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 * Russo Nicholas 001455 Foulk Road Dental 300 Foulk Road Wilmington DE 19803 General Provider New Castle Klassman Bradford 001566 Delaware Periodontics 1110 N. Bancroft Parkway Wilmington DE 19805 Periodontist New Castle Baker Elizabeth 002476 Westside Health 1802 W Fourth St Wilmington DE 19805 General Provider New Castle Kubasko MaryClare 002476 Westside Health 1802 W Fourth St Wilmington DE 19805 General Provider New Castle Swiatowicz Andrew 002476 Westside Health 1802 W Fourth St Wilmington DE 19805 General Provider New Castle Nguyen Keith 001510 Aesthetic & Special Care Associates PA 2323 Pennsylvania Avenue Wilmington DE 19806 General Provider New Castle Veith Charles 001493 Charles J Veith DMD PA MS 2300 Pennsylvania Avenue Wilmington DE 19806 Orthodontist New Castle * Sweeney, III Patrick 002753 Healthy Smiles of Delaware, P.A. 1700 Shall Cross Ave., Suite 2 Wilmington DE 19806 General Provider New Castle * Casalena Herbert 001463 Herbert T. Casalena, D.D.S., P.A. 2300 Pennsylvania Avenue, 6th floor Wilmington DE 19806 General Provider New Castle * Hounsell Jill 001463 Herbert T. Casalena, D.D.S., P.A. 2300 Pennsylvania Avenue, 6th floor Wilmington DE 19806 General Provider New Castle Kim Jung 001573 Kreshtool & Kim Endodontics PA 1815 West 13th Street, Suite 7 Wilmington DE 19806 Endodontist New Castle Kreshtool Daniel 001573 Kreshtool & Kim Endodontics PA 1815 West 13th Street, Suite 7 Wilmington DE 19806 Endodontist New Castle * Rybinski John 001460 John F. Rybinski, D.D.S. 2601 Annand Drive, Suite 6 Wilmington DE 19808 General Provider New Castle Elkington I 033877 Seaford Dental Associates 218 Pennsylvania Ave Seaford DE 19973 General Provider Sussex * Laparle Frank 000454 Frank A. Laparle, D.D.S. 500 Memorial Ave., #401 Cumberland MD 21502 General Provider Allegany * Brodell Lynne 000429 Lynne S. Brodell, D.D.S. 12600 Winchester Rd. #103 LaVale MD 21502 General Provider Allegany Labbe Stephen 000608 Stewart & Labbe, D.D.S., P.A. 101 Ridgely Ave., Suite 21 Annapolis MD 21401 Orthodontist Anne Arundel Stewart Lamon 000608 Stewart & Labbe, D.D.S., P.A. 101 Ridgely Ave., Suite 21 Annapolis MD 21401 Orthodontist Anne Arundel Hlousek Lubor 079093 Walzer Sullivan and Hlousek PA 101 Ridgely Avenue, Suite 21 Annapolis MD 21401 Oral Surgeon Anne Arundel Jones Kurt 079093 Walzer Sullivan and Hlousek PA 101 Ridgely Avenue, Suite 21 Annapolis MD 21401 Oral Surgeon Anne Arundel Sullivan Cornelius 079093 Walzer Sullivan and Hlousek PA 101 Ridgely Avenue, Suite 21 Annapolis MD 21401 Oral Surgeon Anne Arundel Walzer Clifford 079093 Walzer Sullivan and Hlousek PA 101 Ridgely Avenue, Suite 21 Annapolis MD 21401 Oral Surgeon Anne Arundel Granek Warren 050916 Warren Granek DDS 1410 Forest Dr, Suite 29 Annapolis MD 21403 Orthodontist Anne Arundel Hlousek Lubor 000593 Walzer Sullivan and Hlousek PA 275 West St, Suite 100 Annapolis MD 21404 Oral Surgeon Anne Arundel Jones Kurt 000593 Walzer Sullivan and Hlousek PA 275 West St, Suite 100 Annapolis MD 21404 Oral Surgeon Anne Arundel Sullivan Cornelius 000593 Walzer Sullivan and Hlousek PA 275 West St, Suite 100 Annapolis MD 21404 Oral Surgeon Anne Arundel Walzer Clifford 000593 Walzer Sullivan and Hlousek PA 275 West St, Suite 100 Annapolis MD 21404 Oral Surgeon Anne Arundel Heller Alan 004336 Alan R Heller DDS Ms 2200 Defense Highway, Suite 208 Crofton MD 21114 Orthodontist Anne Arundel Batrouni Ziad 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Cohen Lisa 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Griffith Miari-Ann 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Kashyap Anil 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Patel Chirag 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Robinson Brian 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Stark Mitchell 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Trinh Huy 051116 Maryland Oral Surgery Associates 1667 Crofton Centre, Suite 7A Crofton MD 21114 Oral Surgeon Anne Arundel Criscitiello Kevin 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel DeMizio Peter 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 Oral Surgeon Anne Arundel Elrafei Mohamed 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Ganjavian Babak 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Gentile Michael 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 Oral Surgeon Anne Arundel Ghajarnia Katayoun 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Ghajarnia M. Reza 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 Orthodontist Anne Arundel Jun Sung 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Mankiewicz Ryan 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Masood Arif 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Steinberg Wayne 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Tchakarova Ludmila 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Ulery Scott 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Weiss Karl 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 Orthodontist Anne Arundel Wolf Christopher 000479 Ulery Dental & Orthodontics 1286 MD Rt. 3 South, Suite 7 Crofton MD 21114 General Provider Anne Arundel Granek Warren 050917 Warren Granek DDS 3143 Solomns Island Rd Edgewater MD 21037 Orthodontist Anne Arundel Muko Deep 002216 Gambrills Family Dentistry 959 Annapolis Road Gambrills MD 21054 General Provider Anne Arundel Mekouar Hicham 051010 Gambrills Orthodontics 331 Gambrills Rd, Suite 7 Gambrills MD 21054 Orthodontist Anne Arundel Garfinkel Allan 000590 Allan V. Garfinkle, D.D.S. 300 Hospital Drive #237 Glen Burnie MD 21061 Oral Surgeon Anne Arundel Goldman Stephen 037568 Drs. Goldman and Packman 7600 Ritchie Hwy Glen Burnie MD 21061 Periodontist Anne Arundel Anyadike Anthony 037653 Greenway Orthodontics, LLC 30 Greenway St. NW, Suite 4 Glen Burnie MD 21061 Orthodontist Anne Arundel Packman Harold 000760 Harold Packman, D.M.D., PA 7600 Ritchie Hwy. Glen Burnie MD 21061 Periodontist Anne Arundel Exposito Jacques 017299 Jacques P Exposito DDS 1404 Crain Highway South, Suite 110 Glen Burnie MD 21061 General Provider Anne Arundel Abrahams Heather 002337 Orthodontic Associates 7954 Balt-Annapolis Blvd. 2 C Glen Burnie MD 21061 Orthodontist Anne Arundel Miller Jeffrey 002337 Orthodontic Associates 7954 Balt-Annapolis Blvd. 2 C Glen Burnie MD 21061 Orthodontist Anne Arundel Williams David 002337 Orthodontic Associates 7954 Balt-Annapolis Blvd. 2 C Glen Burnie MD 21061 Orthodontist Anne Arundel Baliga Narayani 097167 PDOM Glen Burnie LLC 7704 Quarterfield Rd, Suite F Glen Burnie MD 21061 Pedodontist Anne Arundel Schapiro Howard 097167 PDOM Glen Burnie LLC 7704 Quarterfield Rd, Suite F Glen Burnie MD 21061 Pedodontist Anne Arundel Criscitiello Kevin 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel DeMizio Peter 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Oral Surgeon Anne Arundel * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 2 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 Elrafei Mohamed 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ganjavian Babak 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Gentile Michael 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Oral Surgeon Anne Arundel Ghajarnia Katayoun 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ghajarnia M. Reza 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel Jun Sung 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Mankiewicz Ryan 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Masood Arif 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Tchakarova Ludmila 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ulery Scott 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Weiss Karl 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel Wolf Christopher 050372 Ulery Dental and Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Bonebreak David 069565 Chesapeake Orthodontics 7556 Teague Rd, Suite 106 Hanover MD 21076 Orthodontist Anne Arundel * Stephens George 000284 George M. Stephens, D.D.S. 3450 Ft. Meade Rd., Suite 211 Laurel MD 20724 General Provider Anne Arundel * Tehrani Saideh 000446 Saideh Tehrani, D.M.D. 3450 Fort Meade Rd. #202, Suite 202 Laurel MD 20724 General Provider Anne Arundel Sevilla Guevara Maria 068495 Childrens Dentistry at Odenton LLC 1215 Annapolis Rd, Suite 106 Odenton MD 21113 Pedodontist Anne Arundel Winnard Robert 050799 Robert G. Winnard, D.M.D. 1215 Annapolis Rd., Suite 207 Odenton MD 21113 Orthodontist Anne Arundel Clark Maxine 050731 Maryland Orthodontic Specialists 8028 Ritchie Hwy, Suite 202 Pasadena MD 21122 Orthodontist Anne Arundel Criscitiello Kevin 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel DeMizio Peter 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 Oral Surgeon Anne Arundel Elrafei Mohamed 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Ganjavian Babak 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Gentile Michael 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 Oral Surgeon Anne Arundel Ghajarnia Katayoun 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Ghajarnia M. Reza 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 Orthodontist Anne Arundel Jun Sung 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Mankiewicz Ryan 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Masood Arif 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Steinberg Wayne 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Tchakarova Ludmila 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Ulery Scott 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Weiss Karl 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 Orthodontist Anne Arundel Wolf Christopher 002011 Ulery Dental & Orthodontics 8055 Ritchie Hwy, Suite 102 Pasadena MD 21122 General Provider Anne Arundel Hlousek Lubor 000594 Walzer Sullivan and Hlousek PA 8092 Edwin Raynor Blvd. # A Pasadena MD 21122 Oral Surgeon Anne Arundel Jones Kurt 000594 Walzer Sullivan and Hlousek PA 8092 Edwin Raynor Blvd. # A Pasadena MD 21122 Oral Surgeon Anne Arundel Sullivan Cornelius 000594 Walzer Sullivan and Hlousek PA 8092 Edwin Raynor Blvd. # A Pasadena MD 21122 Oral Surgeon Anne Arundel Walzer Clifford 000594 Walzer Sullivan and Hlousek PA 8092 Edwin Raynor Blvd. # A Pasadena MD 21122 Oral Surgeon Anne Arundel Garden Richard 000689 Richard B. Garden, D.D.S. 555 Benfield Road Severna Park MD 21146 Oral Surgeon Anne Arundel * Bae Hyung Jin 061388 Dental One Associates Security Blvd LLC 6666 Security Blvd Baltimore MD 21207 Pedodontist Baltimore * Huynh Thuylinh 061388 Dental One Associates Security Blvd LLC 6666 Security Blvd Baltimore MD 21207 Orthodontist Baltimore * Patel Yash 061388 Dental One Associates Security Blvd LLC 6666 Security Blvd Baltimore MD 21207 General Provider Baltimore * Seyedsalari Leila 061388 Dental One Associates Security Blvd LLC 6666 Security Blvd Baltimore MD 21207 General Provider Baltimore * Thompson Mellanie 061388 Dental One Associates Security Blvd LLC 6666 Security Blvd Baltimore MD 21207 General Provider Baltimore Dyson, Jr. Joseph 000163 Joseph L. Dyson, Jr., D.D.S. 4901 Liberty Heights Ave. Baltimore MD 21207 General Provider Baltimore Fried Daniel 000582 Daniel I. Fried, D.M.D. 3635 Old Court Rd. #501 Baltimore MD 21208 Oral Surgeon Baltimore Gordon James 000850 Drs. Branoff & Kress PA 3635 Old Court Rd., Suite 505 Baltimore MD 21208 Orthodontist Baltimore Greenberg Ned 011212 Ned S Greenberg DDS PA 2100 Eastern Boulevard Baltimore MD 21220 General Provider Baltimore Livingston Herbert 078261 Ned S Greenberg DDS PA Specialist 2100 Eastern Boulevard Baltimore MD 21220 Periodontist Baltimore Zia Amir 002690 Lansdowne Family Dental 2717 Hammonds Ferry Rd. Baltimore MD 21227 General Provider Baltimore Ramamurthy S 000271 S.V. Ramamurthy, D.D.S. 8713 Harford Rd. Baltimore MD 21234 General Provider Baltimore Romeo Frank 000644 Frank J. Romeo, D.D.S. 7544 Belair Road Baltimore MD 21236 Oral Surgeon Baltimore Fechter Maury 000291 Maury J. Fechter, D.D.S. 8817 Belair Road, Suite 105 Baltimore MD 21236 General Provider Baltimore Abrahams Heather 003409 Orthodontic Associates 7544 Belair Road, 2Nd Floor Baltimore MD 21236 Orthodontist Baltimore Miller Jeffrey 003409 Orthodontic Associates 7544 Belair Road, 2Nd Floor Baltimore MD 21236 Orthodontist Baltimore Williams David 003409 Orthodontic Associates 7544 Belair Road, 2Nd Floor Baltimore MD 21236 Orthodontist Baltimore Kodeck Robert 000356 Robert Kodeck, D.D.S. 7850 Rossville Blvd. Baltimore MD 21236 General Provider Baltimore Angamuthu Vijayalakshmi 017177 Convenient Dental 1726 North Rolling Road Baltimore MD 21244 General Provider Baltimore Yuille Bruce 000409 Bruce E.Yuille, D.D.S. 700 Geipe Road, Suite 270 Catonsville MD 21228 General Provider Baltimore Clark Maxine 050741 Maryland Orthodontic Specialists 2 E Rolling Crossroads Catonsville MD 21228 Orthodontist Baltimore Abrahams Heather 002327 Orthodontic Associates 606 Frederick Road, 2nd Floor Catonsville MD 21228 Orthodontist Baltimore Miller Jeffrey 002327 Orthodontic Associates 606 Frederick Road, 2nd Floor Catonsville MD 21228 Orthodontist Baltimore Williams David 002327 Orthodontic Associates 606 Frederick Road, 2nd Floor Catonsville MD 21228 Orthodontist Baltimore Dahne Marlene 000396 The Dental Care Center 4 East Rolling Crossroads, Suite 104 Catonsville MD 21228 General Provider Baltimore Tzomides Thomas 051041 Thomas G Tzomides DDS LLC 30 Middle River Rd Middle River MD 21220 General Provider Baltimore Berman Barry 000579 Barry R. Berman , D.D.S. 110 Painters Mill Road Owings Mills MD 21117 Oral Surgeon Baltimore Moore Brian 051086 Brian C Moore DMD PC 10085 Red Run Blvd, Suite 407 Owings Mills MD 21117 General Provider Baltimore * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 3 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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