Participating Dentists - GEHA Connection Dental Federal
Participating Dentists - GEHA Connection Dental Federal
Participating Dentists - GEHA Connection Dental Federal
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DENTAL<br />
DIRECTORY
CONNECTION <strong>Dental</strong> Network<br />
Table of Contents<br />
Adams County ..................................................................................................3<br />
Allamakee County .............................................................................................3<br />
Audubon County ...............................................................................................3<br />
Benton County ..................................................................................................3<br />
Black Hawk County...........................................................................................3<br />
Bremer County .................................................................................................3<br />
Carroll County ..................................................................................................3<br />
Cass County ......................................................................................................3<br />
Cerro Gordo County .........................................................................................3<br />
Clayton County .................................................................................................3<br />
Dallas County ...................................................................................................3<br />
Decatur County .................................................................................................3<br />
Des Moines County ............................................................................................3<br />
Dickinson County ..............................................................................................3<br />
Dubuque County ...............................................................................................3<br />
Fayette County ..................................................................................................3<br />
Floyd County ....................................................................................................3<br />
Greene County ..................................................................................................3<br />
Hardin County ..................................................................................................3<br />
Harrison County ...............................................................................................3<br />
Jones County ....................................................................................................4<br />
Linn County......................................................................................................4<br />
Mills County .....................................................................................................4<br />
Mitchell County ................................................................................................4<br />
O'Brien County .................................................................................................4<br />
Osceola County .................................................................................................4<br />
This directory of providers may change from time to time for any number of reasons. Such changes may sometimes<br />
occur before a new directory can be printed. CONNECTION <strong>Dental</strong> does not guarantee the continued participation of<br />
the providers listed or that participating providers are available in all areas. Please refer to your benefit booklet for a<br />
complete description of your plan's coverage, limits, and exclusions.
Table of Contents<br />
Polk County ......................................................................................................4<br />
Pottawattamie County .......................................................................................4<br />
Scott County .....................................................................................................4<br />
Tama County ....................................................................................................5<br />
Taylor County ...................................................................................................5<br />
Union County....................................................................................................5<br />
Warren County .................................................................................................5<br />
Woodbury County .............................................................................................5<br />
Index of <strong>Participating</strong> <strong>Dentists</strong> ..............................................................................7<br />
Provider Nomination Form ....................................................................................9<br />
This directory of providers may change from time to time for any number of reasons. Such changes may sometimes<br />
occur before a new directory can be printed. CONNECTION <strong>Dental</strong> does not guarantee the continued participation of<br />
the providers listed or that participating providers are available in all areas. Please refer to your benefit booklet for a<br />
complete description of your plan's coverage, limits, and exclusions.
Adams County<br />
ADAMS COUNTY<br />
General Dentistry<br />
King, John T DDS<br />
504 8th St<br />
Corning, IA 50841<br />
(515) 322-3146<br />
ALLAMAKEE<br />
COUNTY<br />
General Dentistry<br />
Carlson, Bruce A DDS<br />
267 Main St<br />
Lansing, IA 52151<br />
(563) 538-4673<br />
AUDUBON<br />
COUNTY<br />
General Dentistry<br />
Schultz, Paul R DDS<br />
400 N Park Place<br />
Audubon, IA 50025<br />
(712) 563-2659<br />
BENTON<br />
COUNTY<br />
General Dentistry<br />
Sheronick, James K DDS<br />
201 1st Ave<br />
Van Horne, IA 52346<br />
(319) 228-8404<br />
BLACK HAWK<br />
COUNTY<br />
General Dentistry<br />
Bierciewska, Halina B<br />
DDS<br />
2765 Crossroads Blvd<br />
Waterloo, IA 50702<br />
(319) 233-2400<br />
Eastman, Chris DDS<br />
2765 Crossroads Blvd<br />
Waterloo, IA 50702<br />
(319) 233-2400<br />
Friedman, Thomas G<br />
DDS<br />
1047 Thorndale Ave<br />
Waterloo, IA 50701<br />
(319) 235-0164<br />
Wirth, Michael J DDS<br />
1029 W 4th St<br />
Waterloo, IA 50702<br />
(319) 235-0361<br />
BREMER<br />
COUNTY<br />
General Dentistry<br />
Haw, Richard C DDS<br />
113 W 1st St<br />
Sumner, IA 50674<br />
(563) 578-5232<br />
CARROLL<br />
COUNTY<br />
General Dentistry<br />
Berning, David L DDS<br />
409 W 7th St<br />
Carroll, IA 51401<br />
(712) 792-4776<br />
CASS COUNTY<br />
General Dentistry<br />
Kreifels, Timothy J DDS<br />
402 Poplar St<br />
Atlantic, IA 50022<br />
(712) 243-3275<br />
CERRO GORDO<br />
COUNTY<br />
General Dentistry<br />
Bierciewska, Halina B<br />
DDS<br />
4199 4th St<br />
Mason City, IA 50401<br />
(641) 423-9000<br />
McGregor, Michael DDS<br />
4199 4th St SW<br />
Mason City, IA 50401<br />
(641) 423-9000<br />
CLAYTON<br />
COUNTY<br />
General Dentistry<br />
Arvidson, James R DDS<br />
228 Main St<br />
McGregor, IA 52157<br />
(563) 873-3780<br />
Barron, John D DDS<br />
511 N Bluff<br />
Guttenberg, IA 52052<br />
(563) 252-2150<br />
Iowa<br />
<strong>Participating</strong> <strong>Dentists</strong><br />
DALLAS<br />
COUNTY<br />
General Dentistry<br />
Colwell, Gary W DDS<br />
906 Main St<br />
Adel, IA 50003<br />
(515) 993-3522<br />
DECATUR<br />
COUNTY<br />
General Dentistry<br />
Lesan, Terry B DDS<br />
1330 E Main St<br />
Lamoni, IA 50140<br />
(641) 784-6059<br />
DES MOINES<br />
COUNTY<br />
General Dentistry<br />
Bierciewska, Halina B<br />
DDS<br />
401 S Gear Ave<br />
Suite 101<br />
West Burlington, IA 52655<br />
(319) 754-1800<br />
DICKINSON<br />
COUNTY<br />
General Dentistry<br />
Fischer, Frederic R DDS<br />
2606 17th St<br />
Spirit Lake, IA 51360<br />
(712) 336-3037<br />
DUBUQUE<br />
COUNTY<br />
General Dentistry<br />
Bierciewska, Halina B<br />
DDS<br />
3432 Dodge St<br />
Dubuque, IA 52003<br />
(563) 557-0500<br />
Ghosheh, Natalie J DDS<br />
1645 John F Kennedy Rd<br />
Dubuque, IA 52002<br />
(563) 556-6383<br />
McDevitt, Lacy DDS<br />
3432 Dodge St<br />
Dubuque, IA 52003<br />
(563) 557-0500<br />
This list is subject to change.<br />
3<br />
Nemmers, James J DDS<br />
968 W 3rd<br />
Suite 100<br />
Dubuque, IA 52001<br />
(563) 583-5617<br />
Souto, William T DDS<br />
1789 Elm St<br />
Suite A<br />
Dubuque, IA 52001<br />
(563) 690-2863<br />
Walgren, James C DDS<br />
1122 Rockdale Rd<br />
Dubuque, IA 52003<br />
(563) 556-2650<br />
Pediatric Dentistry<br />
Cheung, Frederick K<br />
DDS<br />
1645 John F Kennedy Rd<br />
Dubuque, IA 52002<br />
(563) 556-6383<br />
FAYETTE<br />
COUNTY<br />
General Dentistry<br />
Bennett, Thomas L DDS<br />
104 N Walnut<br />
West Union, IA 52175<br />
(563) 422-3626<br />
Berryman, Clinton T<br />
DDS<br />
216 E Charles St<br />
Oelwein, IA 50662<br />
(319) 283-4981<br />
FLOYD COUNTY<br />
General Dentistry<br />
Buehler, Jodie A DDS<br />
705 N Main St<br />
Suite 3<br />
Charles City, IA 50616<br />
(641) 228-2936<br />
GREENE<br />
COUNTY<br />
General Dentistry<br />
Teusch, James R DDS<br />
207 W State St<br />
Jefferson, IA 50129<br />
(515) 386-4128<br />
Harrison County<br />
HARDIN<br />
COUNTY<br />
General Dentistry<br />
Stickrod, Dean R DDS<br />
1310 Washington St<br />
Eldora, IA 50627<br />
(641) 939-3214<br />
HARRISON<br />
COUNTY<br />
General Dentistry<br />
Garvey, Jeffrey T DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
Hermsen, Michael S DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
Macaitis, Michael K DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
Pietro, James Vincent<br />
DDS<br />
214 E Erie<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
Steckler, Kimberly A<br />
DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
Swartz, Thomas DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 - 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
Wang, Ruo-Yu J DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136
Harrison County<br />
Yang, Patty I DDS<br />
214 E Erie St<br />
Missouri Valley, IA 51555<br />
(712) 642-4136<br />
73 7th St<br />
Woodbine, IA 51579<br />
(712) 647-2450<br />
JONES COUNTY<br />
General Dentistry<br />
Oldham, Debra K DDS<br />
702 W Main St<br />
Anamosa, IA 52205<br />
(319) 462-2531<br />
Slater, Joslyn A DDS<br />
702 W Main St<br />
Anamosa, IA 52205<br />
(319) 462-2531<br />
Wolken, Richard J DDS<br />
216 N Main St<br />
Monticello, IA 52310<br />
(319) 465-4666<br />
LINN COUNTY<br />
General Dentistry<br />
Bahadur, Shachindra<br />
DDS<br />
2315 Edgewood Rd SW<br />
Cedar Rapids, IA 52404<br />
(319) 390-1400<br />
Bierciewska, Halina B<br />
DDS<br />
2315 Edgewood Rd SW<br />
Suite 160<br />
Cedar Rapids, IA 52404<br />
(319) 390-1400<br />
Choi, Charles J DDS<br />
3500 Center Point Rd NE<br />
Suite 3<br />
Cedar Rapids, IA 52402<br />
(319) 393-4828<br />
Wolken, Richard J DDS<br />
159 Marion Blvd<br />
Marion, IA 52302<br />
(319) 377-4225<br />
MILLS COUNTY<br />
General Dentistry<br />
Lothrop, Robert DDS<br />
112 S Vine<br />
Glenwood, IA 51534<br />
(712) 527-4854<br />
Weber, Calvin A DDS<br />
208 N Walnut St<br />
Glenwood, IA 51534<br />
(712) 527-4801<br />
Weber, George C DDS<br />
208 N Walnut St<br />
Glenwood, IA 51534<br />
(712) 527-4801<br />
MITCHELL<br />
COUNTY<br />
General Dentistry<br />
Buhrow, Guy R DDS<br />
816 N 8th St<br />
Osage, IA 50461<br />
(641) 732-4465<br />
O'BRIEN<br />
COUNTY<br />
General Dentistry<br />
Vander Berg, Michael<br />
DDS<br />
813 3rd Ave<br />
Sheldon, IA 51201<br />
(712) 324-3124<br />
OSCEOLA<br />
COUNTY<br />
General Dentistry<br />
Hauck, James M DDS<br />
106 Cedar Ln<br />
Sibley, IA 51249<br />
(712) 754-2761<br />
Johnson, Jerry L DDS<br />
611 3rd Ave<br />
Sibley, IA 51249<br />
(712) 754-2288<br />
Vadnais, Valerie M DMD<br />
611 3rd Ave<br />
Sibley, IA 51249<br />
(712) 754-2288<br />
POLK COUNTY<br />
General Dentistry<br />
Bates, Robert S DDS<br />
3710 Merle Hay Rd<br />
Des Moines, IA 50310<br />
(515) 270-1646<br />
Bierciewska, Halina B<br />
DDS<br />
2409 SE Delaware Ave<br />
Suite 100<br />
Ankeny, IA 50021<br />
(515) 963-4343<br />
4930 SE 14th St<br />
Des Moines, IA 50320<br />
(515) 953-6000<br />
Iowa<br />
<strong>Participating</strong> <strong>Dentists</strong><br />
Campbell, John E DDS<br />
215 Euclid Ave<br />
Des Moines, IA 50313<br />
(515) 288-1343<br />
Forsberg, Angela DDS<br />
2409 SE Delaware Ave<br />
Suite 100<br />
Ankeny, IA 50021<br />
(515) 963-4343<br />
Jennings, Adrienne<br />
DDS<br />
3710 Merle Hay Rd<br />
Des Moines, IA 50310<br />
(515) 270-1615<br />
Lubow, Richard M DMD<br />
4930 SE 14th St<br />
Des Moines, IA 50320<br />
(515) 953-6000<br />
McDevitt, Lacy DDS<br />
4930 SE 14th St<br />
Des Moines, IA 50320<br />
(515) 953-6000<br />
Meyer, John W DDS<br />
1701 22nd St<br />
Suite 101<br />
West Des Moines, IA 50266<br />
(515) 224-4867<br />
Nordmark, Boyd N DDS<br />
619 W Euclid Ave<br />
Des Moines, IA 50313<br />
(515) 243-2221<br />
Rieck, Terry R DDS<br />
4019 Ingersoll Ave<br />
Des Moines, IA 50312<br />
(515) 255-1195<br />
Sterba, Wayne DDS<br />
3710 Merle Hay Rd<br />
Des Moines, IA 50310<br />
(515) 270-1646<br />
Timmerman, Clinton S<br />
DDS<br />
11088 Hickman Rd<br />
Clive, IA 50325<br />
(515) 278-2253<br />
3710 Merle Hay Rd<br />
Des Moines, IA 50310<br />
(515) 270-1615<br />
Tongsiri, Amy DDS<br />
3710 Merle Hay Rd<br />
Des Moines, IA 50310<br />
(515) 270-1615<br />
POTTAWATTAM<br />
IE COUNTY<br />
General Dentistry<br />
Allen, Amber M DDS<br />
114 1/2 S 6th St<br />
Council Bluffs, IA 51501<br />
(712) 325-1544<br />
This list is subject to change.<br />
4<br />
Cardenzana, Andrea L<br />
DDS<br />
427 E Kanesville Blvd<br />
Suite 200<br />
Council Bluffs, IA 51503<br />
(712) 322-5318<br />
Colwell, Robert F DDS<br />
114 1/2 S 6th St<br />
Council Bluffs, IA 51501<br />
(712) 325-1544<br />
306 Front St<br />
Neola, IA 51559<br />
(712) 485-2033<br />
Dudzinski, Bernard P<br />
DDS<br />
2800 Twin City Plaza<br />
Suite 1R<br />
Council Bluffs, IA 51501<br />
(712) 366-7077<br />
Eischeid, Raymond H<br />
DDS<br />
427 E Kanesville Blvd<br />
Council Bluffs, IA 51503<br />
(712) 323-8402<br />
Garvey, Jeffrey T DDS<br />
114 1/2 S 6th St<br />
Council Bluffs, IA 51501<br />
(712) 325-1544<br />
Greer, Edward P DDS<br />
1920 Rue St<br />
Suite 2<br />
Council Bluffs, IA 51503<br />
(712) 329-8932<br />
Hale, Laura L DDS<br />
114 1/2 S 6th St<br />
Council Bluffs, IA 51501<br />
(712) 325-1544<br />
Higginbotham, Brad D<br />
DDS<br />
200 S 29th St<br />
Council Bluffs, IA 51501<br />
(712) 323-5801<br />
Johnson, J Terry DDS<br />
427 E Kanesville Blvd<br />
Suite 306<br />
Council Bluffs, IA 51503<br />
(712) 328-1885<br />
Lenaghan, Timothy J<br />
DDS<br />
320 Oakland Ave<br />
Oakland, IA 51560<br />
(712) 482-3316<br />
McArdle, Kent E DDS<br />
2800 Twin City Plaza<br />
Suite 1R<br />
Council Bluffs, IA 51501<br />
(712) 366-7077<br />
McGuire, Mark W DDS<br />
114 1/2 S 6th St<br />
Co Bluffs, IA 51501<br />
(712) 325-1544<br />
Scott County<br />
Ott, Sarah L DMD<br />
2800 Twin City Dr<br />
Council Bluffs, IA 51501<br />
(712) 366-7077<br />
Perry, Robert S DDS<br />
532 1st Ave<br />
Suite 210<br />
Council Bluffs, IA 51503<br />
(712) 322-3974<br />
Pietro, James Vincent<br />
DDS<br />
114 S 6th St<br />
Council Bluffs, IA 51501<br />
(712) 325-1544<br />
Rensch, Michael A DDS<br />
1601 McPherson Ave<br />
Suite 500<br />
Council Bluffs, IA 51503<br />
(712) 328-1810<br />
Ronk, Richard J DDS<br />
200 S 29th St<br />
Council Bluffs, IA 51501<br />
(712) 322-7912<br />
Schierbrock, Thomas R<br />
DDS<br />
427 E Kanesville Blvd<br />
Suite 200<br />
Council Bluffs, IA 51503<br />
(712) 322-5318<br />
Steg, Thomas B DDS<br />
317 Main<br />
PO Box 231<br />
Minden, IA 51553<br />
(712) 483-2122<br />
Warner, Richard W DDS<br />
1840 Madison Ave<br />
Suite 1<br />
Council Bluffs, IA 51503<br />
(712) 328-1100<br />
SCOTT COUNTY<br />
General Dentistry<br />
Alpen, Scott A DDS<br />
3575 Jersey Ridge Rd<br />
Davenport, IA 52807<br />
(563) 322-4433<br />
Baumgarten, Jameson C<br />
DMD<br />
4346 E 53rd St<br />
Davenport, IA 52807<br />
(563) 355-5393<br />
Griebahn, Lynn R DDS<br />
1905 Main St<br />
Davenport, IA 52803<br />
(563) 323-2571<br />
Hathaway, Alan D DDS<br />
1333 W Lombard St<br />
Davenport, IA 52804<br />
(563) 322-1451
Scott County<br />
Jennings, Valerie B DDS<br />
4624 Progress Dr<br />
Suite E<br />
Davenport, IA 52807<br />
(563) 355-1251<br />
Kramer, Margaret A DDS<br />
1905 N Main St<br />
Davenport, IA 52803<br />
(563) 323-2571<br />
Mueller, Gene V DDS<br />
2228 Hickory Grove Rd<br />
Davenport, IA 52804<br />
(563) 324-0212<br />
Twyner-Coley, Kathleen<br />
D DDS<br />
121 W Locust St<br />
Davenport, IA 52803<br />
(563) 322-7059<br />
TAMA COUNTY<br />
General Dentistry<br />
McLaughlin, Michael A<br />
DDS<br />
407 Wilson St<br />
Dysart, IA 52224<br />
(319) 476-4110<br />
TAYLOR<br />
COUNTY<br />
General Dentistry<br />
Sawyer, Steven DDS<br />
201 N Main<br />
Lenox, IA 50851<br />
(641) 333-4664<br />
UNION COUNTY<br />
General Dentistry<br />
Scott, William T DDS<br />
304 W Lucas<br />
Creston, IA 50801<br />
(641) 782-7587<br />
WARREN<br />
COUNTY<br />
General Dentistry<br />
Boone, Alan L DDS<br />
204 S Howard<br />
Indianola, IA 50125<br />
(515) 961-2125<br />
Cooney, Thomas R DDS<br />
215 N Buxton<br />
Indianola, IA 50125<br />
(515) 961-5351<br />
Lindeberg, Michael T<br />
DDS<br />
212 N Buxton St<br />
Indianola, IA 50125<br />
(515) 961-0534<br />
Zaborac, David A DDS<br />
212 N Buxton St<br />
Indianola, IA 50125<br />
(515) 961-0534<br />
WOODBURY<br />
COUNTY<br />
General Dentistry<br />
Clark, Thomas J DDS<br />
214 Main St<br />
Moville, IA 51039<br />
(712) 873-3525<br />
Iowa<br />
<strong>Participating</strong> <strong>Dentists</strong><br />
This list is subject to change.<br />
5<br />
Woodbury County
A<br />
Allen, Amber M DDS ....................................4<br />
Alpen, Scott A DDS.......................................4<br />
Arvidson, James R DDS ................................3<br />
B<br />
Bahadur, Shachindra DDS ............................4<br />
Barron, John D DDS ......................................3<br />
Bates, Robert S DDS......................................4<br />
Baumgarten, Jameson C DMD ......................4<br />
Bennett, Thomas L DDS ................................3<br />
Berning, David L DDS ..................................3<br />
Berryman, Clinton T DDS .............................3<br />
Bierciewska, Halina B DDS ......................3, 4<br />
Boone, Alan L DDS .......................................5<br />
Buehler, Jodie A DDS....................................3<br />
Buhrow, Guy R DDS .....................................4<br />
C<br />
Campbell, John E DDS ..................................4<br />
Cardenzana, Andrea L DDS ..........................4<br />
Carlson, Bruce A DDS ...................................3<br />
Cheung, Frederick K DDS .............................3<br />
Choi, Charles J DDS ......................................4<br />
Clark, Thomas J DDS ....................................5<br />
Colwell, Gary W DDS ...................................3<br />
Colwell, Robert F DDS ..................................4<br />
Cooney, Thomas R DDS................................5<br />
D<br />
Dudzinski, Bernard P DDS ............................4<br />
E<br />
Eastman, Chris DDS .....................................3<br />
Eischeid, Raymond H DDS ...........................4<br />
F<br />
Fischer, Frederic R DDS ................................3<br />
Forsberg, Angela DDS ..................................4<br />
Friedman, Thomas G DDS ............................3<br />
G<br />
Garvey, Jeffrey T DDS ..............................3, 4<br />
Ghosheh, Natalie J DDS ................................3<br />
Greer, Edward P DDS ....................................4<br />
Griebahn, Lynn R DDS..................................4<br />
H<br />
Hale, Laura L DDS ........................................4<br />
Hathaway, Alan D DDS .................................4<br />
Alphabetical Index of<br />
<strong>Participating</strong> <strong>Dentists</strong><br />
Hauck, James M DDS ....................................4<br />
Haw, Richard C DDS.....................................3<br />
Hermsen, Michael S DDS ..............................3<br />
Higginbotham, Brad D DDS ..........................4<br />
J<br />
Jennings, Adrienne DDS...............................4<br />
Jennings, Valerie B DDS ...............................5<br />
Johnson, J Terry DDS ...................................4<br />
Johnson, Jerry L DDS ....................................4<br />
K<br />
King, John T DDS .........................................3<br />
Kramer, Margaret A DDS ..............................5<br />
Kreifels, Timothy J DDS ...............................3<br />
L<br />
Lenaghan, Timothy J DDS ............................4<br />
Lesan, Terry B DDS ......................................3<br />
Lindeberg, Michael T DDS............................5<br />
Lothrop, Robert DDS ....................................4<br />
Lubow, Richard M DMD...............................4<br />
M<br />
Macaitis, Michael K DDS ..............................3<br />
McArdle, Kent E DDS ...................................4<br />
McDevitt, Lacy DDS ................................3, 4<br />
McGregor, Michael DDS ..............................3<br />
McGuire, Mark W DDS.................................4<br />
McLaughlin, Michael A DDS ........................5<br />
Meyer, John W DDS ......................................4<br />
Mueller, Gene V DDS....................................5<br />
N<br />
Nemmers, James J DDS.................................3<br />
Nordmark, Boyd N DDS................................4<br />
O<br />
Oldham, Debra K DDS ..................................4<br />
Ott, Sarah L DMD..........................................4<br />
P<br />
Perry, Robert S DDS ......................................4<br />
Pietro, James Vincent DDS.......................3, 4<br />
R<br />
Rensch, Michael A DDS ................................4<br />
Rieck, Terry R DDS.......................................4<br />
Ronk, Richard J DDS.....................................4<br />
This list is subject to change.<br />
7<br />
S<br />
Sawyer, Steven DDS.....................................5<br />
Schierbrock, Thomas R DDS.........................4<br />
Schultz, Paul R DDS......................................3<br />
Scott, William T DDS....................................5<br />
Sheronick, James K DDS...............................3<br />
Slater, Joslyn A DDS .....................................4<br />
Souto, William T DDS...................................3<br />
Steckler, Kimberly A DDS ............................3<br />
Steg, Thomas B DDS .....................................4<br />
Sterba, Wayne DDS ......................................4<br />
Stickrod, Dean R DDS ...................................3<br />
Swartz, Thomas DDS ...................................3<br />
T<br />
Teusch, James R DDS ...................................3<br />
Timmerman, Clinton S DDS .........................4<br />
Tongsiri, Amy DDS ......................................4<br />
Twyner-Coley, Kathleen D DDS ...................5<br />
V<br />
Vadnais, Valerie M DMD..............................4<br />
Vander Berg, Michael DDS ..........................4<br />
W<br />
Walgren, James C DDS .................................3<br />
Wang, Ruo-Yu J DDS ...................................3<br />
Warner, Richard W DDS ...............................4<br />
Weber, Calvin A DDS ...................................4<br />
Weber, George C DDS ..................................4<br />
Wirth, Michael J DDS ...................................3<br />
Wolken, Richard J DDS.................................4<br />
Y<br />
Yang, Patty I DDS .........................................4<br />
Z<br />
Zaborac, David A DDS ..................................5
Dentist Nomination Form<br />
If the dentist of your choice is not listed in this directory, you may complete this form to<br />
nominate the dentist to participate in the CONNECTION <strong>Dental</strong> Network. An application<br />
packet will be sent to eligible providers. The normal time frame for credentialing of dentists<br />
takes approximately 60 days after application has been received.<br />
Dentist Information<br />
Name: ________________________________________________________________<br />
Address: _______________________________________________________________<br />
________________________________________________________________<br />
Phone: __________________________________ Fax: _______________________<br />
Member Information<br />
Name: _______________________________________________________________<br />
Address: _______________________________________________________________<br />
_______________________________________________________________<br />
Phone: __________________________________Fax: _________________________<br />
Member Identification Number: _____________________________________________<br />
Employer Group Name: _________________________Group Number:______________<br />
Please mail the form to the following address:<br />
<strong>GEHA</strong> <strong>Dental</strong> Administration<br />
P.O. Box 455<br />
Independence, MO 64051-0455<br />
Or fax to <strong>GEHA</strong> <strong>Dental</strong> Administration at 816-257-3358<br />
Thank you for your interest in the CONNECTION <strong>Dental</strong> Network.