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 Shroff Amisha 002367 Amisha N. Shroff, D.D.S., P.C. 10320 Westlake Drive, Suite 109 Bethesda MD 20817 General Provider Montgomery Grillon George 000610 George L. Grillon, D.M.D., P.C. 10215 Fernwood Rd, Ste. 510 Bethesda MD 20817 Oral Surgeon Montgomery Sheik Mon 037698 Mon F. Sheik, DMD 15234 Spencerville Ct, 101 Burtonsville MD 20866 General Provider Montgomery Saini Viney 002832 Viney P. Saini, D.D.S., M.S., LLC 23220 Brewers Tavern Way Clarksburg MD 20871 Orthodontist Montgomery Heller Alan 032681 Alan R Heller DDS 12116 Darnestown Road, Suite L 1 Darnestown MD 20878 Orthodontist Montgomery Malhmood Arnold 004589 Arnold I Malhmood DDS 474 North Frederick Avenue Gaithersburg MD 20877 General Provider Montgomery Chung Jay 050592 Chestnut Street Cosmetic Dentistry 101 Chestnut Street, Suite 130 Gaithersburg MD 20877 General Provider Montgomery Dubin Gerry 002432 Gerry Dubin, DMD, P.C. 9069 Shady Grove Ct. Gaithersburg MD 20877 General Provider Montgomery Elkhateeb Mohammad 002854 TLC Modern Dentistry 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Le Chinh 002854 TLC Modern Dentistry 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Nguyen Helen 002854 TLC Modern Dentistry 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Nguyen Thy 002854 TLC Modern Dentistry 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Tran Quang 002854 TLC Modern Dentistry 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Lavine David 000537 Drs. Lavine and Decker 12113 Darnestown Rd Gaithersburg MD 20878 Orthodontist Montgomery Hassani Eftekhar 033884 Angamuthu & Associates DDS PA 4 Professional Dr., Suite 121 Gaithersburg MD 20879 General Provider Montgomery Jesson Vijayalakshmi 033884 Angamuthu & Associates DDS PA 4 Professional Dr., Suite 121 Gaithersburg MD 20879 General Provider Montgomery Tsintolas Chris 000544 Chris E. Tsintolas, D.D.S., M.S. 903 Russell Ave., #101 Gaithersburg MD 20879 Orthodontist Montgomery Romanow Gregory 000557 Goldblatt, Sweeney & Wise, D.D.S., MS 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Sweeney Albert 000557 Goldblatt, Sweeney & Wise, D.D.S., MS 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Wise John 000557 Goldblatt, Sweeney & Wise, D.D.S., MS 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Winnick Mark 000536 Mark B WinnickDDS PA 803 Russell Ave, #3A Gaithersburg MD 20879 Periodontist Montgomery Ghahreman Habib 000463 The Dental Suite 18218 Flower Hill Way Gaithersburg MD 20879 General Provider Montgomery Mirdamadi Behzad 000463 The Dental Suite 18218 Flower Hill Way Gaithersburg MD 20879 General Provider Montgomery Venigalla Lakshmi 004687 Family Dental Care 19729 Executive Park circle Germantown MD 20874 General Provider Montgomery Pierce Kurt 000605 Kurt A. Pierce, D.D.S., M.S. North Lake Medical Park, 19507 Doctors Drive Germantown MD 20874 Orthodontist Montgomery Tomona Natalia 037656 Natalia Tomona, D.D.S., PC 19735 Germantown Rd., Suite 140 Germantown MD 20874 Orthodontist Montgomery Liashek Peter 000551 Peter Liashek, Jr., D.D.S. 19717 Executive Pk. Circle Germantown MD 20874 Oral Surgeon Montgomery DeMizio Peter 037733 Peter S. DeMizio, DDS, Inc. 22 Executive Park Ct Germantown MD 20874 General Provider Montgomery DeMizio Peter 037733 Peter S. DeMizio, DDS, Inc. 22 Executive Park Ct Germantown MD 20874 Oral Surgeon Montgomery Lam Tony 002703 Seneca Park Dental 13529 Clopper Rd. Germantown MD 20874 General Provider Montgomery Nguyen Toan 050893 Smile Design Dental 19735 Germantown RD, Suite 170 Germantown MD 20874 General Provider Montgomery Barnett Robert 014880 Robert Barnett DDS 3720 Farragut Avenue, Suite 101 Kensington MD 20895 General Provider Montgomery Davis Gail 050796 Davis Endodontics 11908 Darnestown Rd., Suite F North Potomac MD 20878 Endodontist Montgomery Assatourian Karineh 050918 Premier Dental Clinic 17904 Georgia Ave, Suite 110 Olney MD 20832 General Provider Montgomery Dowling Thomas 000785 Thomas F. Dowling, D.D.S. 3403 Olandwood Court, Suite 201 Olney MD 20832 Orthodontist Montgomery Mahajan Dipty 097861 Key West Dental Care 9850 Keywest Ave, Suite 302 Rockville MD 20850 General Provider Montgomery Cohen Lisa 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Griffith Miari-Ann 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Kashyap Anil 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Patel Chirag 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Robinson Brian 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Stark Mitchell 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery Trinh Huy 000566 Maryland Oral Surgery Associates 14955 Shady Grove Rd., Suite 330 Rockville MD 20850 Oral Surgeon Montgomery * Kodsi Nadim 037655 North Potomac Smiles LLC 15200 Shady Grove Road, Suite 408 Rockville MD 20850 General Provider Montgomery Chang Richard 000545 Richard Chang, D.M.D. 14955 Shady Grove Rd, 310 Rockville MD 20850 Orthodontist Montgomery Atam Asugman 033849 AA Dental Clinic 751 Rockville Pike, Suite 10A Rockville MD 20852 General Provider Montgomery * Parikh Chetan 002745 Chetan H. Parikh, D.M.D., PA 5808 Hubbard Dr. Rockville MD 20852 General Provider Montgomery Ha Derrick 050814 Happy Dental 4701 Randolph Road, Suite 210 Rockville MD 20852 General Provider Montgomery * Kim Hyosik 001041 Hysosik Kim, D.D.S. 785-A Rockville Pike Rockville MD 20852 General Provider Montgomery Kishter Steven 061397 Maryland Oral Surgery Associates of Bethesda LLC 11404 Old Georgetown Rd, Suite 104 Rockville MD 20852 Oral Surgeon Montgomery Patel Chirag 061397 Maryland Oral Surgery Associates of Bethesda LLC 11404 Old Georgetown Rd, Suite 104 Rockville MD 20852 Oral Surgeon Montgomery Chung Jay 000447 Montrose Dental Office 6232 Montrose Road Rockville MD 20852 General Provider Montgomery Singer Richard 000535 Richard P. Singer, D.D.S. 11300 Rockville Pike, #1210 Rockville MD 20852 Periodontist Montgomery Tofigh Hamid 037731 Rockville Family Dental Group 5806 Hubbard Dr Rockville MD 20852 General Provider Montgomery Esfandiari Sheila 002278 Tenley Orthodontics - Sheila Esfandiari, DDS, P.C. 50 West Edmonston Drive, #205 Rockville MD 20852 Orthodontist Montgomery Atashbar Hedyeh 001753 Hedyeh Atashbar, D.D.S. 11213 Lockwood Drive Silver Spring MD 20901 General Provider Montgomery Lam Wai 097859 Wai Lam DDS PA 11253 Lockwood Dr Silver Spring MD 20901 Orthodontist Montgomery Romanow Gregory 000598 Goldblatt,Sweeney & Wise, D.D.S., P.A. 10313 Georgia Ave # 102 Silver Spring MD 20902 Oral Surgeon Montgomery Sweeney Albert 000598 Goldblatt,Sweeney & Wise, D.D.S., P.A. 10313 Georgia Ave # 102 Silver Spring MD 20902 Oral Surgeon Montgomery Wise John 000598 Goldblatt,Sweeney & Wise, D.D.S., P.A. 10313 Georgia Ave # 102 Silver Spring MD 20902 Oral Surgeon Montgomery Potluri Sumesh 072098 Silver Spring Endodontics 10301 Georgia Ave, Suite 202 Silver Spring MD 20902 Endodontist Montgomery Nuh Asma 051014 Asma Nuh DDS PA 1016 Merrimac Dr Silver Spring MD 20903 General Provider Montgomery De Marco Lisa 000826 Drs DeMarco & Tilkin PA 11120 New Hampshire Ave., Suite 402 Silver Spring MD 20904 Orthodontist Montgomery Tilkin Nancy 000826 Drs DeMarco & Tilkin PA 11120 New Hampshire Ave., Suite 402 Silver Spring MD 20904 Orthodontist Montgomery Okun Martin 043711 Martin L Okun DDS 2415 Musgrove Road, Suite 301 Silver Spring MD 20904 Orthodontist Montgomery Batrouni Ziad 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 6 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 Cohen Lisa 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Griffith Miari-Ann 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Kashyap Anil 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Patel Chirag 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Robinson Brian 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Stark Mitchell 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Trinh Huy 002627 Maryland Oral Surgery Associates, PA 11120 New Hampshire Ave., Suite 501 Silver Spring MD 20904 Oral Surgeon Montgomery Haghighiyan Majid 051079 Silver Spring Dental Care LLC 13321 New Hampshire Ave, Suite 201 Silver Spring MD 20904 General Provider Montgomery Wiltshire Cathy 072079 Straighten Up Orthodontics 2415 Musgrove Rd, Suite 307 Silver Spring MD 20904 Orthodontist Montgomery Hector Ricardo 037792 Aegis Dental Group 14440 Layhill Rd Silver Spring MD 20906 General Provider Montgomery Bayley Neil 050890 Aspen Hill Dental Specialists 13975 Connecticut Ave, Suite 200-201 Silver Spring MD 20906 Oral Surgeon Montgomery Dompkowski Douglas 050890 Aspen Hill Dental Specialists 13975 Connecticut Ave, Suite 200-201 Silver Spring MD 20906 Periodontist Montgomery Mills Cordelia 050890 Aspen Hill Dental Specialists 13975 Connecticut Ave, Suite 200-201 Silver Spring MD 20906 Endodontist Montgomery Bhangra Kuljeet 008779 Aspen Hill General And Cosmetic Dentistry 13975 Connecticut Avenue, Suite 200 Silver Spring MD 20906 General Provider Montgomery Goitom Liya 008779 Aspen Hill General And Cosmetic Dentistry 13975 Connecticut Avenue, Suite 200 Silver Spring MD 20906 General Provider Montgomery Goorah Soorita 008779 Aspen Hill General And Cosmetic Dentistry 13975 Connecticut Avenue, Suite 200 Silver Spring MD 20906 General Provider Montgomery Lee Richard 008779 Aspen Hill General And Cosmetic Dentistry 13975 Connecticut Avenue, Suite 200 Silver Spring MD 20906 Orthodontist Montgomery McLaughlin Kaye 008779 Aspen Hill General And Cosmetic Dentistry 13975 Connecticut Avenue, Suite 200 Silver Spring MD 20906 General Provider Montgomery Elkhateeb Mohammad 050327 TLC Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Le Chinh 050327 TLC Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Nguyen Helen 050327 TLC Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Tran Quang 050327 TLC Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery * Achikeh Kingsley 000339 City Place Dental 8780 Georgia Ave Silver Spring MD 20910 General Provider Montgomery Batrouni Ziad 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Cohen Lisa 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Frey Bradley 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Griffith Miari-Ann 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Kishter Steven 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Nathan Glenn 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Patel Chirag 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Robinson Brian 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Stark Mitchell 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Trinh Huy 097863 MD Oral Surgery Associates of Silver Spring LLC 1300 Spring St, Suite 316 Silver Spring MD 20910 Oral Surgeon Montgomery Moazami Negin 000844 Negin A. Moazami, D.D.S. 8630 Fenton Street, Suite 902 Silver Spring MD 20910 General Provider Montgomery Scott Stuart 038016 Scott Orthodontics 804 Pershing Dr, Suite 106 Silver Spring MD 20910 Orthodontist Montgomery Warner Oswald 000282 Warner Family Dental Center 7000 Carroll Ave. Takoma Park MD 20912 General Provider Montgomery Vaughan William 000692 William E. Vaughan, D.D.S. 7600 Maple Ave. Suite 6 Takoma Park MD 20912 General Provider Montgomery * Winkelman Peter 000192 Sterling Dental Centers 12114 Georgia Avenue Wheaton MD 20902 General Provider Montgomery Brutus Jean-Daniel 068505 Kemmerton Family Dentistry 6000 Laurel-Bowie Rd, Suite 101 Bowie MD 20715 General Provider Prince Georges Menendez Leonardo 004374 Leo F Menendez DDS 3233 Superior Lane, Suite B23 Bowie MD 20715 Oral Surgeon Prince Georges Geballa Marc 000554 Marc G Geballa DDS 6911 Laurel-Bowie Rd., #313 Bowie MD 20715 Endodontist Prince Georges McKen Neville 000332 Neville McKen, D.D.S. 3060 Mitchellville Rd, Suite 213 Bowie MD 20715 General Provider Prince Georges Davis Tanzania 014419 Tanzania Davis DDS 3231 Superior Lane, Suite A 22 Bowie MD 20715 General Provider Prince Georges * Everett Dwayne 021563 Dwayne E Everett DDS 4000 Mitchellville Road, Suite A314 Bowie MD 20716 Oral Surgeon Prince Georges Vargas Eduardo 001680 Eduardo Vargas, D.D.S., M.S., PC 2905 Mitchellville Road, Suite 109 Bowie MD 20716 Prosthodontist Prince Georges Packman Harold 000758 Harold Packman, D.M.D., PA 14999 Health Cntr, Suite 110 Bowie MD 20716 Periodontist Prince Georges Ego Osuala Derek 051031 RCT Endodontics 3060 Mitchellville Rd, Suite 108 Bowie MD 20716 Endodontist Prince Georges Orgel Adam 051031 RCT Endodontics 3060 Mitchellville Rd, Suite 108 Bowie MD 20716 Endodontist Prince Georges Taylor Ronald 051031 RCT Endodontics 3060 Mitchellville Rd, Suite 108 Bowie MD 20716 Endodontist Prince Georges Labbe Stephen 000609 Stewart & Labbe, D.D.S., P.A. 4000 Mitcheville Road, Suite 316-318 Bowie MD 20716 Orthodontist Prince Georges Stewart Lamon 000609 Stewart & Labbe, D.D.S., P.A. 4000 Mitcheville Road, Suite 316-318 Bowie MD 20716 Orthodontist Prince Georges King Michael 072078 King Oral Surgery Group at Camp Springs 5801 Allentown Rd, Suite 408 Camp Springs MD 20746 Oral Surgeon Prince Georges Davis Vincent 000161 Gentle Dental Care / Dr. Vincent Davis 9146 Edgeworth Drive Capitol Heights MD 20743 General Provider Prince Georges McKen Neville 000333 Neville McKen, D.D.S. 9171 Central Ave., Suite L9 Capitol Heights MD 20743 General Provider Prince Georges Wilson Calvin 002862 Alpha Dental Care LLC 8975 Woodyard Rd Clinton MD 20735 General Provider Prince Georges Williams Alvin 037717 Alvin B Williams DDS 9135 Piscataway Rd, #105 Clinton MD 20735 General Provider Prince Georges Ego Osuala Derek 068508 Excelsis Root Canal Specialties 9113 Brandywine Rd Clinton MD 20735 Endodontist Prince Georges * Maloney Joseph 000735 Joseph A. Maloney, D.D.S. 9131 Piscataway Rd., Suite 739 Clinton MD 20735 General Provider Prince Georges Brager Stanley 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Cherot Ani 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Eghtesadi Ali 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 Endodontist Prince Georges Ghosh Gitanjali 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Haghighiyan Majid 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Hoang-Nguyen Jacquelyn 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Hosain Rubeena 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges Kodsi Nadim 037542 College Park Dental 7305 Baltimore Ave., #204 College Park MD 20740 General Provider Prince Georges * Indicates dentist that is accepting current patients only. All Select Plan Dentists Page 7 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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