Select Plan Provider Directory - Dominion Dental Services, Inc.
Select Plan Provider Directory - Dominion Dental Services, Inc.
Select Plan Provider Directory - Dominion Dental Services, Inc.
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SELECT PLAN 1 DENTIST DIRECTORY<br />
Dentists listed are under contract as of 10/1/12<br />
Last Name First Name Fac ID <strong>Dental</strong> Office Name Office Address City ST ZIP Discipline County<br />
Patel Chirag 000567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd., #205 Laurel MD 20708 Oral Surgeon Prince Georges<br />
Robinson Brian 000567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd., #205 Laurel MD 20708 Oral Surgeon Prince Georges<br />
Stark Mitchell 000567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd., #205 Laurel MD 20708 Oral Surgeon Prince Georges<br />
Trinh Huy 000567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd., #205 Laurel MD 20708 Oral Surgeon Prince Georges<br />
Criscitiello Kevin 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
DeMizio Peter 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Oral Surgeon Prince Georges<br />
Elrafei Mohamed 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Ganjavian Babak 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Gentile Michael 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Oral Surgeon Prince Georges<br />
Ghajarnia Katayoun 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Ghajarnia M. Reza 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Orthodontist Prince Georges<br />
Jun Sung 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Mankiewicz Ryan 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Masood Arif 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Steinberg Wayne 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Tchakarova Ludmila 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Ulery Scott 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Weiss Karl 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Orthodontist Prince Georges<br />
Wolf Christopher 002118 Ulery <strong>Dental</strong> & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General <strong>Provider</strong> Prince Georges<br />
Harmon David 061300 David E Harmon Jr DDS MSD PA 10264 Lake Arbor Way Mitchellville MD 20721 Orthodontist Prince Georges<br />
Frankenberry Anishka 000324 David G. O'Neal, D.D.S., & Assoc. 6188 Oxon Hill Rd., Suite 200 Oxon Hill MD 20745 Orthodontist Prince Georges<br />
O'Neal David 000324 David G. O'Neal, D.D.S., & Assoc. 6188 Oxon Hill Rd., Suite 200 Oxon Hill MD 20745 General <strong>Provider</strong> Prince Georges<br />
Rasul Afia 000324 David G. O'Neal, D.D.S., & Assoc. 6188 Oxon Hill Rd., Suite 200 Oxon Hill MD 20745 General <strong>Provider</strong> Prince Georges<br />
Meyer Emory 061335 E Ross Meyer DDS 6130 Oxon Hill Rd, Suite 305 Oxon Hill MD 20745 Oral Surgeon Prince Georges<br />
Monroe Quentin 037629 Quentin E Monroe <strong>Dental</strong> <strong>Services</strong> 5448 St. Barnabas Rd. Oxon Hill MD 20745 General <strong>Provider</strong> Prince Georges<br />
Ruderman Carl 000555 Carl Ruderman DDS PA 6315 Baltimore Ave. Riverdale MD 20737 Oral Surgeon Prince Georges<br />
* Blumenfeld Frederick 000210 The <strong>Dental</strong> Group 6200 Baltimore Ave., Ste. 200 Riverdale MD 20737 General <strong>Provider</strong> Prince Georges<br />
* Digregorio Anthony 000210 The <strong>Dental</strong> Group 6200 Baltimore Ave., Ste. 200 Riverdale MD 20737 General <strong>Provider</strong> Prince Georges<br />
* Pourhmad Haghig Payam 000210 The <strong>Dental</strong> Group 6200 Baltimore Ave., Ste. 200 Riverdale MD 20737 General <strong>Provider</strong> Prince Georges<br />
* Sease, Jr. Tillman 000210 The <strong>Dental</strong> Group 6200 Baltimore Ave., Ste. 200 Riverdale MD 20737 General <strong>Provider</strong> Prince Georges<br />
* Tajick Ramien 000210 The <strong>Dental</strong> Group 6200 Baltimore Ave., Ste. 200 Riverdale MD 20737 General <strong>Provider</strong> Prince Georges<br />
Regil Teresa 002850 The <strong>Dental</strong> Group - Teresa Regil, D.D.S. 6200 Baltimore Avenue, Suite 200 Riverdale MD 20737 Pedodontist Prince Georges<br />
Frankle Kathleen 002849 The <strong>Dental</strong> Group Specialists 6200 Baltimore Ave. Riverdale MD 20737 Endodontist Prince Georges<br />
Park Sarah 002849 The <strong>Dental</strong> Group Specialists 6200 Baltimore Ave. Riverdale MD 20737 Periodontist Prince Georges<br />
Smith Dezrie 016470 Suitland <strong>Dental</strong> Center 4814 Silver Hill Road Suitland MD 20746 General <strong>Provider</strong> Prince Georges<br />
Obianwu Chilo 037663 All Smiles <strong>Dental</strong> Care 3847 Branch Ave, Suite 124 Temple Hills MD 20748 General <strong>Provider</strong> Prince Georges<br />
Kang Sinha 079801 <strong>Dental</strong> Associates of Greater MD at Temple Hills 6339 Allentown Road, Suite E Temple Hills MD 20748 General <strong>Provider</strong> Prince Georges<br />
Park Stanley 079801 <strong>Dental</strong> Associates of Greater MD at Temple Hills 6339 Allentown Road, Suite E Temple Hills MD 20748 General <strong>Provider</strong> Prince Georges<br />
Yoon Jangyeul 079801 <strong>Dental</strong> Associates of Greater MD at Temple Hills 6339 Allentown Road, Suite E Temple Hills MD 20748 General <strong>Provider</strong> Prince Georges<br />
Granger Kevin 051072 Oral Health Associates 4316 St Barnabas Rd Temple Hills MD 20748 General <strong>Provider</strong> Prince Georges<br />
Klapper Harry 000187 Harry J. Klapper, D.D.S. 5749 Crain Hwy. Upper Marlboro MD 20772 General <strong>Provider</strong> Prince Georges<br />
Hlousek Lubor 001441 Walzer Sullivan and Hlousek PA 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes<br />
Jones Kurt 001441 Walzer Sullivan and Hlousek PA 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes<br />
Sullivan Cornelius 001441 Walzer Sullivan and Hlousek PA 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes<br />
Walzer Clifford 001441 Walzer Sullivan and Hlousek PA 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes<br />
Doumit Antoine 061331 Antoine Doumit DMD CAGS PC 23140 Moakley St, Suite 3 Leonardtown MD 20650 Orthodontist Saint Marys<br />
Robertson Robert 000462 Antietam Valley <strong>Dental</strong> Center 1246 Maryland Avenue Hagerstown MD 21740 General <strong>Provider</strong> Washington<br />
Robertson Robert 068461 Antietam Valley <strong>Dental</strong> Center 257 W Main St Hancock MD 21750 General <strong>Provider</strong> Washington<br />
Forno Donald 037588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico<br />
Lee Young 037588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico<br />
Quillin Bartley 037588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico<br />
Viertl George 002319 George C. Viertl, D.D.S., P.C. 560 Riverside Dr., Suite B206 Salisbury MD 21801 General <strong>Provider</strong> Wicomico<br />
Ascher Lynn 001557 Lynn F. Ascher, D.M.D., P.A. 560 Riverside Drive, Suite B-201 Salisbury MD 21801 Oral Surgeon Wicomico<br />
Jain Arvind 002767 Delaware Maryland <strong>Dental</strong> 123 West College Ave. Salisbury MD 21804 General <strong>Provider</strong> Wicomico<br />
Steinberg Robert 033847 Robert D Steinberg DDS 11204 Racetrack Rd, Pavillions Suite 102 Ocean Pines MD 21811 General <strong>Provider</strong> Worcester<br />
Jahansouz Maryam 002603 Sunflower <strong>Dental</strong> Group 90 Main Street, Suite 203 Hackensack NJ 07601 General <strong>Provider</strong> Bergen<br />
Greenberg Jessica 002693 North Arlington Orthodontics 64 Ridge Rd. N Arlington NJ 07031 Orthodontist Bergen<br />
Chew Dennis 000395 Cosmopolitan <strong>Dental</strong> LLC 10000 Lincoln Dr E, Suite 106 Marlton NJ 08053 General <strong>Provider</strong> Burlington<br />
Tinkelman Carl 001319 Stephen E. Shpeen, D.M.D., PC 30 Jackson Rd., Suite C Medford NJ 08055 Endodontist Burlington<br />
Blumenthal Mitchel 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Casey Joseph 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Choksi Raj 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Costello William 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Gershkovich Candace 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Khan Aliya 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 General <strong>Provider</strong> Camden<br />
Koff Howard 002809 American <strong>Dental</strong> Care, PA 61 S. Blackhorse Pike Blackwood NJ 08012 Orthodontist Camden<br />
* Indicates dentist that is accepting current patients only.<br />
All <strong>Select</strong> <strong>Plan</strong> Dentists Page 9<br />
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<br />
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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