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 Shah Nishit 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Sultana Parveen 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Thilak Preetha 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Weinstein Steven 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Yang Qing 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Yao Zheng 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Yoon Simon 002796 American Dental Care, PC 187 W City Line Ave Bala Cynwyd PA 19004 General Provider Montgomery Agrawal Avanti 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Ahmadzadeh Bijan 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Dapkute Ingrida 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Derosa Daniel 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Desai Kaushal 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Dhyllon Amen 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Gombar Anna 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Kim Sunghun 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Kopp Anatoliy 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Li Wei 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Merin Jared 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Miller Andrew 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Mitelman Alexandra 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Moriarty Sean 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Savani Bhaskar 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Savani Bhumi 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Savani Niranjan 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Sitkovetsky Mikhail 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Todd Meredith 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Yanez Rafael 002357 American Family Dental Care PC 301 City Line, Suite G-5 Bala Cynwyd PA 19004 General Provider Montgomery Hodges Kellyn 050525 Dr Kellyn Hodges DMD 1 Belmont Ave, Suite 414 Bala Cynwyd PA 19004 Orthodontist Montgomery Kituskie Leo 002422 Leo J. Kituskie, D.M.D., PC 794 Penlly-Blue Bell Pike Blue Bell PA 19422 Periodontist Montgomery Dudhat Dilip 002811 Dilip N Dudhat DMD PC 2406 North Broad Street Colmar PA 18915 General Provider Montgomery Yankosky Dennis 000531 Dennis E. Yankosky, D.D.S., PC 2009 Butler Pike Conshohocken PA 19428 General Provider Montgomery Bresler David 001197 David A Bresler DDS PC 1650 Linekiln Pike Dresher PA 19025 Pedodontist Montgomery Bresler Jason 001197 David A Bresler DDS PC 1650 Linekiln Pike Dresher PA 19025 Pedodontist Montgomery Bresler Joshua 001197 David A Bresler DDS PC 1650 Linekiln Pike Dresher PA 19025 Pedodontist Montgomery Mayzenberg Julia 001197 David A Bresler DDS PC 1650 Linekiln Pike Dresher PA 19025 Pedodontist Montgomery Cherian Mathew 051006 Advanced Family Dental Care PC 327 Township Line Rd Elkins Park PA 19027 General Provider Montgomery Adibe Elochukwu 051030 Advanced Family Dental Care PC Specialists 327 Township Line Rd Elkins Park PA 19027 Prosthodontist Montgomery Fratamico Claude 070928 Dr C Fratamico 7608 New Second St Elkins Park PA 19027 General Provider Montgomery Funt Mark 000657 Mark J. Funt, D.M.D., P.C. 401 Township Road, Suite C Elkins Park PA 19027 Oral Surgeon Montgomery Mehta Taral 070452 Taral T Mehta DMD 1811 Bethlehem Pike, Suite A102 Flourtown PA 19031 General Provider Montgomery Tran David 081881 A + Oral Surgery Specialty Care PC 260 New York Dr, Ste 104 Fort Washington PA 19034 Oral Surgeon Montgomery Sayles Erik 002819 Drs Schwartz & Schelkun Associates 467 Pennsylvania Ave., Suite 106 Fort Washington PA 19034 Oral Surgeon Montgomery Schelkun Paul 002819 Drs Schwartz & Schelkun Associates 467 Pennsylvania Ave., Suite 106 Fort Washington PA 19034 Oral Surgeon Montgomery Mele Mark 000773 Mark J. Mele, D.M.D. 2826 Mt. Carmel Ave., Suite C1 Glenside PA 19038 Orthodontist Montgomery Tran David 085295 A + Oral Surgery Specialty Care PC 456 School Ln, Ste 102 Harleysville PA 19438 Oral Surgeon Montgomery Agrawal Avanti 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Ahmadzadeh Bijan 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Dapkute Ingrida 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Derosa Daniel 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Desai Kaushal 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Gombar Anna 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Graziano Janele 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Kopp Anatoliy 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Lim Mee Kyung 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Merin Jared 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Mitelman Alexandra 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Moriarty Sean 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Nguyen Vu 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Savani Bhaskar 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Savani Bhumi 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Savani Niranjan 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Todd Meredith 002353 A+ Family Dental Care PC 456 School Lane, Suite 104 Harleysville PA 19438 General Provider Montgomery Bandelac Georges 070947 A+ Periodontic Specialty Care PC 456 School Ln, Suite 104 Harleysville PA 19438 Periodontist Montgomery Evans Marianna 070947 A+ Periodontic Specialty Care PC 456 School Ln, Suite 104 Harleysville PA 19438 Periodontist Montgomery Charkas Ahmad 070955 Allied Orthodontics PC 456 School Ln, Suite 101 Harleysville PA 19438 Orthodontist Montgomery Evans Marianna 070955 Allied Orthodontics PC 456 School Ln, Suite 101 Harleysville PA 19438 Orthodontist Montgomery * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 30 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 Dudhat Dilip 051036 Advanced Dental Services PC 533 N York Rd Hatboro PA 19040 General Provider Montgomery Gevirtz David 000920 Horsham Dental Associates 623-A Horsham Road Horsham PA 19044 General Provider Montgomery Bresler David 025055 David A Bresler DDS PC 101 Old York Road, One Abington Plaza Suite 301 Jenkintown PA 19046 Pedodontist Montgomery Bresler Jason 025055 David A Bresler DDS PC 101 Old York Road, One Abington Plaza Suite 301 Jenkintown PA 19046 Pedodontist Montgomery Bresler Joshua 025055 David A Bresler DDS PC 101 Old York Road, One Abington Plaza Suite 301 Jenkintown PA 19046 Pedodontist Montgomery Mayzenberg Julia 025055 David A Bresler DDS PC 101 Old York Road, One Abington Plaza Suite 301 Jenkintown PA 19046 Pedodontist Montgomery Schoengold Irwin 001098 I.N. Schoengold, D.M.D. & S.J. Ziccinolfi, D.M.D. The Pavilion - Suite 323, 261 Old York Road Jenkintown PA 19046 Endodontist Montgomery Zicchnolfi Steven 001098 I.N. Schoengold, D.M.D. & S.J. Ziccinolfi, D.M.D. The Pavilion - Suite 323, 261 Old York Road Jenkintown PA 19046 Endodontist Montgomery Evian Cyril 000736 Cyril I Evian, D.M.D. 10112 Valley Forge Circle, Suite 112 King Of Prussia PA 19406 Periodontist Montgomery Wohar Robert 000733 Robert M. Wohar, D.M.D. 357 Gulph Rd, 200 King Of Prussia PA 19406 Oral Surgeon Montgomery * Javier Bonifacio 000391 Sumney Forge Family Dentistry 850 S. Valley Forge Rd. Lansdale PA 19446 General Provider Montgomery Iskender Azad 050876 Confident Smile Dental 3 West Ridge Pike Limerick PA 19468 General Provider Montgomery Hodges Kellyn 050527 Dr Kellyn Hodges DMD 411 Doylestown Rd Montgomeryville PA 18936 Orthodontist Montgomery Habboush Sarmad 069566 Essex Dental 106 N Essex Ave, Suite C Narberth PA 19072 General Provider Montgomery Reddy Konreddy 001928 A-One Dental Care 11 West LaFayette St. Norristown PA 19401 General Provider Montgomery Rothman Marc 000713 Bernard N. Rothman, D.D.S., P.A. 1325 West Airy Street Norristown PA 19401 Oral Surgeon Montgomery Hockman Donald 000509 Donald F. Hockman, D.D.S. 323 W Johnson Hwy Norristown PA 19401 General Provider Montgomery Carp Brian 000501 Moses & Carp Dental Associates 610 W. Marshall St. Norristown PA 19401 General Provider Montgomery Yu Paul 000501 Moses & Carp Dental Associates 610 W. Marshall St. Norristown PA 19401 General Provider Montgomery Levito, Jr Vincent 061258 Vincent J Levito Jr DMD PC Family & Cosmetic Denti 1733 Markley St Norristown PA 19401 General Provider Montgomery Elbardissi Angel 000835 Angel W. Elbardissi, D.D.S. 210 Stump Road North Wales PA 19454 General Provider Montgomery Kim Tae-Soo 072104 Apple Family Dentist 275 Deklab Pike North Wales PA 19454 General Provider Montgomery Charkas Ahmad 070962 Allied Orthodontics PC 450 Cresson Blvd, Suite 120 Oaks PA 19456 Orthodontist Montgomery Evans Marianna 070962 Allied Orthodontics PC 450 Cresson Blvd, Suite 120 Oaks PA 19456 Orthodontist Montgomery Desai Kaushal 070932 American Family Dental Care 450 Cresson Blvd, Suite 210 Oaks PA 19456 General Provider Montgomery Kopp Anatoliy 070932 American Family Dental Care 450 Cresson Blvd, Suite 210 Oaks PA 19456 General Provider Montgomery Savani Bhaskar 070932 American Family Dental Care 450 Cresson Blvd, Suite 210 Oaks PA 19456 General Provider Montgomery Savani Bhumi 070932 American Family Dental Care 450 Cresson Blvd, Suite 210 Oaks PA 19456 General Provider Montgomery Yoon Jaewon 070932 American Family Dental Care 450 Cresson Blvd, Suite 210 Oaks PA 19456 General Provider Montgomery Abbott Allyson 002020 Allyson A. Abbott, D.M.D. 2050 Butler Pike, Suite 300 Plymouth Meeting PA 19462 Endodontist Montgomery Kachur Elena 050885 Plymouth Greene Dental Associates 1000 Germantown Pike, Suite F4 Plymouth Meeting PA 19462 General Provider Montgomery Plotkin Richard 001038 Richard J. Plotkin, D.M.D. 531 W. Germantown Pike, Suite 204 Plymouth Meeting PA 19462 Oral Surgeon Montgomery Zhang Ning 037693 All Smile Dental Care 393 N Lewis Rd Royersford PA 19468 General Provider Montgomery Agrawal Avanti 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Ahmadzadeh Bijan 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Dapkute Ingrida 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Derosa Daniel 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Desai Kaushal 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Gajendran Bobby 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Gombar Anna 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Kopp Anatoliy 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Lee Young 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Merin Jared 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Mitelman Alexandra 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Moriarty Sean 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Savani Bhaskar 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Savani Bhumi 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Savani Niranjan 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Todd Meredith 050385 A+ Family Dental Care PC 744 Route 113 N Souderton PA 18964 General Provider Montgomery Bhatnagar Payal 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Chadha Chandan 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Chaudhry Ahmad 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Kim Peter 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Malhotra Swati 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Obaid Michel 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Rajput Bhumika 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Sambaraju Haritha 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Withanachchi Janatha 002580 Aspen Dental 841 South 25th Street Easton PA 18045 Endodontist Northampton Yi Tyler 002580 Aspen Dental 841 South 25th Street Easton PA 18045 General Provider Northampton Chacker Laurence 002146 Associated Dental Specialties 1601Walnut Street, Suite 201 Philadelphia PA 19102 Periodontist Philadelphia Weinberg Martin 000905 Drs. Weinberg & Goldberg, D.D.S. 1528 Walnut Street, Suite 1725 Philadelphia PA 19102 General Provider Philadelphia Braid Stanton 001457 Stanton Braid, D.M.D. 1521 Locust Street, Suite 100 Philadelphia PA 19102 Oral Surgeon Philadelphia Tinkelman Carl 001318 Carl L. Tinkelman, D.M.D., PC 255 South 17th Street, Ste.1806 Philadelphia PA 19103 Endodontist Philadelphia Aranbayev Yefim 069968 Dentex Dental Group Ltd 1625 Chestnut St, Suite 228 Philadelphia PA 19103 General Provider Philadelphia Choi Bokyu 069968 Dentex Dental Group Ltd 1625 Chestnut St, Suite 228 Philadelphia PA 19103 General Provider Philadelphia Cohen Ronald 069968 Dentex Dental Group Ltd 1625 Chestnut St, Suite 228 Philadelphia PA 19103 General Provider Philadelphia * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 31 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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