yang Qing 002801 American Dental Care, PC 1003 W Baltimore Pike Media PA 19063 General Provider Delaware Yao Zheng 002801 American Dental Care, PC 1003 W Baltimore Pike Media PA 19063 General Provider Delaware Yoon Simon 002801 American Dental Care, PC 1003 W Baltimore Pike Media PA 19063 General Provider Delaware Bresler David 025052 David A Bresler DDS PC 1003 West Baltimore Pike Media PA 19063 Pedodontist Delaware Bresler Jason 025052 David A Bresler DDS PC 1003 West Baltimore Pike Media PA 19063 Pedodontist Delaware Bresler Joshua 025052 David A Bresler DDS PC 1003 West Baltimore Pike Media PA 19063 Pedodontist Delaware Mayzenberg Julia 025052 David A Bresler DDS PC 1003 West Baltimore Pike Media PA 19063 Pedodontist Delaware Kahlon Sonia 050566 Rich Family Orthodontics 1022 E Baltimore Pike Media PA 19063 Orthodontist Delaware Rich Jeremy 050566 Rich Family Orthodontics 1022 E Baltimore Pike Media PA 19063 Orthodontist Delaware Panossian Antoine 070973 A+ Oral Surgery Specialty Care PC 35 B Woodland Ave Morton PA 19070 Oral Surgeon Delaware Tran David 070973 A+ Oral Surgery Specialty Care PC 35 B Woodland Ave Morton PA 19070 Oral Surgeon Delaware Bandelac Georges 070946 A+ Periodontic Specialty Care PC 35 B Woodland Ave Morton PA 19070 Periodontist Delaware Evans Marianna 070946 A+ Periodontic Specialty Care PC 35 B Woodland Ave Morton PA 19070 Periodontist Delaware Agrawal Avanti 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Ahmadzadeh Bijan 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Dapkute Ingrida 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Derosa Daniel 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Desai Kaushal 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Gombar Anna 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Kopp Anatoliy 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Merin Jared 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Mitelman Alexandra 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Moriarty Sean 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Savani Bhaskar 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Savani Bhumi 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Savani Niranjan 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Sitkovetsky Mikhail 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Srivastava Rani 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Todd Meredith 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Wang Lin 002354 Advanced Family Dentistry PC 35 B Woodland Avenue Morton PA 19070 General Provider Delaware Bresler David 050961 Doc Breslers Cavity Busters 4659 West Chester Pike Newtown Square PA 19073 Pedodontist Delaware Bresler Jason 050961 Doc Breslers Cavity Busters 4659 West Chester Pike Newtown Square PA 19073 Pedodontist Delaware Bresler Joshua 050961 Doc Breslers Cavity Busters 4659 West Chester Pike Newtown Square PA 19073 Pedodontist Delaware Mayzenberg Julia 050961 Doc Breslers Cavity Busters 4659 West Chester Pike Newtown Square PA 19073 Pedodontist Delaware Zito Domenico 000668 Domenico Zito, D.M.D. 3400 W Chester Pike, Suite 850 Newtown Square PA 19073 Periodontist Delaware Dow Najibe 069534 Najibe H Dow DMD Family Dentistry 3111 West Chester Pike Newtown Square PA 19073 General Provider Delaware Tewari Dinesh 069539 Norwood Family Dentistry 7 W Winona Ave Norwood PA 19074 General Provider Delaware Shore Jeffrey 000361 Shore & Snyder Dental Center 519 Chester Pike, Box 40 Norwood PA 19074 General Provider Delaware Snyder Mark 000361 Shore & Snyder Dental Center 519 Chester Pike, Box 40 Norwood PA 19074 General Provider Delaware Hayes Richard 000664 Orthodontic Associates 101 Dutton Street Ridley Park PA 19078 Orthodontist Delaware Adams Michael 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Bruno Frank 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Endodontist Delaware Chen Yang 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Cohen Hal 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Daly Gerald 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware David Dan 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Edmonds R Blake 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Elkhatib Mohammad 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Fluhr Howard 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Gelbart Steven 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Kim Jae Woo 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Kim Steven 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Periodontist Delaware Koff Howard 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Orthodontist Delaware Levy Jamie 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Oral Surgeon Delaware Li Fuming 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Lu John 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Periodontist Delaware Mojahed Amir 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Mumtaz Samera 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Nguyen Diep 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Oh Jinsuk 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Pereia Christine 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Roth Michael 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 Orthodontist Delaware Ruggieri John 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Sandhu Satinder 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 24 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 Sanfacon Dennis 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Shah Nishit 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Sultana Parveen 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Thilak Preetha 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Weinstein Steven 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Yang Qing 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Yao Zheng 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Yoon Simon 002794 American Dental Care, PC 515 Baltimore Pike Springfield PA 19064 General Provider Delaware Hayes Richard 000663 Orthodontic Associates 1050 Baltimore Pike Springfield PA 19064 Orthodontist Delaware Adams Michael 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Bruno Frank 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Endodontist Delaware Chen Yang 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Cohen Hal 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Daly Gerald 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware David Dan 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Edmonds R Blake 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Elkhatib Mohammad 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Fluhr Howard 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Gelbart Steven 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Kim Jae Woo 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Kim Steven 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Periodontist Delaware Koff Howard 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Orthodontist Delaware Levy Jamie 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Oral Surgeon Delaware Li Fuming 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Lu John 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Periodontist Delaware Mojahed Amir 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Mumtaz Samera 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Nguyen Diep 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Oh Jinsuk 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Pereia Christine 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Roth Michael 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 Orthodontist Delaware Ruggieri John 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Sandhu Satinder 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Sanfacon Dennis 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Shah Nishit 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Sultana Parveen 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Thilak Preetha 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Yang Qing 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Yao Zheng 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Yoon Simon 002795 American Dental Care, PC 6780 Market Street Upper Darby PA 19082 General Provider Delaware Joseph Zacharias 038068 Care Dental LLC 134 S State Rd Upper Darby PA 19082 General Provider Delaware Brown Glen 000498 Glenn A Brown, DMD 6776 Market Street Upper Darby PA 19082 General Provider Delaware Aftab Kanwal 068496 Pristine Dental LLC 392 Avon Rd Upper Darby PA 19082 General Provider Delaware Aranbayev Yefim 068496 Pristine Dental LLC 392 Avon Rd Upper Darby PA 19082 General Provider Delaware Mallya Rachel 000831 Rachel Mallya, D.M.D. 27 Garrett Road Upper Darby PA 19082 General Provider Delaware Gross Stephanie 000751 S. Harris Gross Wallingford Perio Center 9 N. Providence Rd., P.O. Box 81 Wallingford PA 19086 Periodontist Delaware Mostatab Rebecca 002740 Smile By Design 335 West Lancaster Ave Wayne PA 19087 General Provider Delaware Dhillon Upinder 070447 Complete Dental Care 1300 Macdade Blvd, Suite 5 Woodlyn PA 19094 General Provider Delaware Tewari Dinesh 079079 Yeadon Family Dentistry 724 Church Lane Yeadon PA 19050 General Provider Delaware D'Aurora Donald 001993 Community Health Net 1611 Peach Street, Suite 465 Erie PA 16501 General Provider Erie Graham-Kremers Ama 001993 Community Health Net 1611 Peach Street, Suite 465 Erie PA 16501 General Provider Erie Kinnear-Adams Suzanne 001993 Community Health Net 1611 Peach Street, Suite 465 Erie PA 16501 General Provider Erie Rick Andrea 001993 Community Health Net 1611 Peach Street, Suite 465 Erie PA 16501 General Provider Erie D'Aurora Donald 001982 Community Health Net 1720 Holland St Erie PA 16503 General Provider Erie Graham-Kremers Ama 001982 Community Health Net 1720 Holland St Erie PA 16503 General Provider Erie Rick Andrea 001982 Community Health Net 1720 Holland St Erie PA 16503 General Provider Erie Graham-Kremers Ama 033856 Community Health Net 2922 State Street Erie PA 16508 General Provider Erie Rick Andrea 033856 Community Health Net 2922 State Street Erie PA 16508 General Provider Erie Glecos Robert 037963 Aspen Dental Associates of NY., P.C. 2049 Interchange Rd Erie PA 16509 General Provider Erie Mohney Bryan 037963 Aspen Dental Associates of NY., P.C. 2049 Interchange Rd Erie PA 16509 General Provider Erie Aboosi Omar 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 General Provider Fayette Bonczek Brian 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 General Provider Fayette Ciarallo Robert 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 Oral Surgeon Fayette Grinberg Anna 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 General Provider Fayette Monaco Natalie 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 General Provider Fayette Monios George 002825 Aspen Dental of Western PA, PC 100 Pricedale Rd. Belle Vernon PA 15012 General Provider Fayette * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 25 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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