dental provider listing as of september 2013terry r riley dds: general dentistry. 107 twin lakes...

Dental Provider Listing as of September 2013

FIRST NAME LAST NAME GROUP

PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS

CITY STATE ZIP PHONE WEBSITE HEALTH

PLAN NAME

TERRY RILEY TERRY R RILEY

DDS

GENERAL

DENTISTRY

107 TWIN LAKES

MEDICAL

CENTER

ALBANY KY 42602 606 387 8372 COVENTRY


DDS

GENERAL

DENTISTRY

107 TWIN LAKES

MEDICAL

CENTER

ALBANY KY 42602 606 387 8372 FEE FOR

SERVICE


DDS

GENERAL

DENTISTRY

107 TWIN LAKES

MEDICAL

CENTER

ALBANY KY 42602 606 387 8372 WELLCARE

DANIEL BRUMMETT TALLENT

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE



COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE

ALBANY KY 42602 606 557 1023 FEE FOR

SERVICE


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE


DAVID BRUMMETT TALLENT

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE


1



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE

ALBANY KY 42602 606 557 1023 FEE FOR

SERVICE


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE


DENNY BRUMMETT TALLENT

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE



COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE

ALBANY KY 42602 606 557 1023 FEE FOR

SERVICE


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE


STEVEN TALLENT II TALLENT

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE



COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE

ALBANY KY 42602 606 557 1023 FEE FOR

SERVICE

2



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 PLAZA

DRIVE


TALLENT

COSMETIC AND

FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

108 PLAZA

DRIVE

ALBANY KY 42602 606 557 1023 FEE FOR

SERVICE

DAWN ALLEN DAWN R ALLEN

DMD

GENERAL

DENTISTRY

1107 NORTH

CROSS STREET



DMD

GENERAL

DENTISTRY

1107 NORTH

CROSS STREET

ALBANY KY 42602 606 387 6427 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1107 NORTH

CROSS STREET


SUSAN CASH SUSAN E CASH

DMD

GENERAL

DENTISTRY

111 SOUTH

CROSS STREET


SUSAN CASH SUSAN E CASH

DMD

GENERAL

DENTISTRY

111 SOUTH

CROSS STREET

ALBANY KY 42602 606 387 8339 FEE FOR

SERVICE

CHARLES MONTAGUE III CHARLES E

MONTAGUE III

DMD

GENERAL

DENTISTRY

1330 CENTRAL

AVENUE

ASHLAND KY 41101 606 329 0919 COVENTRY


MONTAGUE III

DMD

GENERAL

DENTISTRY

1330 CENTRAL

AVENUE

ASHLAND KY 41101 606 329 0919 FEE FOR

SERVICE

3



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MONTAGUE III

DMD

GENERAL

DENTISTRY

1330 CENTRAL

AVENUE

ASHLAND KY 41101 606 329 0919 WELLCARE

DAVID STEWART DAVID STEWART

DMD

GENERAL

DENTISTRY

1616 CENTRAL

AVENUE



DMD

GENERAL

DENTISTRY

1616 CENTRAL

AVENUE


SERVICE


DMD

GENERAL

DENTISTRY

1616 CENTRAL

AVENUE


MARC SCHNEIDER CARING

DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE

ASHLAND KY 41101 606 324 3552 http://www.ash

landcaringdent

istry.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE


landcaringdent

istry.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE


landcaringdent

istry.com/

WELLCARE

WILLIAM THORNER CARING

DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE


landcaringdent

istry.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE


landcaringdent

istry.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

1800 CARTER

AVENUE


landcaringdent

istry.com/

WELLCARE

4



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CARING

DENTISTRY

MULTI

SPECIALTY

GROUP

1800 CARTER

AVENUE


landcaringdent

istry.com/

FEE FOR

SERVICE

NANCY MUSSETTER PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE



DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE


SERVICE


DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE


GLENN SPRADLIN PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE



DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE


SERVICE


DENTISTRY

PEDIATRIC

DENTIST

2000 CARTER

AVENUE


CHRISTINA WEBB CHRISTINA

JORDAN WEBB

DMD PSC

GENERAL

DENTISTRY

4330 13TH

STREET



JORDAN WEBB

DMD PSC

GENERAL

DENTISTRY

4330 13TH

STREET


SERVICE

5



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


JORDAN WEBB

DMD PSC

GENERAL

DENTISTRY

4330 13TH

STREET


RONNIE SHELTON SHELTON AND

SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 COVENTRY


SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 FEE FOR

SERVICE


SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 WELLCARE

EARL SMITH SHELTON AND

SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 COVENTRY


SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 FEE FOR

SERVICE


SMITH

GENERAL

DENTISTRY

441 21ST STREET ASHLAND KY 41105 606 324 8366 WELLCARE

JOSEPH FRAZIER JOSEPH W

FRAZIER DMD PSC

GENERAL

DENTISTRY

708 13TH STREET ASHLAND KY 41101 606 325 4231 COVENTRY


FRAZIER DMD PSC

GENERAL

DENTISTRY

708 13TH STREET ASHLAND KY 41101 606 325 4231 FEE FOR

SERVICE


FRAZIER DMD PSC

GENERAL

DENTISTRY

708 13TH STREET ASHLAND KY 41101 606 325 4231 WELLCARE

EDWARD JOHNSON EDWARD L

JOHNSON DMD

GENERAL

DENTISTRY

928 STATE RT

716


SERVICE

EDWARD JOHNSON EDWARD L

JOHNSON DMD

GENERAL

DENTISTRY

928 STATE RT

716


6



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

EDWIN SMITH KIDS FIRST

DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

119 PINE STREET BARBOURVILLE KY 40906 606 546 7410 http://www.kid

sfirstdental.org

/#!

COVENTRY


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY


sfirstdental.org

/#!

FEE FOR

SERVICE


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY


sfirstdental.org

/#!

WELLCARE

KIDS FIRST

DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY


sfirstdental.org

/#!

FEE FOR

SERVICE

DEVERT OWENS SMITH AND

OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1

BARBOURVILLE KY 40906 606 546 8217 COVENTRY


OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1

BARBOURVILLE KY 40906 606 546 8217 FEE FOR

SERVICE


OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1

BARBOURVILLE KY 40906 606 546 8217 WELLCARE

7



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BOBBY SMITH SMITH AND

OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1



OWENS

GENERAL

DENTISTRY

PRACTIONER

16 WINBURN

DRIVE SUITE 1


SERVICE


OWENS

GENERAL

DENTISTRY

PRACTIONER

16 WINBURN

DRIVE SUITE 1


EDWIN SMITH SMITH AND

OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1



OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1


SERVICE


OWENS

GENERAL

DENTISTRY

16 WINBURN

DRIVE SUITE 1


ROBIN BONNELL KIDS FIRST

DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE

BARBOURVILLE KY 40906 606 546 7410 http://www.kid

sfirstdental.org

/#!

COVENTRY

8



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE


sfirstdental.org

/#!

FEE FOR

SERVICE


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE


sfirstdental.org

/#!

WELLCARE

JESSICA COOPER KIDS FIRST

DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE


sfirstdental.org

/#!

COVENTRY


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE


sfirstdental.org

/#!

FEE FOR

SERVICE


DENTAL CARE

LLC MOBILE

GENERAL

DENTISTRY

16 WINDBURN

DRIVE


sfirstdental.org

/#!

WELLCARE

A J SMITH JR BARBOURVILLE

FAMILY DENTAL

GENERAL

DENTISTRY

201 NORTH

ALLISON

AVENUE

BARBOURVILLE KY 40906 606 545 7715 http://barbourv

illefamilydenta

l.com/index.ph

p?p=258207

COVENTRY


FAMILY DENTAL

GENERAL

DENTISTRY

201 NORTH

ALLISON

AVENUE


illefamilydenta

l.com/index.ph

p?p=258207

FEE FOR

SERVICE

9



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

GENERAL

DENTISTRY

201 NORTH

ALLISON

AVENUE


illefamilydenta

l.com/index.ph

p?p=258207

WELLCARE

ROBERT DUNAWAY ROBERT A

DUNAWAY DMD

GENERAL

DENTISTRY

240

CUMBERLAND

AVENUE


ROBERT DUNAWAY ROBERT A

DUNAWAY DMD

GENERAL

DENTISTRY

240

CUMBERLAND

AVENUE


SERVICE

BRENT MCDONALD KNOX FAMILY

DENTISTRY

GENERAL

DENTISTRY

608 KNOX

STREET



DENTISTRY

GENERAL

DENTISTRY

608 KNOX

STREET


SERVICE


DENTISTRY

GENERAL

DENTISTRY

608 KNOX

STREET


KNOX FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

608 KNOX

STREET


SERVICE

BROOK MILLS BROOK MILLS

DMD

GENERAL

DENTISTRY

646

MANCHESTER

STREET



DMD

GENERAL

DENTISTRY

646

MANCHESTER

STREET


SERVICE

10



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

646

MANCHESTER

STREET


GINA MESSER GINA A MESSER

DMD

GENERAL

DENTISTRY

96 KY 3439 BARBOURVILLE KY 40906 606 546 7633 COVENTRY


DMD

GENERAL

DENTISTRY

96 KY 3439 BARBOURVILLE KY 40906 606 546 7633 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

96 KY 3439 BARBOURVILLE KY 40906 606 546 7633 WELLCARE

JAMES HAZARD J TAYLOR

HAZARD DMD

AND ASSOCIATES

GENERAL

DENTISTRY

1000 EAST JOHN

ROWAN BLVD

BARDSTOWN KY 40004 502 348 2589 FEE FOR

SERVICE

JAMES HAZARD J TAYLOR

HAZARD DMD

AND ASSOCIATES

GENERAL

DENTISTRY

1000 EAST JOHN

ROWAN BLVD

BARDSTOWN KY 40004 502 348 2589 PASSPORT

STEPHEN RHODES J TAYLOR

HAZARD DMD

AND ASSOCIATES

GENERAL

DENTISTRY

1000 EAST JOHN

ROWAN BLVD


SERVICE

STEPHEN RHODES J TAYLOR

HAZARD DMD

AND ASSOCIATES

GENERAL

DENTISTRY

1000 EAST JOHN

ROWAN BLVD


PENNY CRAIN FORD AND

ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE

BARDSTOWN KY 40004 502 348 9400 COVENTRY

11



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE


SERVICE


ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE

BARDSTOWN KY 40004 502 348 9400 HUMANA


ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE



ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE

BARDSTOWN KY 40004 502 348 9400 WELLCARE

LAURA HOWELL FORD AND

ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE


SERVICE

LAURA HOWELL FORD AND

ASSOCIATES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

115 EAST

FLAGET

AVENUE


PATRICK KEESEE CHILDRENS

SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE

BARDSTOWN KY 40004 502 348 5800 http://www.kid

smouth.com/de

fault.asp

COVENTRY

12



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

FEE FOR

SERVICE


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

HUMANA


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

PASSPORT


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

WELLCARE

MATTHEW MITCHELL CHILDRENS

SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

COVENTRY


SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

FEE FOR

SERVICE


SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

PASSPORT

13



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHILDRENS

SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

120 WEST

STEPHEN

FOSTER AVENUE


smouth.com/de

fault.asp

FEE FOR

SERVICE

ROMEO LAUREANO BLUEGRASS

ORAL SURGERY

ORAL SURGEON 120 WEST

STEPHEN

FOSTER AVENUE

SUITE 107


SERVICE


ORAL SURGERY


STEPHEN

FOSTER AVENUE

SUITE 107



ORAL SURGERY


STEPHEN

FOSTER AVENUE

SUITE 107


ANDREA HAYDON ANDREA G

HAYDON DMD

GENERAL

DENTISTRY

202 WEST

STEPHEN

FOSTER AVENUE

SUITE E



HAYDON DMD

GENERAL

DENTISTRY

202 WEST

STEPHEN

FOSTER AVENUE

SUITE E


SERVICE

14



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


HAYDON DMD

GENERAL

DENTISTRY

202 WEST

STEPHEN

FOSTER AVENUE

SUITE E



HAYDON DMD

GENERAL

DENTISTRY

202 WEST

STEPHEN

FOSTER AVENUE

SUITE E



HAYDON DMD

GENERAL

DENTISTRY

202 WEST

STEPHEN

FOSTER AVENUE

SUITE E


CHRISTAN HOWELL MATTINGLY AND

HOWELL

ORTHODONTICS

PSC

ORTHODONTIST 208 NORTH 2ND

STREET

BARDSTOWN KY 40004 502 349 6300 http://www.ma

ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


STREET


ndhortho.com/l

ocations.aspx

PASSPORT

CHRIS MATTINGLY MATTINGLY AND

HOWELL

ORTHODONTICS

PSC


STREET


ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


STREET


ndhortho.com/l

ocations.aspx

PASSPORT

15



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JEFF SCHROEDER SCHROEDER

FAMILY

DENTISTRY

GENERAL

DENTISTRY

211 EAST

STEPHEN

FOSTER AVENUE


SERVICE

JEFF SCHROEDER SCHROEDER

FAMILY

DENTISTRY

GENERAL

DENTISTRY

211 EAST

STEPHEN

FOSTER AVENUE


MICHAEL HARRIS MICHAEL E

HARRIS DDS

ORTHODONTIST 218 WEST JOHN

FITCH AVENUE



HARRIS DDS


FITCH AVENUE


SERVICE


HARRIS DDS


FITCH AVENUE



HARRIS DDS


FITCH AVENUE


MICHAEL E

HARRIS DDS

GENERAL

DENTISTRY

218 WEST JOHN

FITCH AVENUE


SERVICE

16



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DIANA KOCH PAT DISPONETT

DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A



DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


SERVICE


DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A



DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


JOHN DISPONETT PAT DISPONETT

DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A



DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


SERVICE


DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


17



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A



DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


PAT DISPONETT

DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


SERVICE

PAT DISPONETT

DMD

GENERAL

DENTISTRY

919 CHAMBERS

BLVD SUITE A


JOHN BOYD JOHN A BOYD

DDS

GENERAL

DENTISTRY

268 HIGHWAY 62 BARDWELL KY 42023 270 628 3512 COVENTRY


DDS

GENERAL

DENTISTRY

268 HIGHWAY 62 BARDWELL KY 42023 270 628 3512 FEE FOR

SERVICE


DDS

GENERAL

DENTISTRY

268 HIGHWAY 62 BARDWELL KY 42023 270 628 3512 WELLCARE

ROBERT S ADKINS BEATTYVILLE

DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET

BEATTYVILLE KY 41311 606 464 2447 COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET

BEATTYVILLE KY 41311 606 464 2447 FEE FOR

SERVICE

18



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET

BEATTYVILLE KY 41311 606 464 2447 WELLCARE

HAROLD DANIEL BEATTYVILLE

DENTAL CLINIC

ORAL SURGEON 60 CENTER

STREET



DENTAL CLINIC


STREET


SERVICE


DENTAL CLINIC


STREET

BEATTYVILLE KY 41311 606 464 2447 HUMANA


DENTAL CLINIC


STREET


RANA ZAKHARIA BEATTYVILLE

DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET



DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET


SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

60 CENTER

STREET


BEATTYVILLE

DENTAL CLINIC

MULTI

SPECIALTY

GROUP

60 CENTER

STREET


SERVICE

LISA HALL LISA HALL DMD GENERAL

DENTISTRY

61 EAST MAIN

STREET


19



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

61 EAST MAIN

STREET


SERVICE


DENTISTRY

61 EAST MAIN

STREET


BARRY STEVENS BARRY STEVENS

FAMILY

DENTISTRY

GENERAL

DENTISTRY

104 NORTH MAIN

STREET

BEAVER DAM KY 42320 270 274 3379 COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

104 NORTH MAIN

STREET

BEAVER DAM KY 42320 270 274 3379 FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

104 NORTH MAIN

STREET

BEAVER DAM KY 42320 270 274 3379 HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

104 NORTH MAIN

STREET

BEAVER DAM KY 42320 270 274 3379 WELLCARE

KENNETH ALFORD KENNETH D

ALFORD DMD

GENERAL

DENTISTRY

1269 DUVALL

ROAD

BEAVER DAM KY 42320 270 274 4875 COVENTRY


ALFORD DMD

GENERAL

DENTISTRY

1269 DUVALL

ROAD

BEAVER DAM KY 42320 270 274 4875 FEE FOR

SERVICE


ALFORD DMD

GENERAL

DENTISTRY

1269 DUVALL

ROAD

BEAVER DAM KY 42320 270 274 4875 HUMANA

20



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ALFORD DMD

GENERAL

DENTISTRY

1269 DUVALL

ROAD

BEAVER DAM KY 42320 270 274 4875 WELLCARE

HEALTH

POINT

FAMILY

CARE INC

BELLEVUE

DENTAL

OFFICE

MEDICAL CLINIC 103 LANDMARK

DRIVE

BELLEVUE KY 41073 859 655 6100 http://www.he

althpointfc.org

/index.php?con

tent_id=19

COVENTRY

HEALTH

POINT

FAMILY

CARE INC

BELLEVUE

DENTAL

OFFICE

MEDICAL CLINIC 103 LANDMARK

DRIVE

BELLEVUE KY 41073 859 655 6100 http://www.he

althpointfc.org

/index.php?con

tent_id=19

FEE FOR

SERVICE

WILLIAM PASCO WILLIAM N

PASCO DMD

GENERAL

DENTISTRY

1317 MAIN

STREET SUITE 1

BENTON KY 40205 270 527 3434 COVENTRY


PASCO DMD

GENERAL

DENTISTRY

1317 MAIN

STREET SUITE 1

BENTON KY 40205 270 527 3434 FEE FOR

SERVICE


PASCO DMD

GENERAL

DENTISTRY

1317 MAIN

STREET SUITE 1

BENTON KY 40205 270 527 3434 WELLCARE

DAKSHA PARIKH TODAYS FAMILY

DENTAL

GENERAL

DENTISTRY

1007 ACE DRIVE BEREA KY 40403 859 986 5391 http://www.tod

aysfamilydenta

lky.com/

COVENTRY

21



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY


aysfamilydenta

lky.com/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY


aysfamilydenta

lky.com/

WELLCARE

SHERRY SENTERS WHITE HOUSE

CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE

BEREA KY 40403 859 986 2323 http://www.wh

itehouseclinics

.com/index.ht

m

COVENTRY


CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE


itehouseclinics

.com/index.ht

m

FEE FOR

SERVICE


CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE


itehouseclinics

.com/index.ht

m

WELLCARE

CHARLES VOSE WHITE HOUSE

CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE


itehouseclinics

.com/index.ht

ml

COVENTRY


CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE


itehouseclinics

.com/index.ht

ml

FEE FOR

SERVICE


CLINC BEREA

GENERAL

DENTISTRY

104 LEGACY

DRIVE


itehouseclinics

.com/index.ht

ml

WELLCARE

22



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRENT CLARK BRENT CLARK

DMD

GENERAL

DENTISTRY

11105 US

HIGHWAY 23

BETSY LAYNE KY 41605 606 478 9290 COVENTRY


DMD

GENERAL

DENTISTRY

11105 US

HIGHWAY 23

BETSY LAYNE KY 41605 606 478 9290 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

11105 US

HIGHWAY 23

BETSY LAYNE KY 41605 606 478 9290 HUMANA


DMD

GENERAL

DENTISTRY

11105 US

HIGHWAY 23

BETSY LAYNE KY 41605 606 478 9290 WELLCARE

RED BIRD

CLINIC INC

MEDICAL CLINIC 53 QUEENDALE

CENTER

BEVERLY KY 40913 606 598 5135 http://rbmissio

n.org/

FEE FOR

SERVICE

JASON GAY BOONESVILLE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

706

COURTHOUSE

SQUARE

BOONESVILLE KY 41343 606 593 5100 COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

706

COURTHOUSE

SQUARE

BOONESVILLE KY 41343 606 593 5100 FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

706

COURTHOUSE

SQUARE

BOONESVILLE KY 41343 606 593 5100 WELLCARE

BOONESVILLE

FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

706

COURTHOUSE

SQUARE

BOONEVILLE KY 41314 606 723 1000 FEE FOR

SERVICE

SARATH BACHALI BOWLING GREEN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET

BOWLING GREEN KY 42103 270 842 0025 http://www.bo

wlinggreenfam

ilydental.com/

COVENTRY

23



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

PASSPORT


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

WELLCARE

LORNA SALYER BOWLING GREEN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

WELLCARE

24



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RYAN VONNAHME BOWLING GREEN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

WELLCARE

BOWLING GREEN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1025 ASHLEY

STREET


wlinggreenfam

ilydental.com/

FEE FOR

SERVICE

SHELDON BALLOU BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET

BOWLING GREEN KY 42101 270 781 8039 http://www.bar

renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

25



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHANNA BURRESS BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

HUMANA


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

LESLIE CAMPBELL BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE

26



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

HUMANA


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

JASON COOMER BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

MARK FROEDGE BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY

27



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

PASSPORT


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

WILLIAM WHITESIDE BARREN RIVER

DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

WELLCARE

28



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BARREN RIVER

DENTAL CLINIC

MULTI

SPECIALTY

GROUP

1109 STATE

STREET


renriverhealth.

org/mx/hm.asp

?id=DentalHea

lth

FEE FOR

SERVICE

ERIN ELLIOTT ELLIOT AND

ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT

BOWLING GREEN KY 42103 270 782 0716 COVENTRY


ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT

BOWLING GREEN KY 42103 270 782 0716 FEE FOR

SERVICE


ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT

BOWLING GREEN KY 42103 270 782 0716 WELLCARE

RANDALL ELLIOTT ELLIOT AND

ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT



ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT


SERVICE


ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT


ELLIOT AND

ELLIOT

PEDIATRIC

DENTIST

120 CALLAWAY

COURT


SERVICE

CHRISTOPHE

R

PITCOCK WESTERN

KENTUCKY

DENTAL

GENERAL

DENTISTRY

1355 VETERANS

MEMORIAL

BLVD SUITE 100


29



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

PITCOCK WESTERN

KENTUCKY

DENTAL

GENERAL

DENTISTRY

1355 VETERANS

MEMORIAL

BLVD SUITE 100


SERVICE

CHRISTOPHE

R

HANES BLEVINS AND

HANES

GENERAL

DENTISTRY

1658 CAMPBELL

LANE


CHRISTOPHE

R

HANES BLEVINS AND

HANES

GENERAL

DENTISTRY

1658 CAMPBELL

LANE


SERVICE

CHRISTOPHE

R

HANES BLEVINS AND

HANES

GENERAL

DENTISTRY

1658 CAMPBELL

LANE


JAMES CRAYCROFT J ANDREW

CRAYCROFT DMD

GENERAL

DENTISTRY

1711 ASHLEY

CIRCLE SUITE 3

BOWLING GREEN KY 42104 270 781 4997 http://www.cra

ycroftfamilyde

ntistry.com/ind

ex.htm

COVENTRY


CRAYCROFT DMD

GENERAL

DENTISTRY

1711 ASHLEY

CIRCLE SUITE 3


ycroftfamilyde

ntistry.com/ind

ex.htm

FEE FOR

SERVICE


CRAYCROFT DMD

GENERAL

DENTISTRY

1711 ASHLEY

CIRCLE SUITE 3


ycroftfamilyde

ntistry.com/ind

ex.htm

WELLCARE

MARK ALLEN MARK S ALLEN

DMD

ORAL SURGEON 1716 ASHLEY

CIRCLE


30



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD


CIRCLE


SERVICE


DMD


CIRCLE


GINA DAVIS DENTISTY

DENTAL

GENERAL

DENTISTRY

1720 DESTINY

LANE

BOWLING GREEN KY 42104 270 842 3554 http://www.bg

destinydental.c

om/

COVENTRY

GINA DAVIS DENTISTY

DENTAL

GENERAL

DENTISTRY

1720 DESTINY

LANE


destinydental.c

om/

FEE FOR

SERVICE

GINA DAVIS DENTISTY

DENTAL

GENERAL

DENTISTRY

1720 DESTINY

LANE


destinydental.c

om/

WELLCARE

J SCOTT BARBEE BARBEE DENTAL GENERAL

DENTISTRY

1830 DESTINY

LANE SUITE 119


beedental.com/

COVENTRY


DENTISTRY

1830 DESTINY

LANE SUITE 119


beedental.com/

FEE FOR

SERVICE


DENTISTRY

1830 DESTINY

LANE SUITE 119


beedental.com/

WELLCARE

31



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JEFFREY CLARK SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES

ORAL SURGEON 1938 LYDA

AVENUE

BOWLING GREEN KY 42104 270 783 0064 http://omsbg.c

om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

WELLCARE

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

COVENTRY

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

FEE FOR

SERVICE

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

WELLCARE

32



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JAMES SUTTON SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

WELLCARE

THOMAS THOMPSON SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

WELLCARE

33



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


AVENUE


om/

FEE FOR

SERVICE

DAVID BUCHANAN BUCHANAN

DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100

BOWLING GREEN KY 42101 270 781 3133 http://www.bu

chanandentistr

yky.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

WELLCARE

JOHN BUCHANAN BUCHANAN

DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

WELLCARE

BUCHANAN

DENTISTRY

MULTI

SPECIALTY

GROUP

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

FEE FOR

SERVICE

BUCHANAN

DENTISTRY

MULTI

SPECIALTY

GROUP

546 PARK

STREET SUITE

100


chanandentistr

yky.com/

WELLCARE

34



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

REGAN ACKERMAN BLUEGRASS

ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400

BOWLING GREEN KY 42101 270 781 6161 http://bgohc.co

m/default.asp

CoventryCares

of Kentucky


ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400


m/default.asp

FEE FOR

SERVICE


ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400


m/default.asp

WELLCARE

MEGHAN BIRKENHAUER BLUEGRASS

ORAL HEALTH

CENTER

BOWLING GREEN

ORAL SURGEON 546 PARK

STREET SUITE

400


m/default.asp

COVENTRY


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

FEE FOR

SERVICE

35



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

HUMANA


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

WELLCARE

THOMAS BIRKENHAUER BLUEGRASS

ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

COVENTRY


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

FEE FOR

SERVICE


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

HUMANA

36



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/default.asp

WELLCARE

ANDREW BURT BLUEGRASS

ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/

COVENTRY


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/

FEE FOR

SERVICE


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/

HUMANA


ORAL HEALTH

CENTER

BOWLING GREEN


STREET SUITE

400


m/

WELLCARE

37



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LESLIE CAMPBELL BLUEGRASS

ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400


m/

COVENTRY


ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400


m/

FEE FOR

SERVICE


ORAL HEALTH

CENTER

BOWLING GREEN

GENERAL

DENTISTRY

546 PARK

STREET SUITE

400


m/

HUMANA

JULIE GASKILL JULIE A GASKILL

DDS


STREET SUITE

500



DDS


STREET SUITE

500


SERVICE


DDS


STREET SUITE

500


FAIRVIEW

COMMUNITY

HEALTH

CENTER

MEDICAL CLINIC 615 7TH AVENUE BOWLING GREEN KY 42101 270 783 3573 http://www.fai

rviewcommuni

tyhealth.org/in

dex.php

COVENTRY

38



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

FAIRVIEW

COMMUNITY

HEALTH

CENTER


rviewcommuni

tyhealth.org/in

dex.php

FEE FOR

SERVICE

FAIRVIEW

COMMUNITY

HEALTH

CENTER


rviewcommuni

tyhealth.org/in

dex.php

WELLCARE

CHARLES NUCKOLS BOWLING GREEN

SURGERY

ASSOCIATIES

ORAL SURGEON 627 EASTWOOD

STREET



SURGERY

ASSOCIATIES


STREET


SERVICE


SURGERY

ASSOCIATIES


STREET

BOWLING GREEN KY 42103 270 843 4341 HUMANA


SURGERY

ASSOCIATIES


STREET

BOWLING GREEN KY 42103 270 843 4341 PASSPORT


SURGERY

ASSOCIATIES


STREET


39



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRENDA WALDEN FAMILY DENTAL

CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A



CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A


SERVICE


CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A


GARY WALDEN FAMILY DENTAL

CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A



CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A


SERVICE


CARE

GENERAL

DENTISTRY

725 KENTON

STREET SUITE A


MICHAEL HUBBARD THE DENTAL

CLINIC

GENERAL

DENTISTRY

740 EAST 10TH

STREET

BOWLING GREEN KY 42101 270 781 9687 http://www.co

mmonwealthhe

althfreeclinic.c

om/dental_clin

ic.htm

COVENTRY

40



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CLINIC

GENERAL

DENTISTRY

740 EAST 10TH

STREET


mmonwealthhe

althfreeclinic.c

om/dental_clin

ic.htm

FEE FOR

SERVICE


CLINIC

GENERAL

DENTISTRY

740 EAST 10TH

STREET


mmonwealthhe

althfreeclinic.c

om/dental_clin

ic.htm

WELLCARE

THE DENTAL

CLINIC

MULTI

SPECIALTY

GROUP

740 EAST 10TH

STREET


mmonwealthhe

althfreeclinic.c

om/dental_clin

ic.htm

FEE FOR

SERVICE

EDYEE STURGILL KENTUCKY

CENTER OR ORAL

AND IMPLANT

SURGERY

ORAL SURGEON 895 WILKINSON

TRACE SUITE B

BOWLING GREEN KY 42103 270 745 9001 http://www.ed

yeesturgill.co

m/index.html

COVENTRY


CENTER OR ORAL

AND IMPLANT

SURGERY


TRACE SUITE B


yeesturgill.co

m/index.html

FEE FOR

SERVICE


CENTER OR ORAL

AND IMPLANT

SURGERY


TRACE SUITE B


yeesturgill.co

m/index.html

WELLCARE

41



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JERRY COHRON JERRY E COHRON

DMD

ORAL SURGEON 948 ELM STREET

SUITE 2



DMD


SUITE 2


SERVICE


DMD


SUITE 2



DMD


SUITE 2


MICHAEL HOWELL MICHAEL W

HOWELL DMD

GENERAL

DENTISTRY

952 US HIGHWAY

31 WEST BYPASS



HOWELL DMD

GENERAL

DENTISTRY

952 US HIGHWAY

31 WEST BYPASS


SERVICE


HOWELL DMD

GENERAL

DENTISTRY

952 US HIGHWAY

31 WEST BYPASS



HOWELL DMD

GENERAL

DENTISTRY

952 US HIGHWAY

31 WEST BYPASS


42



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ROBERT B ADKINS COMMONWEALT

H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6

BOWLING GREEN KY 42101 270 782 1128 http://www.cw

dental.net/

FEE FOR

SERVICE


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/

WELLCARE

AUDRA DORROH COMMONWEALT

H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/

COVENTRY


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/

FEE FOR

SERVICE


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/

WELLCARE

WILLIAM HARRIS COMMONWEALT

H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/abou

t_us.htm

COVENTRY

43



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/abou

t_us.htm

FEE FOR

SERVICE


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


dental.net/abou

t_us.htm

WELLCARE

ROGER MCALPIN COMMONWEALT

H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6

BOWLING GREEN KY 42103 270 782 1128 http://mycomm

onwealthdental

.com/doctors.h

tm

COVENTRY


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


onwealthdental

.com/doctors.h

tm

FEE FOR

SERVICE


H DENTAL OF

BOWLING GREEN

GENERAL

DENTISTRY

996 WILKINSON

TRACE SUITE B6


onwealthdental

.com/doctors.h

tm

WELLCARE

COMMONWEALT

H DENTAL OF

BOWLING GREEN

MULTI

SPECIALTY

GROUP

996 WILKINSON

TRACE SUITE B6


dental.net/

FEE FOR

SERVICE

44



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

WILLIAM DENTON BRANDENBURG

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET

BRANDENBURG KY 40108 270 422 4921 http://brandenb

urgfamilydenti

stry.com/

COVENTRY


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

WELLCARE

JOSEPH MILLER BRANDENBURG

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

COVENTRY


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

PASSPORT


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

1120 HIGH

STREET


urgfamilydenti

stry.com/

WELLCARE

45



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRANDENBURG

FAMILY

DENTISTRY PLLC

MULTI

SPECIALTY

GROUP

1120 HIGH

STREET


urgfamilydenti

stry.com/

FEE FOR

SERVICE

JOHN DEVRIES DEVRIES FAMILY

DENTISTRY

GENERAL

DENTISTRY

415 MAIN

STREET

BRANDENBURG KY 40105 270 422 1181 http://www.de

vriesdental.co

m/

FEE FOR

SERVICE

JOHN DEVRIES DEVRIES FAMILY

DENTISTRY

GENERAL

DENTISTRY

415 MAIN

STREET

BRANDENBURG KY 40105 270 422 1181 http://www.de

vriesdental.co

m/

PASSPORT

JOHN DUPLESSIS JR DUPLESSIS

ORTHODONTICS

ORTHODONTIST 618 RIVER RIDGE

PLAZA

BRANDENBURG KY 40108 270 422 5437 http://www.du

plessisorthodo

ntics.com/

COVENTRY


ORTHODONTICS


PLAZA


plessisorthodo

ntics.com/

FEE FOR

SERVICE


ORTHODONTICS


PLAZA


plessisorthodo

ntics.com/

WELLCARE

DELORES ODANIEL DELORES M O

DANIEL DMD

GENERAL

DENTISTRY

1064 BROOKS

HILL ROAD

SUITE A

BROOKS KY 40109 502 955 1084 FEE FOR

SERVICE

DELORES ODANIEL DELORES M O

DANIEL DMD

GENERAL

DENTISTRY

1064 BROOKS

HILL ROAD

SUITE A

BROOKS KY 40109 502 955 1084 PASSPORT

TARA JEFFERSON MCCORD AND

JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET

BROOKSVILLE KY 41004 606 735 3114 COVENTRY

46



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET

BROOKSVILLE KY 41004 606 735 3114 FEE FOR

SERVICE


JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET

BROOKSVILLE KY 41004 606 735 3114 WELLCARE

GARY MCCORD MCCORD AND

JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET

BROOKSVILLE KY 41004 606 735 3114 COVENTRY


JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET


SERVICE


JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET

BROOKSVILLE KY 41004 606 735 3114 WELLCARE

MCCORD AND

JEFFERSON

GENERAL

DENTISTRY

224 FRANKFORT

STREET


SERVICE

BRENTLEY STICE RIVERHILL

DENTAL CLINIC

GENERAL

DENTISTRY

1427 KENTUCKY

HIGHWAY 259

NORTH

BROWNSVILLE KY 42210 270 597 3711 COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

1427 KENTUCKY

HIGHWAY 259

NORTH

BROWNSVILLE KY 42210 270 597 3711 FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

1427 KENTUCKY

HIGHWAY 259

NORTH

BROWNSVILLE KY 42210 270 597 3711 HUMANA

47



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JOHN STEPHENSON STEPHENSON

DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 COVENTRY


DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 FEE FOR

SERVICE


DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 WELLCARE

JULIUS STEPHENSON STEPHENSON

DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 COVENTRY


DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 FEE FOR

SERVICE


DENTIAL CLINIC

GENERAL

DENTISTRY

405 NORTH

MAIN STREET

BURKESVILLE KY 42714 270 864 3465 WELLCARE

CUMBERLAN

D FAMILY

MEDICAL

CENTER

MEDICAL CLINIC 360 KEEN

STREET

BURKESVILLE KY 42717 270 864 2889 http://www.cu

mberlandfamil

ymedical.com/

COVENTRY

CUMBERLAN

D FAMILY

MEDICAL

CENTER


STREET


mberlandfamil

ymedical.com/

FEE FOR

SERVICE

CUMBERLAN

D FAMILY

MEDICAL

CENTER


STREET


mberlandfamil

ymedical.com/

WELLCARE

48



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHARITY BARTH

OMOSIVWE

BARTH FAMILY

DENTISTRY

GENERAL

DENTISTRY

1821 FLORENCE

PIKE SUITE 2`

BURLINGTON KY 41005 859 689 7700 http://www.bar

thfamilydentist

ry.com/

COVENTRY

CHARITY BARTH

OMOSIVWE

BARTH FAMILY

DENTISTRY

GENERAL

DENTISTRY

1821 FLORENCE

PIKE SUITE 2`


thfamilydentist

ry.com/

FEE FOR

SERVICE

CHARITY BARTH

OMOSIVWE

BARTH FAMILY

DENTISTRY

GENERAL

DENTISTRY

1821 FLORENCE

PIKE SUITE 2`


thfamilydentist

ry.com/

WELLCARE

ERIC SOPER THE PEDIATRIC

DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102

BURLINGTON KY 41005 859 534 5640 http://www.drs

oper.com/

COVENTRY


DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102


oper.com/

FEE FOR

SERVICE


DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102


oper.com/

WELLCARE

ANGELICA WONG THE PEDIATRIC

DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102


oper.com/

COVENTRY

49



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102


oper.com/

FEE FOR

SERVICE


DENTAL CENTER

PEDIATRIC

DENTIST

5495 NORTH

BEND ROAD

SUITE 102


oper.com/

WELLCARE

DAWN ROSE DAWN ROSE DDS GENERAL

DENTISTRY

104 COMMERCE

STREET

CADIZ KY 42211 270 522 7867 COVENTRY


DENTISTRY

104 COMMERCE

STREET

CADIZ KY 42211 270 522 7867 FEE FOR

SERVICE


DENTISTRY

104 COMMERCE

STREET

CADIZ KY 42211 270 522 7867 WELLCARE

MICHAEL GROSS MICHAEL L

GROSS DMD

GENERAL

DENTISTRY

51 SOUTH ROAD CADIZ KY 42211 270 522 3484 COVENTRY


GROSS DMD

GENERAL

DENTISTRY

51 SOUTH ROAD CADIZ KY 42211 270 522 3484 FEE FOR

SERVICE


GROSS DMD

GENERAL

DENTISTRY

51 SOUTH ROAD CADIZ KY 42211 270 522 3484 WELLCARE

DAVID EMBRY DAVID L EMBRY

DMD

GENERAL

DENTISTRY

8910 MAIN

STREET

CAMPBELLSBURG KY 40011 502 532 6315 COVENTRY


DMD

GENERAL

DENTISTRY

8910 MAIN

STREET

CAMPBELLSBURG KY 40011 502 532 6315 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

8910 MAIN

STREET

CAMPBELLSBURG KY 40011 502 532 6315 PASSPORT


DMD

GENERAL

DENTISTRY

8910 MAIN

STREET

CAMPBELLSBURG KY 40011 502 532 6315 WELLCARE

50



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DAVID GRAVES DAVID A GRAVES

DMD

ORAL SURGEON 105 MEDICAL

PARK DRIVE

CAMPBELLSVILLE KY 42718 270 789 4540 COVENTRY


DMD


PARK DRIVE

CAMPBELLSVILLE KY 42718 270 789 4540 FEE FOR

SERVICE


DMD


PARK DRIVE

CAMPBELLSVILLE KY 42718 270 789 4540 HUMANA


DMD


PARK DRIVE

CAMPBELLSVILLE KY 42718 270 789 4540 PASSPORT


DMD


PARK DRIVE

CAMPBELLSVILLE KY 42718 270 789 4540 WELLCARE

HEATHER WISE WISE DENTISTRY

FOR KIDS PSC

PEDIATRIC

DENTIST

105 MEDICAL

PARK DRIVE

CAMPBELLSVILLE KY 42718 270 469 1403 http://www.wi

sedentistry4kid

s.com/

COVENTRY


FOR KIDS PSC

PEDIATRIC

DENTIST

105 MEDICAL

PARK DRIVE


sedentistry4kid

s.com/

FEE FOR

SERVICE

51



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FOR KIDS PSC

PEDIATRIC

DENTIST

105 MEDICAL

PARK DRIVE


sedentistry4kid

s.com/

WELLCARE

WISE DENTISTRY

FOR KIDS PSC

MULTI

SPECIALTY

GROUP

105 MEDICAL

PARK DRIVE


sedentistry4kid

s.com/

FEE FOR

SERVICE

THOMAS BALDWIN INMAN AND

BALDWIN

ORTHODONTICS

ORTHODONTIST 1485 OLD

LEBANON ROAD

CAMPBELLSVILLE KY 42718 270 789 4542 http://bracesby

inmanandbald

win.com/

COVENTRY


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

PASSPORT


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

WELLCARE

52



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

GARY INMAN INMAN AND

BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

PASSPORT

GREGORY INMAN INMAN AND

BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

COVENTRY


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

PASSPORT

53



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BALDWIN

ORTHODONTICS


LEBANON ROAD


inmanandbald

win.com/

WELLCARE

MATT AKRIDGE AKRIDGE

ORTHODONTICS


LEBANON ROAD

CAMPBELLSVILLE KY 42718 270 465 6570 http://www.akr

idgeorthodonti

cs.com/

COVENTRY


ORTHODONTICS


LEBANON ROAD


idgeorthodonti

cs.com/

FEE FOR

SERVICE


ORTHODONTICS


LEBANON ROAD


idgeorthodonti

cs.com/

HUMANA


ORTHODONTICS


LEBANON ROAD


idgeorthodonti

cs.com/

PASSPORT


ORTHODONTICS


LEBANON ROAD


idgeorthodonti

cs.com/

WELLCARE

HAROLD WILKERSON HAROLD T

WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET



WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET


SERVICE


WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET



WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET

CAMPBELLSVILLE KY 42718 270 465 6204 PASSPORT

54



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET


HAROLD T

WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET


HAROLD T

WILKERSON DMD

GENERAL

DENTISTRY

227 WEST MAIN

STREET


SERVICE

RICKY COX RICKY L COX

DMD PSC

GENERAL

DENTISTRY

603 EAST MAPLE

STREET



DMD PSC

GENERAL

DENTISTRY

603 EAST MAPLE

STREET


SERVICE


DMD PSC

GENERAL

DENTISTRY

603 EAST MAPLE

STREET



DMD PSC

GENERAL

DENTISTRY

603 EAST MAPLE

STREET


BRANDON ALLEN CARLISLE

FAMILY DENTAL

GENERAL

DENTISTRY

110 SOUTH

LOCUST STREET

CARLISLE KY 40311 859 289 5418 COVENTRY


FAMILY DENTAL

GENERAL

DENTISTRY

110 SOUTH

LOCUST STREET

CARLISLE KY 40311 859 289 5418 FEE FOR

SERVICE


FAMILY DENTAL

GENERAL

DENTISTRY

110 SOUTH

LOCUST STREET

CARLISLE KY 40311 859 289 5418 WELLCARE

55



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DANIELLE RENSLOW MORTENSON

FAMILY DENTAL

CARROLLTON

GENERAL

DENTISTRY

2482 HIGHWAY

227

CARROLLTON KY 41008 502 732 0333 http://mortenso

ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

CARROLLTON

GENERAL

DENTISTRY

2482 HIGHWAY

227


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

CARROLLTON

GENERAL

DENTISTRY

2482 HIGHWAY

227


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

CARROLLTON

GENERAL

DENTISTRY

2482 HIGHWAY

227


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

CARROLLTON

GENERAL

DENTISTRY

2482 HIGHWAY

227


ndental.com/D

efault.asp

WELLCARE

RALPH BEADLE 23 BEADLE

DENTISTRY PSC

GENERAL

DENTISTRY

16005 US 23

SOUTH

CATLETTSBURG KY 41129 606 739 0403 COVENTRY


DENTISTRY PSC

GENERAL

DENTISTRY

16005 US 23

SOUTH

CATLETTSBURG KY 41129 606 739 0403 FEE FOR

SERVICE


DENTISTRY PSC

GENERAL

DENTISTRY

16005 US 23

SOUTH

CATLETTSBURG KY 41129 606 739 0403 WELLCARE

56



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHELDON BALLOU BALLOU FAMILY

DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY

CAVE CITY KY 42127 270 773 3943 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY

CAVE CITY KY 42127 270 773 3943 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY

CAVE CITY KY 42127 270 773 3943 WELLCARE

JASON COOMER BALLOU FAMILY

DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY

CAVE CITY KY 42127 270 773 3943 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY


SERVICE


DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY


BALLOU FAMILY

DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY


SERVICE

BALLOU FAMILY

DENTISTRY

GENERAL

DENTISTRY

203 SOUTH DIXIE

HIGHWAY


DAVID MOREHEAD MOREHEAD

FAMILY

DENTSITRY

GENERAL

DENTISTRY

300 WEST

BROAD STREET

CENTRAL CITY KY 42330 270 754 1888 COVENTRY


FAMILY

DENTSITRY

GENERAL

DENTISTRY

300 WEST

BROAD STREET

CENTRAL CITY KY 42330 270 754 1888 FEE FOR

SERVICE

57



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTSITRY

GENERAL

DENTISTRY

300 WEST

BROAD STREET

CENTRAL CITY KY 42330 270 754 1888 WELLCARE

SMALL SMILES OF

ROSELAWN

PEDIATRIC

DENTIST

1860 SEYMOUR

AVENUE

CINCINNATI OH 45237 513 841 1000 http://www.sm

allsmilesusa.co

m/index.php

FEE FOR

SERVICE

UNIVERSITY

ORAL AND

MAXILLOFAC

IAL SURGERY

ASSOCIATES

MULTI

SPECIALTY

GROUP

222 PIEDMONT

AVENUE

CINCINNATI OH 45219 513 475 8783 FEE FOR

SERVICE

SMALL SMILES OF

CINCINNATI

PEDIATRIC

DENTIST

2830 COLERAIN

AVENUE

CINCINNATI OH 45225 513 591 1400 http://www.sm

allsmilesusa.co

m/index.php

FEE FOR

SERVICE

CHILDRENS

HOSPITAL

MEDICAL

CENTER

GENERAL

DENTISTRY

3333 BURNET

AVENUE ML5021

CINCINNATI OH 45229 513 636 4641 http://www.cin

cinnatichildren

s.org/service/d/

dentistry/defau

lt/

FEE FOR

SERVICE

SANDRA CRUM STEVENS POWELL COUNTY

DENTAL CENTER

GENERAL

DENTISTRY

98 RIVER

STREET SUITE A

CLAY CITY KY 40312 606 633 5473 COVENTRY

58



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

98 RIVER

STREET SUITE A

CLAY CITY KY 40312 606 633 5473 HUMANA


DENTAL CENTER

GENERAL

DENTISTRY

98 RIVER

STREET SUITE A

CLAY CITY KY 40312 606 633 5473 WELLCARE

JANELLA BROWN JANELLA BROWN

DMD PSC

GENERAL

DENTISTRY

318 PUBLIC

SQUARE

COLUMBIA KY 42728 270 384 3481 FEE FOR

SERVICE

JANELLA BROWN JANELLA BROWN

DMD PSC

GENERAL

DENTISTRY

318 PUBLIC

SQUARE

COLUMBIA KY 42728 270 384 3481 WELLCARE

JANELLA BROWN JANELLA F

BROWN DMD PSC

GENERAL

DENTISTRY

318 PUBLIC

SQUARE

COLUMBIA KY 42728 270 384 3481 COVENTRY

JANELLA BROWN

DMD PSC

GENERAL

DENTISTRY

318 PUBLIC

SQUARE

COLUMBIA KY 42728 270 384 3481 FEE FOR

SERVICE

ROBIN PENNINGTON ROBIN L

PENNINGTON

DMD

ORTHODONTIST 562 HIGHWAY 80

WEST

COMBS KY 41729 606 439 3740 COVENTRY


PENNINGTON

DMD


WEST

COMBS KY 41729 606 439 3740 FEE FOR

SERVICE


PENNINGTON

DMD


WEST

COMBS KY 41729 606 439 3740 WELLCARE

59



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LEROY COUCH COUCH FAMILY

AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

107 BRENTWOOD

PLACE

CORBIN KY 40701 606 528 5600 COVENTRY


AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

107 BRENTWOOD

PLACE

CORBIN KY 40701 606 528 5600 FEE FOR

SERVICE


AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

107 BRENTWOOD

PLACE

CORBIN KY 40701 606 528 5600 WELLCARE

JAMES GREER GREER AND

GREER

ORTHODONTIST 1200 MASTERS

STREET SUITE 1



GREER


STREET SUITE 1

CORBIN KY 40475 606 523 1961 FEE FOR

SERVICE


GREER


STREET SUITE 1


RUSSELL GREER GREER AND

GREER


STREET SUITE 1


60



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


GREER


STREET SUITE 1

CORBIN KY 40475 606 523 1961 FEE FOR

SERVICE


GREER


STREET SUITE 1


SUZANNE BARNHILL BARNHILL

PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223



PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223

CORBIN KY 40701 606 526 9636 FEE FOR

SERVICE


PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223


JEFFREY JOHNSON BARNHILL

PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223



PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223

CORBIN KY 40701 606 526 9636 FEE FOR

SERVICE

61



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223


JOHN THOBABEN BARNHILL

PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223



PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223

CORBIN KY 40701 606 526 9636 FEE FOR

SERVICE


PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223

CORBIN KY 40701 606 526 9636 PASSPORT


PEDIATRIC

DENTISTRY PSC

PEDIATRIC

DENTIST

129 STATE

HIGHWAY 1223


BARNHILL

PEDIATRIC

DENTISTRY PSC

MULTI

SPECIALTY

GROUP

129 STATE

HIGHWAY 1223

CORBIN KY 40701 606 526 9636 FEE FOR

SERVICE

MICHAEL MURPHY MICHAEL T

MURPHY DMD

PSC

ORAL SURGEON 1400

CUMBERLAND

FALLS HIGHWAY

SUITE B

CORBIN KY 40701 606 528 9402 http://www.cor

binoralsurgery.

com/

COVENTRY

62



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MURPHY DMD

PSC

ORAL SURGEON 1400

CUMBERLAND

FALLS HIGHWAY

SUITE B


binoralsurgery.

com/

FEE FOR

SERVICE


MURPHY DMD

PSC

ORAL SURGEON 1400

CUMBERLAND

FALLS HIGHWAY

SUITE B


binoralsurgery.

com/

PASSPORT


MURPHY DMD

PSC

ORAL SURGEON 1400

CUMBERLAND

FALLS HIGHWAY

SUITE B


binoralsurgery.

com/

WELLCARE

JOHN NEWCOMB ORTHODONTIC

CENTER

ORTHODONTIST 14659 NORTH US

HIGHWAY 25

EAST



CENTER


HIGHWAY 25

EAST

CORBIN KY 40701 606 528 8302 FEE FOR

SERVICE


CENTER


HIGHWAY 25

EAST


JOSEPH PETREY ORTHODONTIC

CENTER


HIGHWAY 25

EAST


63



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER


HIGHWAY 25

EAST

CORBIN KY 40701 606 528 8302 FEE FOR

SERVICE


CENTER


HIGHWAY 25

EAST


PHILIP HENDERLIGHT

JR

PHILIP E

HENDERLIGHT JR

DMD

GENERAL

DENTISTRY

1507 SOUTH

MAIN STREET


PHILIP HENDERLIGHT

JR

PHILIP E

HENDERLIGHT JR

DMD

GENERAL

DENTISTRY

1507 SOUTH

MAIN STREET

CORBIN KY 40701 606 523 1110 FEE FOR

SERVICE

PHILIP HENDERLIGHT

JR

PHILIP E

HENDERLIGHT JR

DMD

GENERAL

DENTISTRY

1507 SOUTH

MAIN STREET


STEVEN HAINES STEVEN L HAINES

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1608

CUMBERLAND

FALLS HIGHWAY



FAMILY

DENTISTRY

GENERAL

DENTISTRY

1608

CUMBERLAND

FALLS HIGHWAY

CORBIN KY 40701 606 549 0374 FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1608

CUMBERLAND

FALLS HIGHWAY


64



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KEITH GIBSON KEITH GIBSON

DMD

GENERAL

DENTISTRY

213 SOUTH MAIN

STREET



DMD

GENERAL

DENTISTRY

213 SOUTH MAIN

STREET

CORBIN KY 40701 606 523 1415 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

213 SOUTH MAIN

STREET


CUMBERLAND

DENTURE

DENTAL CENTER

GENERAL

DENTISTRY

40 MOONBOW

PLAZA SUITE 3

CORBIN KY 40701 606 528 6104 FEE FOR

SERVICE

JEANNE MARTIN CORBIN SMILES

DENTISTRY

CENTER

GENERAL

DENTISTRY

406 MASTER

STREET

CORBIN KY 40701 606 528 3540 http://www.dr

martincorbin.c

om/index.html

COVENTRY


DENTISTRY

CENTER

GENERAL

DENTISTRY

406 MASTER

STREET


martincorbin.c

om/index.html

FEE FOR

SERVICE


DENTISTRY

CENTER

GENERAL

DENTISTRY

406 MASTER

STREET


martincorbin.c

om/index.html

WELLCARE

ALVIN CHUMBLEY ALVIN

CHUMBLEY PSC

ORTHODONTIST 727 WEST

CUMBERLAND

GAP PARKWAY

SUITE D


65



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CHUMBLEY PSC


CUMBERLAND

GAP PARKWAY

SUITE D

CORBIN KY 40701 606 523 2000 FEE FOR

SERVICE


CHUMBLEY PSC


CUMBERLAND

GAP PARKWAY

SUITE D


JOHN NEWCOMB PETRY AND

NEWCOMB

ORTHODONTICS

ORTHODONTIST 83 PARK HILL

ROAD



NEWCOMB

ORTHODONTICS


ROAD

CORBIN KY 40701 606 528 0107 FEE FOR

SERVICE


NEWCOMB

ORTHODONTICS


ROAD


JOSEPH PETREY PETRY AND

NEWCOMB

ORTHODONTICS


ROAD



NEWCOMB

ORTHODONTICS


ROAD

CORBIN KY 40701 606 528 0107 FEE FOR

SERVICE

66



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


NEWCOMB

ORTHODONTICS


ROAD


TRACEY ROSS TRACEY BUTLER

ROSS DMD PLLC

GENERAL

DENTISTRY

1044 SCOTT

STREET

COVINGTON KY 41011 859 291 1818 COVENTRY


ROSS DMD PLLC

GENERAL

DENTISTRY

1044 SCOTT

STREET

COVINGTON KY 41011 859 291 1818 FEE FOR

SERVICE


ROSS DMD PLLC

GENERAL

DENTISTRY

1044 SCOTT

STREET

COVINGTON KY 41011 859 291 1818 WELLCARE

JEFFREY KAISER JEFFERY KAISER

DMD

GENERAL

DENTISTRY

2 WEST

SOUTHERN

AVENUE



DMD

GENERAL

DENTISTRY

2 WEST

SOUTHERN

AVENUE


SERVICE


DMD

GENERAL

DENTISTRY

2 WEST

SOUTHERN

AVENUE


DANNY COLLINS COVINGTON

FAMILY DENTAL

GENERAL

DENTISTRY

300 PIKE STREET COVINGTON KY 41011 859 491 7453 https://sites.go

ogle.com/site/c

ovingtondentis

t2011/

COVENTRY


FAMILY DENTAL

GENERAL

DENTISTRY


ogle.com/site/c

ovingtondentis

t2011/

FEE FOR

SERVICE

67



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

GENERAL

DENTISTRY


ogle.com/site/c

ovingtondentis

t2011/

WELLCARE

COVINGTON

FAMILY DENTAL

INC

MULTI

SPECIALTY

GROUP

300 PIKE STREET COVINGTON KY 41011 859 491 7453 FEE FOR

SERVICE

MICHELE BECK MICHELE BECK

DDS

GENERAL

DENTISTRY

640 SCOTT

STREET



DDS

GENERAL

DENTISTRY

640 SCOTT

STREET


SERVICE


DDS

GENERAL

DENTISTRY

640 SCOTT

STREET


STEVEN NEELY STEVEN W NEELY

DMD

GENERAL

DENTISTRY

801 SCOTT

STREET

COVINGTON KY 41011 859 431 8800 http://www.drs

neely.com/

COVENTRY


DMD

GENERAL

DENTISTRY

801 SCOTT

STREET


neely.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

801 SCOTT

STREET


neely.com/

WELLCARE

MARTIN HAAS HAAS AND

WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY

CRESTVIEW HILLS KY 41017 859 341 3012 COVENTRY


WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY

CRESTVIEW HILLS KY 41017 859 341 3012 FEE FOR

SERVICE


WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY

CRESTVIEW HILLS KY 41017 859 341 3012 WELLCARE

68



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MARK WEHRMAN HAAS AND

WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY

CRESTVIEW HILLS KY 41017 859 341 3012 COVENTRY


WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY


SERVICE


WEHRMAN

PEDIATRIC

DENTIST

220 THOMAS

MORE

PARKWAY

CRESTVIEW HILLS KY 41017 859 341 3012 WELLCARE

HAAS AND

WEHRMAN

GENERAL

DENTISTRY

220 THOMAS

MORE

PARKWAY


SERVICE

SOPHIE DUVAL AUSTIN PEDIATRIC

DENTAL GARDEN

CENTER INC

PEDIATRIC

DENTIST

2765 CHAPEL

PLACE DRIVE

SUITE 250

CRESTVIEW HILLS KY 41017 859 344 6200 http://www.de

ntalbuds.com/

COVENTRY


DENTAL GARDEN

CENTER INC

PEDIATRIC

DENTIST

2765 CHAPEL

PLACE DRIVE

SUITE 250


ntalbuds.com/

FEE FOR

SERVICE


DENTAL GARDEN

CENTER INC

PEDIATRIC

DENTIST

2765 CHAPEL

PLACE DRIVE

SUITE 250


ntalbuds.com/

WELLCARE

69



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

TIMOTHY ACORD KENTUCKY ORAL

SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146

CRESTWOOD KY 40014 502 241 0714 http://www.ke

ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

WELLCARE

W RONALD HARRIS KENTUCKY ORAL

SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

COVENTRY

70



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

WELLCARE

THAD SCHULTEN KENTUCKY ORAL

SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE

71



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER


HIGHWAY 146


ntuckyoralsurg

ery.com/

WELLCARE

THOMAS THURMAN MORTENSON

FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10

CRESTWOOD KY 40014 502 243 0123 http://mortenso

ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

PASSPORT

72



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

WELLCARE

ANASTASIA COMBS MORTENSON

FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

CRESTWOOD

GENERAL

DENTISTRY

6408 WEST

HIGHWAY 146

SUITE 10


ndental.com/D

efault.asp

WELLCARE

TREVOR TAYLOR TAYLOR

ORTHODONTICS


HIGHWAY 146

CRESTWOOD KY 40014 502 241 1515 http://www.tay

lororthodontics

.com/default.as

p

FEE FOR

SERVICE

73



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORTHODONTICS


HIGHWAY 146

CRESTWOOD KY 40014 502 241 1515 http://www.tay

lororthodontics

.com/default.as

p

PASSPORT

A LEE CRUSH A LEE CRUSH

DMD

GENERAL

DENTISTRY

7025 WEST

HIGHWAY 22

SUITE 4

CRESTWOOD KY 40014 502 241 9880 COVENTRY


DMD

GENERAL

DENTISTRY

7025 WEST

HIGHWAY 22

SUITE 4

CRESTWOOD KY 40014 502 241 9880 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

7025 WEST

HIGHWAY 22

SUITE 4

CRESTWOOD KY 40014 502 241 9880 HUMANA


DMD

GENERAL

DENTISTRY

7025 WEST

HIGHWAY 22

SUITE 4

CRESTWOOD KY 40014 502 241 9880 PASSPORT


DMD

GENERAL

DENTISTRY

7025 WEST

HIGHWAY 22

SUITE 4

CRESTWOOD KY 40014 502 241 9880 WELLCARE

JACK LENIHAN LENIHAN DENTAL GENERAL

DENTISTRY

800 VIOLET

ROAD

CRITTENDEN KY 41030 859 428 3100 http://www.len

ihandental.com

/

FEE FOR

SERVICE

JACK LENIHAN LENIHAN DENTAL GENERAL

DENTISTRY

800 VIOLET

ROAD

CRITTENDEN KY 41030 859 428 3100 http://www.len

ihandental.com

/

WELLCARE

MARTY GAMBLE CROFTON

DENTAL CENTER

PLLC

GENERAL

DENTISTRY

115 EAST MILL

STREET

CROFTON KY 42217 270 424 5999 http://croftond

entalky.com/

COVENTRY


DENTAL CENTER

PLLC

GENERAL

DENTISTRY

115 EAST MILL

STREET


entalky.com/

FEE FOR

SERVICE

74



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

PLLC

GENERAL

DENTISTRY

115 EAST MILL

STREET


entalky.com/

PASSPORT


DENTAL CENTER

PLLC

GENERAL

DENTISTRY

115 EAST MILL

STREET


entalky.com/

WELLCARE

DARRELL RISNER FAMILY

DENTISTRY

CLINIC

GENERAL

DENTISTRY

110 MYERS

STREET

CUMBERLAND KY 40823 606 589 5112 COVENTRY


DENTISTRY

CLINIC

GENERAL

DENTISTRY

110 MYERS

STREET

CUMBERLAND KY 40823 606 589 5112 FEE FOR

SERVICE


DENTISTRY

CLINIC

GENERAL

DENTISTRY

110 MYERS

STREET

CUMBERLAND KY 40823 606 589 5112 WELLCARE

CLYDE BLAIR CLYDE E BLAIR

DMD

GENERAL

DENTISTRY

1620 EAST MAIN

STREET

CUMBERLAND KY 40823 606 589 6113 COVENTRY


DMD

GENERAL

DENTISTRY

1620 EAST MAIN

STREET

CUMBERLAND KY 40823 606 589 6113 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1620 EAST MAIN

STREET

CUMBERLAND KY 40823 606 589 6113 WELLCARE

CLARK CASH EARLY YEARS

ORTHODONTICS

ORTHODONTIST 109 SOUTH

WALNUT

STREET

CYNTHIANA KY 41031 859 234 5523 http://www.sm

ileearly.com/in

dex.asp

COVENTRY

75



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORTHODONTICS


WALNUT

STREET


ileearly.com/in

dex.asp

FEE FOR

SERVICE


ORTHODONTICS


WALNUT

STREET


ileearly.com/in

dex.asp

WELLCARE

JASON MCILVAIN CYNTHIANA

DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST

CYNTHIANA KY 41031 859 234 9944 COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST

CYNTHIANA KY 41031 859 234 9944 FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST

CYNTHIANA KY 41031 859 234 9944 WELLCARE

JEWELL MEADE CYNTHIANA

DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST



DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST


SERVICE

76



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST

CYNTHIANA KY 41031 859 234 9944 HUMANA


DENTAL CENTER

GENERAL

DENTISTRY

111 KENTUCKY

HIGHWAY 32

WEST


CYNTHIANA

DENTAL CENTER

MULTI

SPECIALTY

GROUP

111 KENTUCKY

HIGHWAY 32

WEST


SERVICE

KEVIN STEPHENS DENTISTRY

TOMORROW

GENERAL

DENTISTRY

1606 US

HIGHWAY 27

NORTH



TOMORROW

GENERAL

DENTISTRY

1606 US

HIGHWAY 27

NORTH


SERVICE


TOMORROW

GENERAL

DENTISTRY

1606 US

HIGHWAY 27

NORTH



TOMORROW

GENERAL

DENTISTRY

1606 US

HIGHWAY 27

NORTH


NEIL RUSH NEIL RUSH DMD GENERAL

DENTISTRY

216 SOUTH MAIN

STREET



DENTISTRY

216 SOUTH MAIN

STREET


SERVICE

77



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

216 SOUTH MAIN

STREET



DENTISTRY

216 SOUTH MAIN

STREET


JOHN HANKLA JOHN HANKLA

DMD

GENERAL

DENTISTRY

1000 EAST

LEXINGTON

AVENUE SUITE

35

DANVILLE KY 40422 859 236 2243 COVENTRY


DMD

GENERAL

DENTISTRY

1000 EAST

LEXINGTON

AVENUE SUITE

35

DANVILLE KY 40422 859 236 2243 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1000 EAST

LEXINGTON

AVENUE SUITE

35

DANVILLE KY 40422 859 236 2243 HUMANA


DMD

GENERAL

DENTISTRY

1000 EAST

LEXINGTON

AVENUE SUITE

35

DANVILLE KY 40422 859 236 2243 WELLCARE

JEFFREY JOHNSON DANVILLE

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

126 DANIEL

DRIVE



PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

126 DANIEL

DRIVE


SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

126 DANIEL

DRIVE


78



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DANVILLE

PEDIATRIC

DENTISTRY

MULTI

SPECIALTY

GROUP

126 DANIEL

DRIVE


SERVICE

CLIFFORD LOWDENBACK WHITE GREER

AND MAGGARD

ORTHODONTICS

ORTHODONTIST 126 DANIEL

DRIVE SUITE B

DANVILLE KY 40422 859 936 9937 http://www.wg

mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

WELLCARE

MICHAEL MAGGARD WHITE GREER

AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

FEE FOR

SERVICE

79



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

WELLCARE

JAMES WHITE WHITE GREER

AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE SUITE B


mortho.com/H

ome.aspx

WELLCARE

SARAH IQBAL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET

DANVILLE KY 40422 859 236 2488 http://www.da

nvillefamilyde

ntists.org/hom

e.nxg

COVENTRY

80



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

FEE FOR

SERVICE


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

HUMANA


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

WELLCARE

LISA NEAL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

COVENTRY

LISA NEAL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

FEE FOR

SERVICE

LISA NEAL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

HUMANA

LISA NEAL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

WELLCARE

81



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JESSICA POPPLEWELL DANVILLE

FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

COVENTRY


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

FEE FOR

SERVICE


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

HUMANA


FAMILY

DENTISTRY PLLC

GENERAL

DENTISTRY

132 NORTH 2ND

STREET


nvillefamilyde

ntists.org/hom

e.nxg

WELLCARE

CAROLYN MOODY CAROLYN S

MOODY DMD

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

303 SOUTH 4TH

STREET SUITE

200

DANVILLE KY 40422 859 236 8448 http://www.car

olynmoodydm

d.com/

COVENTRY


MOODY DMD

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

303 SOUTH 4TH

STREET SUITE

200


olynmoodydm

d.com/

FEE FOR

SERVICE


MOODY DMD

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

303 SOUTH 4TH

STREET SUITE

200


olynmoodydm

d.com/

HUMANA

82



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MOODY DMD

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

303 SOUTH 4TH

STREET SUITE

200


olynmoodydm

d.com/

PASSPORT


MOODY DMD

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

303 SOUTH 4TH

STREET SUITE

200


olynmoodydm

d.com/

WELLCARE

ROBERT WEBSTER WEBSTER

ORTHODONTICS

ORTHODONTIST 359 SOUTH 4TH

STREET SUITE B



ORTHODONTICS


STREET SUITE B


SERVICE


ORTHODONTICS


STREET SUITE B


CORKY DEATON DEATON AND

DEATON

GENERAL

DENTISTRY

359 SOUTH 4TH

STREET SUITE C



DEATON

GENERAL

DENTISTRY

359 SOUTH 4TH

STREET SUITE C


SERVICE

83



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DEATON

GENERAL

DENTISTRY

359 SOUTH 4TH

STREET SUITE C

DANVILLE KY 40422 859 236 5703 HUMANA


DEATON

GENERAL

DENTISTRY

359 SOUTH 4TH

STREET SUITE C


LOUIS BETO DANVILLE ORAL

AND

MAXILLOFACIAL

SURGERY

ORAL SURGEON 400 SOUTH 4TH

STREET


nvilleoms.com/

COVENTRY


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

FEE FOR

SERVICE


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

HUMANA


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

WELLCARE

AMY BOGARDUS DANVILLE ORAL

AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

COVENTRY

84



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

FEE FOR

SERVICE


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

WELLCARE

GREGORY COBETTO DANVILLE ORAL

AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

COVENTRY


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

FEE FOR

SERVICE


AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

WELLCARE

DANVILLE ORAL

AND

MAXILLOFACIAL

SURGERY


STREET


nvilleoms.com/

FEE FOR

SERVICE

JEFFREY WINFREY JEFFERY L

WINFREY DDS

GENERAL

DENTISTRY

115 WEST MUNN

STREET

DAWSON SPRINGS KY 42408 270 797 4171 COVENTRY


WINFREY DDS

GENERAL

DENTISTRY

115 WEST MUNN

STREET

DAWSON SPRINGS KY 42408 270 797 4171 FEE FOR

SERVICE

85



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


WINFREY DDS

GENERAL

DENTISTRY

115 WEST MUNN

STREET

DAWSON SPRINGS KY 42408 270 797 4171 WELLCARE

STEPHEN AGENT STEPHEN AGENT

DMD

GENERAL

DENTISTRY

308 EAST

ARCADIA

AVENUE

DAWSON SPRINGS KY 42408 270 797 3319 COVENTRY


DMD

GENERAL

DENTISTRY

308 EAST

ARCADIA

AVENUE

DAWSON SPRINGS KY 42408 270 797 3319 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

308 EAST

ARCADIA

AVENUE

DAWSON SPRINGS KY 42408 270 797 3319 WELLCARE

BUFORD HILL DAYTON

BELLEVUE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

625 6TH AVENUE DAYTON KY 41074 859 261 0101 http://www.dbf

dentistry.com/

COVENTRY

BUFORD HILL DAYTON

BELLEVUE

FAMILY

DENTISTRY

GENERAL

DENTISTRY


dentistry.com/

FEE FOR

SERVICE

BUFORD HILL DAYTON

BELLEVUE

FAMILY

DENTISTRY

GENERAL

DENTISTRY


dentistry.com/

WELLCARE

DAYTON

BELLEVUE

FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP


dentistry.com/

FEE FOR

SERVICE

86



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

THAD THOMAS THAD F THOMAS

DMD

GENERAL

DENTISTRY

118 SOUTH MAIN

STREET SUITE 5

DRY RIDGE KY 41035 859 824 5454 COVENTRY


DMD

GENERAL

DENTISTRY

118 SOUTH MAIN

STREET SUITE 5

DRY RIDGE KY 41035 859 824 5454 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

118 SOUTH MAIN

STREET SUITE 5

DRY RIDGE KY 41035 859 824 5454 WELLCARE

JONATHAN RICH PRECISION

DENTAL CARE

GENERAL

DENTISTRY

139 SOUTH MAIN

STREET

DRY RIDGE KY 41035 859 824 7133 http://www.pre

cisiondentalky.

com/home/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

139 SOUTH MAIN

STREET


cisiondentalky.

com/home/

WELLCARE

WILLIAM RICH PRECISION

DENTAL CARE

GENERAL

DENTISTRY

139 SOUTH MAIN

STREET


cisiondentalky.

com/home/

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

139 SOUTH MAIN

STREET


cisiondentalky.

com/home/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

139 SOUTH MAIN

STREET


cisiondentalky.

com/home/

WELLCARE

TIMOTHY MCMAHON COMFORT

DENTISTRY

GENERAL

DENTISTRY

300 ARBORS

DRIVE SUITE 5

DRY RIDGE KY 41035 859 823 0111 http://www.co

mfortdentistry

ky.com/

COVENTRY

87



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

300 ARBORS

DRIVE SUITE 5


mfortdentistry

ky.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

300 ARBORS

DRIVE SUITE 5


mfortdentistry

ky.com/

WELLCARE

TAMMY SANDERS EARLINGTON

FAMILY DENTAL

CARE

GENERAL

DENTISTRY

122 SOUTH LEE

TROVER JR

HIGHWAY

EARLINGTON KY 42410 270 383 5511 COVENTRY


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

122 SOUTH LEE

TROVER JR

HIGHWAY

EARLINGTON KY 42410 270 383 5511 FEE FOR

SERVICE


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

122 SOUTH LEE

TROVER JR

HIGHWAY

EARLINGTON KY 42410 270 383 5511 WELLCARE

WILLIAM PETREY EAST BERNSTADT

DENTAL

GENERAL

DENTISTRY

2725 US

HIGHWAY 25

NORTH

EAST BERNSTADT KY 40729 606 843 6476 http://www.eas

tbernstadtdenta

l.com/

COVENTRY


DENTAL

GENERAL

DENTISTRY

2725 US

HIGHWAY 25

NORTH


tbernstadtdenta

l.com/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

2725 US

HIGHWAY 25

NORTH


tbernstadtdenta

l.com/

WELLCARE

88



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

STAN HAYES STAN HAYES

DMD

GENERAL

DENTISTRY

292 HIGHWAY

550

EASTERN KY 41622 606 358 4157 COVENTRY


DMD

GENERAL

DENTISTRY

292 HIGHWAY

550

EASTERN KY 41622 606 358 4157 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

292 HIGHWAY

550

EASTERN KY 41622 606 358 4157 WELLCARE

JOHN SIMS JOHN J SIMS DMD

PSC

GENERAL

DENTISTRY

260 COMMERCE

STREET

EDDYVILLE KY 42038 270 388 9712 COVENTRY


PSC

GENERAL

DENTISTRY

260 COMMERCE

STREET

EDDYVILLE KY 42038 270 388 9712 FEE FOR

SERVICE


PSC

GENERAL

DENTISTRY

260 COMMERCE

STREET

EDDYVILLE KY 42038 270 388 9712 WELLCARE

NORTHERN

KY

INDEPENDEN

T DISTRIST

HEALTH

DEPARTMEN

T

GENERAL

DENTISTRY

610 MEDICAL

VILLAGE DRIVE

EDGEWOOD KY 41017 859 341 4264 http://www.nk

yhealth.org/

FEE FOR

SERVICE

JOHN MILLER MILLER FAMILY

DENTISTRY

GENERAL

DENTISTRY

108 ELMORE

STREET

EDMONTON KY 42129 270 432 7211 COVENTRY

89



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

108 ELMORE

STREET

EDMONTON KY 42129 270 432 7211 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

108 ELMORE

STREET

EDMONTON KY 42129 270 432 7211 WELLCARE

MARK FROEDGE EDMONTON

DENTAL CENTER

GENERAL

DENTISTRY

706 WEST

STOCKTON

STREET

EDMONTON KY 42129 270 432 3617 COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

706 WEST

STOCKTON

STREET

EDMONTON KY 42129 270 432 3617 FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

706 WEST

STOCKTON

STREET

EDMONTON KY 42129 270 432 3617 PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

706 WEST

STOCKTON

STREET

EDMONTON KY 42129 270 432 3617 WELLCARE

NICHOLAS ISING ISING

ORTHODONTICS

ORTHODONTIST 1102 WOODLAND

DRIVE

ELIZABETHTOWN KY 42701 270 769 2186 http://www.is

milesbyising.c

om/home.aspx

FEE FOR

SERVICE

NICHOLAS ISING ISING

ORTHODONTICS

ORTHODONTIST 1102 WOODLAND

DRIVE

ELIZABETHTOWN KY 42701 270 769 2186 http://www.is

milesbyising.c

om/home.aspx

PASSPORT

RODERICK ABANG ELIZABETHTOWN

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210

ELIZABETHTOWN KY 42701 270 769 3858 COVENTRY

90



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210

ELIZABETHTOWN KY 42701 270 769 3858 FEE FOR

SERVICE


DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210

ELIZABETHTOWN KY 42701 270 769 3858 HUMANA


DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210

ELIZABETHTOWN KY 42701 270 769 3858 PASSPORT


DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210

ELIZABETHTOWN KY 42701 270 769 3858 WELLCARE

NICHOLAS MURPHY ELIZABETHTOWN

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210



DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210


SERVICE

91



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210



DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210



DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210


MARIANNE SHEROAN ELIZABETHTOWN

DENTISTRY FOR

CHILDREN

GENERAL

DENTISTRY

1107 CROWNE

POINTE DRIVE

SUITE 210



DENTISTRY FOR

CHILDREN

GENERAL

DENTISTRY

1107 CROWNE

POINTE DRIVE

SUITE 210


SERVICE


DENTISTRY FOR

CHILDREN

GENERAL

DENTISTRY

1107 CROWNE

POINTE DRIVE

SUITE 210


92



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY FOR

CHILDREN

GENERAL

DENTISTRY

1107 CROWNE

POINTE DRIVE

SUITE 210



DENTISTRY FOR

CHILDREN

GENERAL

DENTISTRY

1107 CROWNE

POINTE DRIVE

SUITE 210


ELIZABETHTOWN

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210


SERVICE

ELIZABETHTOWN

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1107 CROWNE

POINTE DRIVE

SUITE 210


TONI IRWIN HEARTLAND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1205 WOODLAND

DRIVE

ELIZABETHTOWN KY 42701 270 737 4746 http://www.he

artlandfamilyd

entistry.net/40

1.html#top

FEE FOR

SERVICE

TONI IRWIN HEARTLAND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1205 WOODLAND

DRIVE

ELIZABETHTOWN KY 42701 270 737 4746 http://www.he

artlandfamilyd

entistry.net/40

1.html#top

PASSPORT

MOLLY BRAUN KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE

ELIZABETHTOWN KY 42701 270 872 4629 http://www.my

koolsmiles.co

m/

COVENTRY

93



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

CHRISTOPHE

R

CORDER KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY

CHRISTOPHE

R

CORDER KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE

CHRISTOPHE

R

CORDER KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA

CHRISTOPHE

R

CORDER KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT

CHRISTOPHE

R

CORDER KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

TONDA HELTON KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY

94



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

MEGAN JACKSON KOOL SMILES OF

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m

COVENTRY


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m

PASSPORT

95



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m

WELLCARE

PAUL KOSHGERIAN III KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT

ASHLEY LEE KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT

SARA PAIGE

TROMBETTI

KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

PRACTICE

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE

SARA PAIGE

TROMBETTI

KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

PRACTICE

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA

96



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SARA PAIGE

TROMBETTI

KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

PRACTICE

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT

SARA PAIGE

TROMBETTI

KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

PRACTICE

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

BRITNEY PHILLIPS KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

ANDREW RAY KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY

JAMIE RECTOR KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE

97



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

MICHAEL STURGEON JR KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

HUMANA


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

SHARLETTE VICTORINO KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY

SOLITAIRE WIX KOOL SMILES

ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

COVENTRY

98



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

FEE FOR

SERVICE


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

PASSPORT


ELIZABETHTOWN

GENERAL

DENTISTRY

201 TOWNE

DRIVE


koolsmiles.co

m/

WELLCARE

LAUREN THOMAS ELIZABETHTOWN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

2101 NORTH

DIXIE HIGHWAY

SUITE 100

ELIZABETHTOWN KY 42721 270 735 1441 http://www.eto

wnfamilydenti

stry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

2101 NORTH

DIXIE HIGHWAY

SUITE 100


wnfamilydenti

stry.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

2101 NORTH

DIXIE HIGHWAY

SUITE 100


wnfamilydenti

stry.com/

PASSPORT

SARAH PROCTOR PROCTOR

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

PRACTIONER

2110 NORTH

DIXIE HIGHWAY

SUITE 100

ELIZABETHTOWN KY 42701 270 982 4433 http://www.pro

ctordentistry.c

om/index.asp

FEE FOR

SERVICE


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

PRACTIONER

2110 NORTH

DIXIE HIGHWAY

SUITE 100


ctordentistry.c

om/index.asp

HUMANA

99



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

PRACTIONER

2110 NORTH

DIXIE HIGHWAY

SUITE 100


ctordentistry.c

om/index.asp

PASSPORT


ORTHODONTICS

ORTHODONTIST 2401 RING ROAD ELIZABETHTOWN KY 42701 270 765 6502 http://www.du

plessisorthodo

ntics.com/

COVENTRY


ORTHODONTICS


plessisorthodo

ntics.com/

FEE FOR

SERVICE


ORTHODONTICS


plessisorthodo

ntics.com/

HUMANA


ORTHODONTICS


plessisorthodo

ntics.com/

PASSPORT


ORTHODONTICS


plessisorthodo

ntics.com/

WELLCARE

DUPLESSIS

ORTHODONTICS


plessisorthodo

ntics.com/

FEE FOR

SERVICE

MATTHEW MORGAN MORTENSON

FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137

ELIZABETHTOWN KY 42701 270 360 0480 http://mortenso

ndental.com/de

fault.asp

COVENTRY

100



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/de

fault.asp

WELLCARE

SARA ROGERS MORTENSON

FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/D

efault.asp

FEE FOR

SERVICE

101



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

ELIZABETHTOWN

GENERAL

DENTISTRY

2407 RING ROAD

SUITE 137


ndental.com/D

efault.asp

WELLCARE

SANA ABUROB BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 COVENTRY


DENTAL CARE

PSC

GENERAL

DENTISTRY

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 FEE FOR

SERVICE


DENTAL CARE

PSC

GENERAL

DENTISTRY

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 HUMANA


DENTAL CARE

PSC

GENERAL

DENTISTRY

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 PASSPORT

102



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

PSC

GENERAL

DENTISTRY

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 WELLCARE

JOHN FRITZ JR. BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY



DENTAL CARE

PSC

GENERAL

DENTISTRY


SERVICE


DENTAL CARE

PSC

GENERAL

DENTISTRY



DENTAL CARE

PSC

GENERAL

DENTISTRY


ANN

MARGARET

LUCKETT BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY


ANN

MARGARET


DENTAL CARE

PSC

GENERAL

DENTISTRY


SERVICE

103



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ANN

MARGARET


DENTAL CARE

PSC

GENERAL

DENTISTRY


ANN

MARGARET


DENTAL CARE

PSC

GENERAL

DENTISTRY


SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY

PRACTICE


SERVICE

SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY

PRACTICE

2900 RING ROAD ELIZABETHTOWN KY 42701 270 737 6453 HUMANA

SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY

PRACTICE


SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

PSC

GENERAL

DENTISTRY

PRACTICE



DMD


POPLAR STREET



DMD


POPLAR STREET


SERVICE

104



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD


POPLAR STREET



DMD


POPLAR STREET



DMD


POPLAR STREET



BALDWIN

ORTHODONTICS

ORTHODONTIST 520 NORTH

MILES STREET

ELIZABETHTOWN KY 42701 270 769 1349 http://bracesby

inmanandbald

win.com/

COVENTRY


BALDWIN

ORTHODONTICS


MILES STREET


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


MILES STREET


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS


MILES STREET


inmanandbald

win.com/

PASSPORT


BALDWIN

ORTHODONTICS


MILES STREET


inmanandbald

win.com/

WELLCARE

105



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BALDWIN

ORTHODONTICS


MILES STREET

ELIZABETHTOWN KY 42701 270 769 1349 http://www.sm

ilesbyibo.com/

index.asp

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

HUMANA


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

PASSPORT


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

COVENTRY


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

HUMANA


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

PASSPORT

106



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BALDWIN

ORTHODONTICS


MILES STREET


ilesbyibo.com/

index.asp

WELLCARE

JAMES JUSTICE ELKHORN

DENTAL

GENERAL

DENTISTRY

155 EAST MAIN

STREET

ELKHORN CITY KY 41522 606 754 0155 http://elkhornd

ental.com/

COVENTRY


DENTAL

GENERAL

DENTISTRY

155 EAST MAIN

STREET


ental.com/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

155 EAST MAIN

STREET


ental.com/

WELLCARE

REBECCA ANDERSON REBECCA

ANDERSON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

170 5TH STREET ELKHORN CITY KY 41522 606 754 7198 COVENTRY


ANDERSON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

170 5TH STREET ELKHORN CITY KY 41522 606 754 7198 FEE FOR

SERVICE


ANDERSON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

170 5TH STREET ELKHORN CITY KY 41522 606 754 7198 WELLCARE

LARRY LYNN LARRY W LYNN

DMD

GENERAL

DENTISTRY

919 ELKHORN

CREEK ROAD

ELKHORN CITY KY 41522 606 754 4936 COVENTRY

107



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

919 ELKHORN

CREEK ROAD

ELKHORN CITY KY 41522 606 754 4936 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

919 ELKHORN

CREEK ROAD

ELKHORN CITY KY 41522 606 754 4936 WELLCARE

JOHN JAEGER JOHN E JAEGER

DMD

GENERAL

DENTISTRY

105 EMINENCE

TERRACE

EMINENCE KY 40019 502 845 5338 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

105 EMINENCE

TERRACE

EMINENCE KY 40019 502 845 5338 HUMANA


DMD

GENERAL

DENTISTRY

105 EMINENCE

TERRACE

EMINENCE KY 40019 502 845 5338 PASSPORT

MIA SELLARS CLOVER

FORK CLINIC

GENERAL

DENTISTRY

101 CHAD

STREET

EVARTS KY 40828 606 837 2108 http://www.clo

verforkclinic.o

rg/index.htm

COVENTRY

MIA SELLARS CLOVER

FORK CLINIC

GENERAL

DENTISTRY

101 CHAD

STREET


verforkclinic.o

rg/index.htm

FEE FOR

SERVICE

MIA SELLARS CLOVER

FORK CLINIC

GENERAL

DENTISTRY

101 CHAD

STREET


verforkclinic.o

rg/index.htm

WELLCARE

108



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CLOVER

FORK CLINIC

MEDICAL CLINIC 101 CHAD

STREET


verforkclinic.o

rg/index.htm

COVENTRY

CLOVER

FORK CLINIC


STREET


verforkclinic.o

rg/index.htm

FEE FOR

SERVICE

CLOVER

FORK CLINIC


STREET


verforkclinic.o

rg/index.htm

FEE FOR

SERVICE

CLOVER

FORK CLINIC


STREET


verforkclinic.o

rg/index.htm

WELLCARE

WILLIAM VERAX III WILLIAM J

VERAX III DMD

HIGHLANDS

FAMILY

DENTISTRY

211 WEST

SHELBY STREET

FALMOUTH KY 41040 859 654 5041 COVENTRY


VERAX III DMD

GENERAL

DENTISTRY

211 WEST

SHELBY STREET

FALMOUTH KY 41040 859 654 5041 FEE FOR

SERVICE


VERAX III DMD

GENERAL

DENTISTRY

211 WEST

SHELBY STREET

FALMOUTH KY 41040 859 654 5041 WELLCARE

WILLIAM J

VERAX III DMD

MULTI

SPECIALTY

GROUP

211 WEST

SHELBY STREET

FALMOUTH KY 41040 859 654 5041 FEE FOR

SERVICE

ROBERT WAGNER ROBERT L

WAGNER DMD

GENERAL

DENTISTRY

1402 ARGILLITE

ROAD

FLATWOODS KY 41139 606 836 1646 COVENTRY

109



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


WAGNER DMD

GENERAL

DENTISTRY

1402 ARGILLITE

ROAD

FLATWOODS KY 41139 606 836 1646 FEE FOR

SERVICE


WAGNER DMD

GENERAL

DENTISTRY

1402 ARGILLITE

ROAD

FLATWOODS KY 41139 606 836 1646 WELLCARE

RONALD LEWIS RONALD E LEWIS

DMD

GENERAL

DENTISTRY

909 POWELL

LANE

FLATWOODS KY 41139 606 836 4717 FEE FOR

SERVICE

RONALD LEWIS RONALD E LEWIS

DMD

GENERAL

DENTISTRY

909 POWELL

LANE

FLATWOODS KY 41139 606 836 4717 WELLCARE

WILLIAM MOORHEAD FLEMINGSBURG

DENTAL CARE

GENERAL

DENTISTRY

303 SOUTH MAIN

CROSS

FLEMINGSBURG KY 41041 606 845 2273 http://www.dr

moorhead.com

/flemingsburgd

entalcare/

FEE FOR

SERVICE

WILLIAM MOORHEAD FLEMINGSBURG

DENTAL CARE

GENERAL

DENTISTRY

303 SOUTH MAIN

CROSS

FLEMINGSBURG KY 41041 606 845 2273 http://www.dr

moorhead.com

/flemingsburgd

entalcare/

WELLCARE

THOMAS PERKINS THOMAS PERKINS

DMD

GENERAL

DENTISTRY

708 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 849 2151 COVENTRY


DMD

GENERAL

DENTISTRY

708 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 849 2151 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

708 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 849 2151 WELLCARE

110



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KENT KALB KENT KALB DMD GENERAL

DENTISTRY

800 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 845 3010 COVENTRY


DENTISTRY

800 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 845 3010 FEE FOR

SERVICE


DENTISTRY

800 ELIZAVILLE

AVENUE

FLEMINGSBURG KY 41041 606 845 3010 WELLCARE

KENNETH WALLACE KENNETH F

WALLACE DDS

GENERAL

DENTISTRY

280 MOUNT ZION

ROAD SUITE D

FLORENCE KY 41042 859 283 1986 http://www.dr

wallacedentist.

com/

COVENTRY


WALLACE DDS

GENERAL

DENTISTRY

280 MOUNT ZION

ROAD SUITE D


wallacedentist.

com/

FEE FOR

SERVICE


WALLACE DDS

GENERAL

DENTISTRY

280 MOUNT ZION

ROAD SUITE D


wallacedentist.

com/

WELLCARE

KENNETH F

WALLACE DDS

GENERAL

DENTISTRY

280 MOUNT ZION

ROAD SUITE D


wallacedentist.

com/

FEE FOR

SERVICE

MARY JAY BEAM IMMEDIADENT

FLORENCE

GENERAL

DENTISTRY

4960 HOUSTON

ROAD SUITE G

FLORENCE KY 41042 859 971 1505 http://www.im

mediadent.com

/

COVENTRY


FLORENCE

GENERAL

DENTISTRY

4960 HOUSTON

ROAD SUITE G


mediadent.com

/

FEE FOR

SERVICE

111



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FLORENCE

GENERAL

DENTISTRY

4960 HOUSTON

ROAD SUITE G


mediadent.com

/

WELLCARE

MARTIN MOORE MOORE DENTAL

SERVICES

GENERAL

DENTISTRY

59 CAVALIER

BLVD SUITE 300

FLORENCE KY 41042 859 525 0507 http://www.mo

oredentalservic

es.com/

COVENTRY


SERVICES

GENERAL

DENTISTRY

59 CAVALIER

BLVD SUITE 300


oredentalservic

es.com/

FEE FOR

SERVICE


SERVICES

GENERAL

DENTISTRY

59 CAVALIER

BLVD SUITE 300


oredentalservic

es.com/

WELLCARE

CURTIS ZIMMERMAN MORTENSON

FAMILY DENTAL

FLORENCE

GENERAL

DENTISTRY

7033

BURLINGTON

PIKE

FLORENCE KY 40243 859 525 7586 http://mortenso

ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

FLORENCE

GENERAL

DENTISTRY

7033

BURLINGTON

PIKE


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FLORENCE

GENERAL

DENTISTRY

7033

BURLINGTON

PIKE


ndental.com/D

efault.asp

WELLCARE

112



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ALBERT BATHIANY IV BURT BATHIANY

PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

7400 HIGHWAY

42

FLORENCE KY 41042 859 525 2100 COVENTRY


PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

7400 HIGHWAY

42

FLORENCE KY 41042 859 525 2100 FEE FOR

SERVICE


PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

7400 HIGHWAY

42

FLORENCE KY 41042 859 525 2100 WELLCARE

SUZANNE SEXTON URGENT DETNAL

CARE LLC

GENERAL

DENTISTRY

7901 MALL ROAD

SUITE 500

FLORENCE KY 41042 859 647 7600 http://urgent

dentist.com/

COVENTRY


CARE LLC

GENERAL

DENTISTRY

7901 MALL ROAD

SUITE 500


dentist.com/

FEE FOR

SERVICE


CARE LLC

GENERAL

DENTISTRY

7901 MALL ROAD

SUITE 500


dentist.com/

WELLCARE

J DAVIDSON PHILBRICK WEAVER DENTAL

CARE

GENERAL

DENTISTRY

8449 US

HIGHWAY 42

SUITE K

FLORENCE KY 41042 859 372 6300 http://www.we

averdentalcare.

com/index.php

COVENTRY


CARE

GENERAL

DENTISTRY

8449 US

HIGHWAY 42

SUITE K


averdentalcare.

com/index.php

FEE FOR

SERVICE

113



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CARE

GENERAL

DENTISTRY

8449 US

HIGHWAY 42

SUITE K


averdentalcare.

com/index.php

WELLCARE

MARK GLOCKNER GLOCKNER

DENTISTRY

GENERAL

DENTISTRY

2011 DIXIE

HIGHWAY

FORT MITCHELL KY 41011 859 331 6677 http://www.ma

rkjglocknerdm

d.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

2011 DIXIE

HIGHWAY


rkjglocknerdm

d.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2011 DIXIE

HIGHWAY


rkjglocknerdm

d.com/

WELLCARE

JOHN SCHULTE JOHN SCHULTE

DMD

PEDIATRIC

DENTIST

2078 DIXIE

HIGHWAY

FORT MITCHELL KY 41011 859 331 0763 http://www.ft

mitchelldentist

.net/

COVENTRY


DMD

PEDIATRIC

DENTIST

2078 DIXIE

HIGHWAY


mitchelldentist

.net/

FEE FOR

SERVICE


DMD

PEDIATRIC

DENTIST

2078 DIXIE

HIGHWAY


mitchelldentist

.net/

WELLCARE

STEPHEN KEES STEPHEN R KEES

DMD

GENERAL

DENTISTRY

2370

GRANDVIEW

DRIVE

FORT MITCHELL KY 41017 859 331 4449 COVENTRY


DMD

GENERAL

DENTISTRY

2370

GRANDVIEW

DRIVE

FORT MITCHELL KY 41017 859 331 4449 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

2370

GRANDVIEW

DRIVE

FORT MITCHELL KY 41017 859 331 4449 WELLCARE

114



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MAMARI MAHER FORT MITCHELL

DENTAL CARE

GENERAL

DENTISTRY

2503 CHELSA

DRIVE


mitchelldental

care.com/

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

2503 CHELSA

DRIVE


mitchelldental

care.com/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

2503 CHELSA

DRIVE


mitchelldental

care.com/

WELLCARE

FORT MITCHELL

DENTAL CARE

GENERAL

DENTISTRY

2503 CHELSA

DRIVE


mitchelldental

care.com/

FEE FOR

SERVICE

FORT MITCHELL

DENTAL CARE

GENERAL

DENTISTRY

2503 CHELSA

DRIVE


mitchelldental

care.com/

WELLCARE

LAURA BOWMAN LAURA H

BOWMAN DDS

GENERAL

DENTISTRY

14 NORTH FORT

THOMAS

AVENUE

FORT THOMAS KY 41075 859 441 1696 COVENTRY


BOWMAN DDS

GENERAL

DENTISTRY

14 NORTH FORT

THOMAS

AVENUE

FORT THOMAS KY 41075 859 441 1696 FEE FOR

SERVICE

115



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BOWMAN DDS

GENERAL

DENTISTRY

14 NORTH FORT

THOMAS

AVENUE

FORT THOMAS KY 41075 859 441 1696 WELLCARE


PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

18 NORTH FORT

THOMAS

AVENUE

FORT THOMAS KY 41075 859 781 4100 COVENTRY


PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

18 NORTH FORT

THOMAS

AVENUE


SERVICE


PEDIATRIC

DENTISRTRY

PEDIATRIC

DENTIST

18 NORTH FORT

THOMAS

AVENUE

FORT THOMAS KY 41075 859 781 4100 WELLCARE

BURT BATHIANY

PEDIATRIC

DENTISRTRY

GENERAL

DENTISTRY

18 NORTH FORT

THOMAS

AVENUE


SERVICE

MARK PFEIFFER PFEIFFER FAMILY

DENTISTRY

GENERAL

DENTISTRY

20 NORTH

GRAND AVENUE

SUITE 10

FORT THOMAS KY 41075 859 441 1900 http://www.my

dr2th.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

20 NORTH

GRAND AVENUE

SUITE 10


dr2th.com/

FEE FOR

SERVICE

116



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

20 NORTH

GRAND AVENUE

SUITE 10


dr2th.com/

WELLCARE

DOUGLAS STEPHENS DOUGLAS K

STEPHENS DMD

GENERAL

DENTISTRY

880

ALEXANDRIA

PIKE SUITE 104


SERVICE

DOUGLAS STEPHENS DOUGLAS K

STEPHENS DMD

GENERAL

DENTISTRY

880

ALEXANDRIA

PIKE SUITE 104

FORT THOMAS KY 41075 859 441 2332 PASSPORT

ONHEALTHCARE

DENTAL

MULTI

SPECIALTY

GROUP

35 AUGUSTA

AVE

FORT WRIGHT KY 41011 859 750 5642 http://www.on

healthcare.com

/dental.html

FEE FOR

SERVICE


ORTHODONTICS

ORTHODONTIST 635 COMANCHE

TRAIL

FRANKFORT KY 40601 502 227 1931 http://www.sm

ileearly.com/in

dex.asp

FEE FOR

SERVICE


ORTHODONTICS


TRAIL


ileearly.com/in

dex.asp

HUMANA


ORTHODONTICS


TRAIL


ileearly.com/in

dex.asp

WELLCARE

117



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRENT MORTENSON ORAL AND

FACIAL SURGERY

GROUP

FRANKFORT

ORAL SURGEON 103 C MICHAEL

DAVENPORT DR

#3

FRANKFORT KY 40601 502 352 2510 http://www.the

ofsgroup.com/i

ndex.php

COVENTRY


FACIAL SURGERY

GROUP

FRANKFORT


DAVENPORT DR

#3


ofsgroup.com/i

ndex.php

FEE FOR

SERVICE


FACIAL SURGERY

GROUP

FRANKFORT


DAVENPORT DR

#3


ofsgroup.com/i

ndex.php

HUMANA


FACIAL SURGERY

GROUP

FRANKFORT


DAVENPORT DR

#3


ofsgroup.com/i

ndex.php

WELLCARE

JAMES SALMAN ORAL AND

FACIAL SURGERY

GROUP

FRANKFORT


DAVENPORT DR

#3


ofsgroup.com/i

ndex.php

FEE FOR

SERVICE

JAMES SALMAN ORAL AND

FACIAL SURGERY

GROUP

FRANKFORT


DAVENPORT DR

#3


ofsgroup.com/i

ndex.php

HUMANA

118



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ORAL SURGERY

GROUP OF

FRANKFORT

MULTI

SPECIALTY

GROUP

103 C MICHAEL

DAVENPORT DR.

#3

FRANKFORT KY 40601 502 352 2510 FEE FOR

SERVICE

ORAL SURGERY

GROUP OF

FRANKFORT

103 C MICHAEL

DAVENPORT DR.

#3


SERVICE

HAROLD DANIEL ORAL AND FACIL

SURGERY GROUP

OF FRANKFORT


DAVENPORT

DRIVE SUITE 3


ofsgroup.com/i

ndex.php

COVENTRY


SURGERY GROUP

OF FRANKFORT


DAVENPORT

DRIVE SUITE 3


ofsgroup.com/i

ndex.php

FEE FOR

SERVICE


SURGERY GROUP

OF FRANKFORT


DAVENPORT

DRIVE SUITE 3


ofsgroup.com/i

ndex.php

HUMANA


SURGERY GROUP

OF FRANKFORT


DAVENPORT

DRIVE SUITE 3


ofsgroup.com/i

ndex.php

WELLCARE

119



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KENNETH BONDRA KENTUCKY

CENTER FOR

ORAL SURGERY

ORAL SURGEON 105 DIAGNOSTIC

DRIVE

FRANKFORT KY 40601 502 875 4608 http://www.ke

ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

ROBERT CLARK KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

120



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

BRUCE NICOL KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

121



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

HUMANA


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

KENTUCKY

CENTER FOR

ORAL SURGERY

MULTI

SPECIALTY

GROUP

105 DIAGNOSTIC

DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DAVID SKAFF DAVID M SKAFF

DDS

PEDIATRIC

DENTIST

110 DIAGNOSTIC

DRIVE

FRANKFORT KY 40601 502 223 7186 COVENTRY


DDS

PEDIATRIC

DENTIST

110 DIAGNOSTIC

DRIVE


SERVICE


DDS

PEDIATRIC

DENTIST

110 DIAGNOSTIC

DRIVE

FRANKFORT KY 40601 502 223 7186 HUMANA


DDS

PEDIATRIC

DENTIST

110 DIAGNOSTIC

DRIVE

FRANKFORT KY 40601 502 223 7186 WELLCARE

MICHAEL BARRINGTON MORTENSON

FAMILY DENTAL

FRANKFORT

GENERAL

DENTISTRY

1230 US

HIGHWAY 127

SUITE 2

FRANKFORT KY 40601 502 352 2512 http://mortenso

ndental.com/D

efault.asp

COVENTRY

122



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

FRANKFORT

GENERAL

DENTISTRY

1230 US

HIGHWAY 127

SUITE 2


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FRANKFORT

GENERAL

DENTISTRY

1230 US

HIGHWAY 127

SUITE 2


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

FRANKFORT

GENERAL

DENTISTRY

1230 US

HIGHWAY 127

SUITE 2


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

FRANKFORT

GENERAL

DENTISTRY

1230 US

HIGHWAY 127

SUITE 2


ndental.com/D

efault.asp

WELLCARE

DOUGLAS DURBIN THE KENTUCKY

CENTER FOR

ORTHODONTICS

ORTHODONTIST 193 VERSAILLES

ROAD SUITE 37

FRANKFORT KY 40601 800 929 7733 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

WELLCARE

123



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

THOMAS GARNER THE KENTUCKY

CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

WELLCARE

JOHN HUANG THE KENTUCKY

CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


ROAD SUITE 37


ortho.com/

WELLCARE

124



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DARRYL SMITH DARRYL V SMITH

FAMILY

DENTISTRY

GENERAL

DENTISTRY

571 EAST MAIN

STREET SUITE 4

FRANKFORT KY 40601 502 227 2740 COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

571 EAST MAIN

STREET SUITE 4


SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

571 EAST MAIN

STREET SUITE 4

FRANKFORT KY 40601 502 227 2740 HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

571 EAST MAIN

STREET SUITE 4

FRANKFORT KY 40601 502 227 2740 WELLCARE

ARLENE BALUYUT DESIGNING

SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A

FRANKFORT KY 40601 502 226 1900 http://www.des

igningsmiles.n

et/

COVENTRY


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

FEE FOR

SERVICE


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

HUMANA

125



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

WELLCARE

BRIAN DEATON DESIGNING

SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

COVENTRY


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

FEE FOR

SERVICE


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

WELLCARE

CANDACE FLENER DESIGNING

SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

COVENTRY


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

FEE FOR

SERVICE


SMILES

GENERAL

DENTISTRY

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

WELLCARE

126



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DESIGNING

SMILES

MULTI

SPECIALTY

GROUP

630 COMANCHE

TRAIL SUITE A


igningsmiles.n

et/

FEE FOR

SERVICE

JAMES FOWLER FRANKLIN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

112

MORGANTOWN

ROAD

FRANKLIN KY 42134 270 586 0606 http://www.ffd

ent.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

112

MORGANTOWN

ROAD


ent.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

112

MORGANTOWN

ROAD


ent.com/

WELLCARE


KENTUCKY ORAL

SURGERY

ASSOCIATES

ORAL SURGEON 1300 BLUEGRASS

ROAD SUITE 7

FRANKLIN KY 42134 270 586 5445 http://omsbg.c

om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

WELLCARE

127



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

COVENTRY

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

FEE FOR

SERVICE

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

WELLCARE


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

WELLCARE

128



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


ROAD SUITE 7


om/

WELLCARE

JEFFREY HARVEY JEFFEREY T

HARVEY DMD

GENERAL

DENTISTRY

320 MCCLENDON

ROAD

FRANKLIN KY 42134 270 598 0508 COVENTRY


HARVEY DMD

GENERAL

DENTISTRY

320 MCCLENDON

ROAD

FRANKLIN KY 42134 270 598 0508 FEE FOR

SERVICE


HARVEY DMD

GENERAL

DENTISTRY

320 MCCLENDON

ROAD

FRANKLIN KY 42134 270 598 0508 WELLCARE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD

FRANKLIN KY 42134 270 586 9444 http://mycomm

onwealthdental

.com/doctors.h

tm

FEE FOR

SERVICE

129



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

WELLCARE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

COVENTRY


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

FEE FOR

SERVICE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

WELLCARE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

COVENTRY


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

FEE FOR

SERVICE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

WELLCARE

130



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

COVENTRY


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

FEE FOR

SERVICE


H DENTAL

GENERAL

DENTISTRY

927

BROOKHAVEN

ROAD


onwealthdental

.com/doctors.h

tm

WELLCARE

SAINT

CLAIRE

REGIONAL

FAMILY

MEDICAL

CLINIC

DENTAL

OFFICE

MEDICAL CLINIC 732 HIGHWAY 36 FRENCHBURG KY 40322 606 768 6345 http://www.st

claire.org/servi

ces_procedure

s/family_medi

cine/frenchbur

g_

_dental_office.

aspx

FEE FOR

SERVICE

SAINT

CLAIRE

REGIONAL

FAMILY

MEDICAL

CLINIC

DENTAL

OFFICE

MEDICAL CLINIC 732 HIGHWAY 36 FRENCHBURG KY 40322 606 768 6345 http://www.st

claire.org/servi

ces_procedure

s/family_medi

cine/frenchbur

g_

_dental_office.

aspx

WELLCARE

KEVIN MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 COVENTRY

131



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KEVIN MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 FEE FOR

SERVICE

KEVIN MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 HUMANA

KEVIN MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 WELLCARE

TANDY MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 FEE FOR

SERVICE

TANDY MOORE MOORE

DENTISTRY

GENERAL

DENTISTRY

95 STONE COAL

ROAD

GARRETT KY 41630 606 358 9135 WELLCARE


AND MAGGARD

ORTHODONTICS

ORTHODONTIST 101 DARBY

DRIVE

GEORGETOWN KY 40324 502 863 2720 http://www.wg

mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE

132



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE

133



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE

ROBERT W HENDERSON GEORGETOWN

ORAL AND

FACIAL SURGERY

ORAL SURGEON 101 DARBY

DRIVE SUITE 101

GEORGETOWN KY 40324 502 863 5858 COVENTRY


ORAL AND

FACIAL SURGERY


DRIVE SUITE 101

GEORGETOWN KY 40324 502 863 5858 FEE FOR

SERVICE


ORAL AND

FACIAL SURGERY


DRIVE SUITE 101

GEORGETOWN KY 40324 502 863 5858 WELLCARE

PAULA LENOX ADVANCED

DENTAL CARE OF

CENTERAL

KENTUCKY

GENERAL

DENTISTRY

1154 LEXINGTON

ROAD

GEORGETOWN KY 40324 502 863 2207 http://www.drl

enox.com/

COVENTRY


DENTAL CARE OF

CENTERAL

KENTUCKY

GENERAL

DENTISTRY

1154 LEXINGTON

ROAD


enox.com/

FEE FOR

SERVICE

134



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE OF

CENTERAL

KENTUCKY

GENERAL

DENTISTRY

1154 LEXINGTON

ROAD


enox.com/

WELLCARE

ROBERT WARRING ROBERT T

WARRING

FAMILY

DENTISTRY

GENERAL

DENTISTRY

120 EDWARD

AVENUE

GEORGETOWN KY 40324 502 863 1505 COVENTRY


WARRING

FAMILY

DENTISTRY

GENERAL

DENTISTRY

120 EDWARD

AVENUE


SERVICE


WARRING

FAMILY

DENTISTRY

GENERAL

DENTISTRY

120 EDWARD

AVENUE

GEORGETOWN KY 40324 502 863 1505 WELLCARE

JOHN GRAY III THE IMPLANT

AND ORAL

SURGERY

CENTER

ORAL SURGEON 204 BEVINS

LANE SUITE F

GEORGETOWN KY 40324 502 863 1402 http://www.ge

orgetownorals

urgeons.com/

COVENTRY


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

FEE FOR

SERVICE


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

WELLCARE

135



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DONALD MCLAURIN THE IMPLANT

AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

COVENTRY


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

FEE FOR

SERVICE


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

WELLCARE

THE IMPLANT &

ORAL SURGERY

CENTER LLC

204 BEVINS

LANE SUITE F


SERVICE

GILMAN PETERSON III THE IMPLANT

AND ORAL

SURGERY

CENTER

ORAL SURGEON 204 BLEVINS

LANE SUITE F


orgetownorals

urgeons.com/

COVENTRY


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

FEE FOR

SERVICE


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

HUMANA

136



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND ORAL

SURGERY

CENTER


LANE SUITE F


orgetownorals

urgeons.com/

WELLCARE

BETTY HUANG DENTISTRY FOR

CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9

GEORGETOWN KY 40324 502 868 9300 http://dentistry

forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

WELLCARE

HAYDEN PHILLIPS DENTISTRY FOR

CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE

137



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

WELLCARE

CATHERINE ROBINETTE DENTISTRY FOR

CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

GEORGETOWN

PEDIATRIC

DENTIST

205 CHAMPION

WAY SUITE 9


forchildrenky.c

om/Home.aspx

WELLCARE

RONALD DAY PEDIATRIC

DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A

GEORGETOWN KY 40324 502 572 2829 http://www.kid

steethofky.com

/index.html

COVENTRY

138



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

WELLCARE

MORGAN DILLOW PEDIATRIC

DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

COVENTRY


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

WELLCARE

139



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RODNEY JACKSON PEDIATRIC

DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

COVENTRY


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG AT

GEORGETOWN

PEDIATRIC

DENTIST

208 BEVINS

LANE SUITE A


steethofky.com

/index.html

WELLCARE

JAMES BIENEMAN LIFETIME FAMILY

DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 1

GEORGETOWN KY 40324 502 570 8778 http://www.life

timefamilydent

alcare.com/

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 1


timefamilydent

alcare.com/

FEE FOR

SERVICE

140



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 1


timefamilydent

alcare.com/

WELLCARE

AARON BALDWIN BLOSSOM PARK

DENTAL CARE

ORAL SURGEON 240 BLOSSOM

PARK DRIVE

SUITE 2

GEORGETOWN KY 40324 502 570 8841 http://www.blo

ssomparkdenta

lcare.com/

COVENTRY


DENTAL CARE


PARK DRIVE

SUITE 2


ssomparkdenta

lcare.com/

FEE FOR

SERVICE


DENTAL CARE


PARK DRIVE

SUITE 2


ssomparkdenta

lcare.com/

WELLCARE

JOANN HOLLEN BLOSSOM PARK

DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 2


ssomparkdenta

lcare.com/

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 2


ssomparkdenta

lcare.com/

FEE FOR

SERVICE

141



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

240 BLOSSOM

PARK DRIVE

SUITE 2


ssomparkdenta

lcare.com/

WELLCARE


KENTUCKY ORAL

SURGERY

ASSOCIATES

ORAL SURGEON 1214 NORTH

RACE STREET

SUITE A

GLASCOW KY 42141 270 629 3040 http://omsbg.c

om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

WELLCARE


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

FEE FOR

SERVICE

142



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

WELLCARE


CENTER OR ORAL

AND IMPLANT

SURGERY


RACE STREET

SUITE B

GLASCOW KY 42121 270 659 2665 http://www.ed

yeesturgill.co

m/index.html

COVENTRY


CENTER OR ORAL

AND IMPLANT

SURGERY


RACE STREET

SUITE B


yeesturgill.co

m/index.html

FEE FOR

SERVICE


CENTER OR ORAL

AND IMPLANT

SURGERY


RACE STREET

SUITE B


yeesturgill.co

m/index.html

WELLCARE


DMD

ORAL SURGEON 203

PROFESSIONAL

PARK DRIVE

GLASCOW KY 42141 270 651 6868 COVENTRY


DMD

ORAL SURGEON 203

PROFESSIONAL

PARK DRIVE

GLASCOW KY 42141 270 651 6868 FEE FOR

SERVICE

143



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

ORAL SURGEON 203

PROFESSIONAL

PARK DRIVE

GLASCOW KY 42141 270 651 6868 WELLCARE


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE

GLASCOW KY 42141 270 651 9386 http://bracesby

inmanandbald

win.com/

COVENTRY


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

PASSPORT


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

WELLCARE


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

FEE FOR

SERVICE

144



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

PASSPORT


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

COVENTRY


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

FEE FOR

SERVICE


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

HUMANA


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

PASSPORT


BALDWIN

ORTHODONTICS

ORTHODONTIST 207

PROFESSIONAL

PARK DRIVE


inmanandbald

win.com/

WELLCARE

145



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A

GLASGOW KY 42141 270 629 3040 http://omsbg.c

om/

COVENTRY


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

FEE FOR

SERVICE


KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

WELLCARE

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

COVENTRY

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

FEE FOR

SERVICE

TONY GREER SOUTHERN

KENTUCKY ORAL

SURGERY

ASSOCIATES


RACE STREET

SUITE A


om/

WELLCARE

146



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

WILLIAM MYERS WILLIAM W

MYERS DMD

GENERAL

DENTISTRY

207

PROFESSIONAL

PARK DRIVE

GLASGOW KY 42141 270 651 3709 COVENTRY


MYERS DMD

GENERAL

DENTISTRY

207

PROFESSIONAL

PARK DRIVE

GLASGOW KY 42141 270 651 3709 FEE FOR

SERVICE


MYERS DMD

GENERAL

DENTISTRY

207

PROFESSIONAL

PARK DRIVE

GLASGOW KY 42141 270 651 3709 WELLCARE

GRACE

COMMUNITY

HEALTH

CENTER INC

MEDICAL CLINIC 39

CUMBERLAND

GAP PLAZA

GRAY KY 40734 606 526 9005 http://www.gra

cechc.com/

COVENTRY

GRACE

COMMUNITY

HEALTH

CENTER INC

MEDICAL CLINIC 39

CUMBERLAND

GAP PLAZA


cechc.com/

FEE FOR

SERVICE

GRACE

COMMUNITY

HEALTH

CENTER INC

MEDICAL CLINIC 39

CUMBERLAND

GAP PLAZA


cechc.com/

WELLCARE

CARL BLEVINS CARL E BLEVINS

FAMILY

DENTISTRY

GENERAL

DENTISTRY

138 SOUTH

CAROL MALONE

BLVD

GRAYSON KY 41143 606 474 5600 FEE FOR

SERVICE

147



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHARLES HOWARD CHARLES

HOWARD DMD

PSC

GENERAL

DENTISTRY

500 NORTH

CAROL MALONE

BLVD

GRAYSON KY 41143 606 474 6655 COVENTRY


HOWARD DMD

PSC

GENERAL

DENTISTRY

500 NORTH

CAROL MALONE

BLVD

GRAYSON KY 41143 606 474 6655 FEE FOR

SERVICE


HOWARD DMD

PSC

GENERAL

DENTISTRY

500 NORTH

CAROL MALONE

BLVD

GRAYSON KY 41143 606 474 6655 WELLCARE

GARTH BOBROWSKI BOBROWSKI

FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 HEALTHY

WAY

GREENSBURG KY 42743 270 932 3666 http://www.bo

browskidentist

ry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 HEALTHY

WAY


browskidentist

ry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 HEALTHY

WAY


browskidentist

ry.com/

WELLCARE

ROBERT BAKER ROBERT L BAKER

DMD PSC

GENERAL

DENTISTRY

1121 SEATON

AVENUE

GREENUP KY 41144 606 473 5252 COVENTRY


DMD PSC

GENERAL

DENTISTRY

1121 SEATON

AVENUE

GREENUP KY 41144 606 473 5252 FEE FOR

SERVICE


DMD PSC

GENERAL

DENTISTRY

1121 SEATON

AVENUE

GREENUP KY 41144 606 473 5252 WELLCARE

148



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

R BROOKS CALLIHAN R BROOKS

CALLIHAN DMD

GENERAL

DENTISTRY

219 MAIN

STREET

GREENUP KY 41144 606 473 6322 COVENTRY


CALLIHAN DMD

GENERAL

DENTISTRY

219 MAIN

STREET

GREENUP KY 41144 606 473 6322 FEE FOR

SERVICE


CALLIHAN DMD

GENERAL

DENTISTRY

219 MAIN

STREET

GREENUP KY 41144 606 473 6322 WELLCARE

MARY BROWN MARY W BROWN

DMD

GENERAL

DENTISTRY

105 COURT ROW GREENVILLE KY 42345 270 338 0606 http://www.dr

marywebbbro

wn.com/

COVENTRY


DMD

GENERAL

DENTISTRY


marywebbbro

wn.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY


marywebbbro

wn.com/

WELLCARE

WILLIAM EADES GREENVILLE

DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET

GREENVILLE KY 42345 270 338 2532 COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET

GREENVILLE KY 42345 270 338 2532 FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET

GREENVILLE KY 42345 270 338 2532 WELLCARE

149



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

TIMOTHY FRITSCH GREENVILLE

DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET

GREENVILLE KY 42345 270 338 2532 COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET


SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

132 EAST MAIN

CROSS STREET

GREENVILLE KY 42345 270 338 2532 WELLCARE

GREENVILLE

DENTAL CENTER

MULTI

SPECIALTY

GROUP

132 EAST MAIN

CROSS STREET


SERVICE

SCHOOL SMILES GENERAL

DENTISTRY

1499

WINDHORST

WAY SUITE 100

GREENWOOD IN 46143 855 497 6453 http://www.sch

oolsmiles.com/

index.html

FEE FOR

SERVICE

BIG SANDY

HEALTH

CARE MUD

CREEK

DENTAL

CLINIC

MEDICAL CLINIC 7629 EULA HALL

HIGHWAY

GRETHEL KY 41631 606 587 2800 http://www.bs

hc.org/

COVENTRY

150



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BIG SANDY

HEALTH

CARE MUD

CREEK

DENTAL

CLINIC


HIGHWAY


hc.org/

FEE FOR

SERVICE

BIG SANDY

HEALTH

CARE MUD

CREEK

DENTAL

CLINIC


HIGHWAY


hc.org/

WELLCARE

VIRGINIA OWEN VIRGINIA C OWEN

DMD

GENERAL

DENTISTRY

113 EAST 2ND

STREET

HARDINSBURG KY 40143 270 756 5792 COVENTRY


DMD

GENERAL

DENTISTRY

113 EAST 2ND

STREET

HARDINSBURG KY 40143 270 756 5792 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

113 EAST 2ND

STREET

HARDINSBURG KY 40143 270 756 5792 HUMANA


DMD

GENERAL

DENTISTRY

113 EAST 2ND

STREET

HARDINSBURG KY 40143 270 756 5792 PASSPORT


DMD

GENERAL

DENTISTRY

113 EAST 2ND

STREET

HARDINSBURG KY 40143 270 756 5792 WELLCARE

REBECCA DRISKELL

MCCOY

REBECCA

DRISKELL MCCOY

DMD

GENERAL

DENTISTRY

122 WEST 3RD

STREET


151



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

REBECCA DRISKELL

MCCOY

REBECCA

DRISKELL MCCOY

DMD

GENERAL

DENTISTRY

122 WEST 3RD

STREET


SERVICE

REBECCA DRISKELL

MCCOY

REBECCA

DRISKELL MCCOY

DMD

GENERAL

DENTISTRY

122 WEST 3RD

STREET


REBECCA DRISKELL

MCCOY

REBECCA

DRISKELL MCCOY

DMD

GENERAL

DENTISTRY

122 WEST 3RD

STREET


REBECCA DRISKELL

MCCOY

REBECCA

DRISKELL MCCOY

DMD

GENERAL

DENTISTRY

122 WEST 3RD

STREET


JOSEPH HIGGINSON JOSEPH H

HIGGINSON DMD

ORTHODONTIST 124 EAST 3RD

STREET



HIGGINSON DMD


STREET


SERVICE


HIGGINSON DMD


STREET


AARON POWERS AARON C

POWERS DMD

GENERAL

DENTISTRY

124 EAST 3RD

STREET


SERVICE


POWERS DMD

GENERAL

DENTISTRY

124 EAST 3RD

STREET



POWERS DMD

GENERAL

DENTISTRY

124 EAST 3RD

STREET


152



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MATTHEW NUNEZ THE HARLAN

DENTAL CLINIC

PSC

GENERAL

DENTISTRY

106 RAILROAD

STREET SUITE 3

HARLAN KY 40831 606 573 9944 COVENTRY


DENTAL CLINIC

PSC

GENERAL

DENTISTRY

106 RAILROAD

STREET SUITE 3

HARLAN KY 40831 606 573 9944 FEE FOR

SERVICE


DENTAL CLINIC

PSC

GENERAL

DENTISTRY

106 RAILROAD

STREET SUITE 3

HARLAN KY 40831 606 573 9944 WELLCARE

THE HARLAN

DENTAL CLINIC

PSC

GENERAL

DENTISTRY

106 RAILROAD

STREET SUITE 3

HARLAN KY 40831 606 573 9944 FEE FOR

SERVICE

DEREK WATTS HARLAN

ORTHODONTIC

CLINIC

ORTHODONTIST 106 RAILROAD

STREET SUITE

104


DEREK WATTS HARLAN

ORTHODONTIC

CLINIC


STREET SUITE

104

HARLAN KY 40831 606 573 7441 FEE FOR

SERVICE

DEREK WATTS HARLAN

ORTHODONTIC

CLINIC


STREET SUITE

104


153



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

STEPHEN BRYSON STEPHEN C

BRYSON DMD

GENERAL

DENTISTRY

110

PROFESSIONAL

LANE SUITE 201



BRYSON DMD

GENERAL

DENTISTRY

110

PROFESSIONAL

LANE SUITE 201

HARLAN KY 40831 606 573 6007 FEE FOR

SERVICE


BRYSON DMD

GENERAL

DENTISTRY

110

PROFESSIONAL

LANE SUITE 201


CLINT MCQUEEN HARLAN FAMILY

DENTISTRY

GENERAL

DENTISTRY

118 SOUTH 1ST

STREET



DENTISTRY

GENERAL

DENTISTRY

118 SOUTH 1ST

STREET

HARLAN KY 40831 606 574 9000 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

118 SOUTH 1ST

STREET


H FRED HOWARD H FRED HOWARD

DMD

GENERAL

DENTISTRY

301 CENTRAL

STREET



DMD

GENERAL

DENTISTRY

301 CENTRAL

STREET

HARLAN KY 40831 606 573 2822 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

301 CENTRAL

STREET


154



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

NEWTON GUY III NEWTON GUY III

DMD

GENERAL

DENTISTRY

303 EAST

MOUND STREET



DMD

GENERAL

DENTISTRY

303 EAST

MOUND STREET

HARLAN KY 40831 606 573 4707 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

303 EAST

MOUND STREET


DENNIS HISE DENNIS A HISE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1028 NORTH

COLLEGE

STREET

HARRODSBURG KY 40330 859 734 5437 COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1028 NORTH

COLLEGE

STREET

HARRODSBURG KY 40330 859 734 5437 FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1028 NORTH

COLLEGE

STREET

HARRODSBURG KY 40330 859 734 5437 HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1028 NORTH

COLLEGE

STREET

HARRODSBURG KY 40330 859 734 5437 WELLCARE

DENNIS A HISE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1028 NORTH

COLLEGE

STREET


SERVICE

EDWARD RITCHIE HARRODSBURG

DETNAL CENTER

GENERAL

DENTISTRY

117 EAST

LEXINGTON

STREET

HARRODSBURG KY 40330 859 734 3819 COVENTRY


DETNAL CENTER

GENERAL

DENTISTRY

117 EAST

LEXINGTON

STREET


SERVICE

155



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DETNAL CENTER

GENERAL

DENTISTRY

117 EAST

LEXINGTON

STREET

HARRODSBURG KY 40330 859 734 3819 HUMANA


DETNAL CENTER

GENERAL

DENTISTRY

117 EAST

LEXINGTON

STREET

HARRODSBURG KY 40330 859 734 3819 WELLCARE

CONSTANCE HUFF MERCER DENTAL

CARE

GENERAL

DENTISTRY

135 COLLIN

DRIVE

HARRODSBURG KY 40330 859 734 4944 http://www.me

rcerdentalcare.

com/

COVENTRY


CARE

GENERAL

DENTISTRY

135 COLLIN

DRIVE


rcerdentalcare.

com/

FEE FOR

SERVICE


CARE

GENERAL

DENTISTRY

135 COLLIN

DRIVE


rcerdentalcare.

com/

HUMANA


CARE

GENERAL

DENTISTRY

135 COLLIN

DRIVE


rcerdentalcare.

com/

WELLCARE

BRANDI COX DOWLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3

HARRODSBURG KY 40330 859 734 2338 http://www.do

wlendental.co

m/index.html

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

WELLCARE

156



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON DOWLEN DOWLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

HUMANA


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

WELLCARE

KYLE REYNOLDS DOWLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

HUMANA

157



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

507 ST JOSEPH

DRIVE SUITE 3


wlendental.co

m/index.html

WELLCARE

JESSE DOUGLASS JR CUMBERLAND

GAP

ORTHODONTICS

INC

ORTHODONTIST 119

WESTMORELAN

D STREET

HARROGATE TN 37752 423 869 5719 COVENTRY


GAP

ORTHODONTICS

INC

ORTHODONTIST 119

WESTMORELAN

D STREET

HARROGATE TN 37752 423 869 5719 FEE FOR

SERVICE


GAP

ORTHODONTICS

INC

ORTHODONTIST 119

WESTMORELAN

D STREET

HARROGATE TN 37752 423 869 5719 WELLCARE

JOSEPH MCCARTY JOSEPH S

MCCARTY DMD

GENERAL

DENTISTRY

904 SOUTH MAIN

STREET

HARTFORD KY 42347 270 298 3555 COVENTRY


MCCARTY DMD

GENERAL

DENTISTRY

904 SOUTH MAIN

STREET

HARTFORD KY 42347 270 298 3555 FEE FOR

SERVICE


MCCARTY DMD

GENERAL

DENTISTRY

904 SOUTH MAIN

STREET

HARTFORD KY 42347 270 298 3555 WELLCARE

WALTON ALLEN ALLEN AND

ALLEN

GENERAL

DENTISTRY

140 MAIN CROSS

STREET

HAWESVILLE KY 42348 270 927 6045 COVENTRY


ALLEN

GENERAL

DENTISTRY

140 MAIN CROSS

STREET

HAWESVILLE KY 42348 270 927 6045 FEE FOR

SERVICE

158



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ALLEN

GENERAL

DENTISTRY

140 MAIN CROSS

STREET

HAWESVILLE KY 42348 270 927 6045 HUMANA


ALLEN

GENERAL

DENTISTRY

140 MAIN CROSS

STREET

HAWESVILLE KY 42348 270 927 6045 WELLCARE

SAMANTHA NAPIER SAMANTHA S

NAPIER DMD

GENERAL

DENTISTRY

116 VETERANS

DRIVE

HAZARD KY 41701 606 439 0577 COVENTRY


NAPIER DMD

GENERAL

DENTISTRY

116 VETERANS

DRIVE

HAZARD KY 41701 606 439 0577 FEE FOR

SERVICE


NAPIER DMD

GENERAL

DENTISTRY

116 VETERANS

DRIVE

HAZARD KY 41701 606 439 0577 WELLCARE

PRIMARY

CARE

CENTERS OF

EASTERN KY

HAZARD

RURAL HEALTH

CLINIC

145 CITIZENS

LANE SUITE B

HAZARD KY 41701 606 439 1300 http://www.pc

cek.com/index.

html

COVENTRY

PRIMARY

CARE

CENTERS OF

EASTERN KY

HAZARD

RURAL HEALTH

CLINIC

145 CITIZENS

LANE SUITE B


cek.com/index.

html

FEE FOR

SERVICE

159



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PRIMARY

CARE

CENTERS OF

EASTERN KY

HAZARD

RURAL HEALTH

CLINIC

145 CITIZENS

LANE SUITE B


cek.com/index.

html

WELLCARE

JAMES JOLLY JR JAMES M JOLLY

JR DMD

GENERAL

DENTISTRY

1724 1/2 NORTH

MAIN STREET



JR DMD

GENERAL

DENTISTRY

1724 1/2 NORTH

MAIN STREET

HAZARD KY 41701 606 439 4581 FEE FOR

SERVICE


JR DMD

GENERAL

DENTISTRY

1724 1/2 NORTH

MAIN STREET


WILLIAM GIBSON GIBSON SUGICAL ORAL SURGEON 200 MEDICAL

CENTER DRIVE



CENTER DRIVE

HAZARD KY 41701 606 487 0088 FEE FOR

SERVICE


CENTER DRIVE

HAZARD KY 41701 606 487 0088 PASSPORT

160



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER DRIVE


SHANNA COUCH

HOLLIDAY

DEATON AND

HOLLIDAY

DENTAL

GENERAL

DENTISTRY

251 MORTON

BLVD


SHANNA COUCH

HOLLIDAY

DEATON AND

HOLLIDAY

DENTAL

GENERAL

DENTISTRY

251 MORTON

BLVD

HAZARD KY 41702 606 439 1079 FEE FOR

SERVICE

SHANNA COUCH

HOLLIDAY

DEATON AND

HOLLIDAY

DENTAL

GENERAL

DENTISTRY

251 MORTON

BLVD



CENTER

ORTHODONTIST 260 VILLIAGE

LANE SUITE 32A



CENTER


LANE SUITE 32A

HAZARD KY 41701 606 439 3856 FEE FOR

SERVICE


CENTER


LANE SUITE 32A


DEREK WATTS HAZARD

ORTHODONTIC

CLINIC

ORTHODONTIST 285 BLACK GOLD

BLVD


DEREK WATTS HAZARD

ORTHODONTIC

CLINIC


BLVD

HAZARD KY 41701 606 439 0881 FEE FOR

SERVICE

161



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DEREK WATTS HAZARD

ORTHODONTIC

CLINIC


BLVD


ANDREW FARMER FARMER

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

305 MORTON

BLVD



PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

305 MORTON

BLVD

HAZARD KY 41701 606 436 5437 FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

305 MORTON

BLVD


UK NORTH

FORK

VALLEY

COMMUNITY

HEALTH

DENTAL

CLINIC

FEDERALLY

QUALIFIED

HEALTH CLINIC

750 MORTON

BLVD

HAZARD KY 41701 606 439 1559 http://ukhealth

care.uky.edu/n

orthfork/

COVENTRY

UK NORTH

FORK

VALLEY

COMMUNITY

HEALTH

DENTAL

CLINIC

FEDERALLY

QUALIFIED

HEALTH CLINIC

750 MORTON

BLVD

HAZARD KY 41701 606 439 1559 http://ukhealth

care.uky.edu/n

orthfork/

FEE FOR

SERVICE

KATHRYN HAYNES KATHRYN D

HANES DMD

GENERAL

DENTISTRY

941 NORTH MAIN

STREET


162



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


HANES DMD

GENERAL

DENTISTRY

941 NORTH MAIN

STREET

HAZARD KY 41702 606 436 4648 FEE FOR

SERVICE


HANES DMD

GENERAL

DENTISTRY

941 NORTH MAIN

STREET


MATTHEW PAGNOTTO TRISTATE ORAL

AND

MAXILLOFACIAL

SURGERY

ORAL SURGEON 2300 CONNER

ROAD

HEBRON KY 41048 859 586 4825 http://www.tris

tateoms.com/in

dex.html

COVENTRY


AND

MAXILLOFACIAL

SURGERY


ROAD


tateoms.com/in

dex.html

FEE FOR

SERVICE


AND

MAXILLOFACIAL

SURGERY


ROAD


tateoms.com/in

dex.html

WELLCARE

RODNEY STIGALL TRI STATE ORAL

AND

MAXILLOFACIAL

SURGERY


ROAD


tateoms.com/in

dex.html

COVENTRY


AND

MAXILLOFACIAL

SURGERY


ROAD


tateoms.com/in

dex.html

FEE FOR

SERVICE


AND

MAXILLOFACIAL

SURGERY


ROAD


tateoms.com/in

dex.html

WELLCARE

163



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRAD FULKERSON BRAD T

FULERSON DMD

MSD LLC

PEDIATRIC

DENTIST

700A BARRET

BLVD

HENDERSON KY 42420 270 827 5522 http://www.drf

ulkerson.com/

COVENTRY


FULERSON DMD

MSD LLC

PEDIATRIC

DENTIST

700A BARRET

BLVD


ulkerson.com/

FEE FOR

SERVICE


FULERSON DMD

MSD LLC

PEDIATRIC

DENTIST

700A BARRET

BLVD


ulkerson.com/

WELLCARE

LAUREN SIMMONS BRAD T

FULERSON DMD

MSD LLC

GENERAL

DENTISTRY

700A BARRET

BLVD


ulkerson.com/

COVENTRY


FULERSON DMD

MSD LLC

GENERAL

DENTISTRY

700A BARRET

BLVD


ulkerson.com/

FEE FOR

SERVICE


FULERSON DMD

MSD LLC

GENERAL

DENTISTRY

700A BARRET

BLVD


ulkerson.com/

WELLCARE

STEVEN WILSON AUDUBON

DENTAL CENTER

PSC

GENERAL

DENTISTRY

716 2ND STREET HENDERSON KY 42420 270 826 2092 http://www.au

dubonsmile.co

m/

COVENTRY


DENTAL CENTER

PSC

GENERAL

DENTISTRY


dubonsmile.co

m/

FEE FOR

SERVICE

164



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

PSC

GENERAL

DENTISTRY


dubonsmile.co

m/

WELLCARE

AUDUBON

DENTAL CENTER

PSC

GENERAL

DENTISTRY


dubonsmile.co

m/

FEE FOR

SERVICE

JAMES ELLIS JAMES C ELLIS

DMD

PEDIATRIC

DENTIST

801 NORTH ELM

STREET

HENDERSON KY 42420 270 827 2555 COVENTRY


DMD

PEDIATRIC

DENTIST

801 NORTH ELM

STREET

HENDERSON KY 42420 270 827 2555 FEE FOR

SERVICE


DMD

PEDIATRIC

DENTIST

801 NORTH ELM

STREET

HENDERSON KY 42420 270 827 2555 WELLCARE

ROBERT WAGONER II GREEN RIVER

ORAL SURGERY

ORAL SURGEON 801 NORTH ELM

STREET

HENDERSON KY 42420 270 212 0330 http://www.gre

enriveroralsurg

ery.com/

COVENTRY


ORAL SURGERY


STREET


enriveroralsurg

ery.com/

FEE FOR

SERVICE


ORAL SURGERY


STREET


enriveroralsurg

ery.com/

WELLCARE

CHANDANA JAIN PEDIATRIC

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1809

ALEXANDRIA

PIKE

HIGHLAND HEIGHTS KY 41076 859 781 1500 http://www.tee

th4kidz.com/in

dex.htm

FEE FOR

SERVICE

165



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHANDANA JAIN PEDIATRIC

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1809

ALEXANDRIA

PIKE


th4kidz.com/in

dex.htm

WELLCARE

DAVID RIDER PEDIATRIC

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1809

ALEXANDRIA

PIKE


th4kidz.com/in

dex.htm

FEE FOR

SERVICE

DAVID RIDER PEDIATRIC

DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1809

ALEXANDRIA

PIKE


th4kidz.com/in

dex.htm

WELLCARE

LISA TRIPLETT

SHORT

LISA R TRIPLETT

SHORT DMD

GENERAL

DENTISTRY

1797 HIGHWAY

160 SOUTH

HINDMAN KY 41822 606 785 0600 COVENTRY

LISA TRIPLETT

SHORT

LISA R TRIPLETT

SHORT DMD

GENERAL

DENTISTRY

1797 HIGHWAY

160 SOUTH

HINDMAN KY 41822 606 785 0600 FEE FOR

SERVICE

LISA TRIPLETT

SHORT

LISA R TRIPLETT

SHORT DMD

GENERAL

DENTISTRY

1797 HIGHWAY

160 SOUTH

HINDMAN KY 41822 606 785 0600 WELLCARE

SID PRATT SID PRATT DMD GENERAL

DENTISTRY

PRACTIONER

358 HINDMAN

BYPASS

HINDMAN KY 41822 606 785 1111 COVENTRY


DENTISTRY

PRACTIONER

358 HINDMAN

BYPASS

HINDMAN KY 41822 606 785 1111 FEE FOR

SERVICE

166



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

PRACTIONER

358 HINDMAN

BYPASS

HINDMAN KY 41822 606 785 1111 WELLCARE

DAVID ROLLINS MOUNTAIN

DENTAL SERVICE

GENERAL

DENTISTRY

388 HIGHWAY 80 HINDMAN KY 41822 606 785 3559 COVENTRY


DENTAL SERVICE

GENERAL

DENTISTRY

388 HIGHWAY 80 HINDMAN KY 41822 606 785 3559 FEE FOR

SERVICE


DENTAL SERVICE

GENERAL

DENTISTRY

388 HIGHWAY 80 HINDMAN KY 41822 606 785 3559 WELLCARE

UK NORTH

FORK

VALLEY

JUNE

BUCHANAN

CLINIC

RURAL HEALTH

CLINIC

59 COWTOWN

ROAD

HINDMAN KY 41822 606 785 3175 http://ukhealth

care.uky.edu/lo

cations/jbcmai

n/

FEE FOR

SERVICE

SCOTT BOLEY BOLEY FAMILY

DENTISTRY

GENERAL

DENTISTRY

1031 OLD

ELIZABETHTOW

N ROAD

HODGENVILLE KY 42748 270 737 3368 http://www.ho

dgenvilledentis

t.com/

FEE FOR

SERVICE

SCOTT BOLEY BOLEY FAMILY

DENTISTRY

GENERAL

DENTISTRY

1031 OLD

ELIZABETHTOW

N ROAD

HODGENVILLE KY 42748 270 737 3368 http://www.ho

dgenvilledentis

t.com/

PASSPORT

DOUGLAS BAUMGARDNER DOUGLAS L

BAUMGARDNER

DMD PSC

GENERAL

DENTISTRY

104 NORTH

WALTERS

AVENUE

HODGENVILLE KY 42748 270 358 3189 FEE FOR

SERVICE

167



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BAUMGARDNER

DMD PSC

GENERAL

DENTISTRY

104 NORTH

WALTERS

AVENUE

HODGENVILLE KY 42748 270 358 3189 HUMANA


BAUMGARDNER

DMD PSC

GENERAL

DENTISTRY

104 NORTH

WALTERS

AVENUE

HODGENVILLE KY 42748 270 358 3189 PASSPORT

JEFFREY CHAPMAN JEFFERY

CHAPMAN DMD

GENERAL

DENTISTRY

1910 SOUTH

VIRGINIA

STREET SUITE

104

HOPKINSVILLE KY 42240 270 885 7156 COVENTRY

JEFFREY CHAPMAN JEFFERY

CHAPMAN DMD

GENERAL

DENTISTRY

1910 SOUTH

VIRGINIA

STREET SUITE

104

HOPKINSVILLE KY 42240 270 885 7156 FEE FOR

SERVICE

MARK MILLER MARK D MILLER

DDS

ORAL SURGEON 320 COOL

WATER COURT

HOPKINSVILLE KY 42240 270 885 0165 http://www.mil

leroralsurgery.

com/

COVENTRY


DDS


WATER COURT


leroralsurgery.

com/

FEE FOR

SERVICE


DDS


WATER COURT


leroralsurgery.

com/

PASSPORT


DDS


WATER COURT


leroralsurgery.

com/

WELLCARE

TRESA WHITE TERSA C WHITE

DMD

GENERAL

DENTISTRY

440 EAST 18TH

STREET


168



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

440 EAST 18TH

STREET


SERVICE


DMD

GENERAL

DENTISTRY

440 EAST 18TH

STREET

HOPKINSVILLE KY 42241 270 886 0581 WELLCARE

RICHARD ALLEN R CRAIG ALLEN

PSC

ORTHODONTIST 520 NOEL

AVENUE



PSC


AVENUE


SERVICE


PSC


AVENUE


R CRAIG ALLEN

PSC


AVENUE


SERVICE

WILLIAM R NUNN

DDS PSC

PEDIATRIC

DENTIST

522B NOEL

AVENUE


WILLIAM R NUNN

DDS PSC

PEDIATRIC

DENTIST

522B NOEL

AVENUE


SERVICE

WILLIAM R NUNN

DDS PSC

PEDIATRIC

DENTIST

522B NOEL

AVENUE


LESLIE NEVILLE NEVILLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET

HORSE CAVE KY 42749 270 786 2547 http://www.ne

villefamilydent

istry.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

FEE FOR

SERVICE

169



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

HUMANA


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

PASSPORT


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

WELLCARE

STEVEN NEVILLE NEVILLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

HUMANA


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

PASSPORT


DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

WELLCARE

NEVILLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

113 SOUTH DIXIE

STREET


villefamilydent

istry.com/

FEE FOR

SERVICE

VALLEY HEALTH

SYSTEMS INC

GENERAL

DENTISTRY

2585 3RD

AVENUE

HUNTINGTON WV 25703 304 525 3334 http://www.val

leyhealth.orG

FEE FOR

SERVICE

170



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

VALLEY HEALTH

WESTMORELAND

GENERAL

DENTISTRY

2908 AUBURN

ROAD


leyhealth.orG

FEE FOR

SERVICE

VALLEY HEALTH

EAST

HUNTINGTON

GENERAL

DENTISTRY

3377 U.S. ROUTE

60 EAST


leyhealth.orG

FEE FOR

SERVICE

VALLEY HEALTH

SOUTHSIDE

YOUTH HEALTH

CTR

GENERAL

DENTISTRY

723 9TH AVENUE HUNTINGTON WV 25701 304 529 0645 http://www.val

leyhealth.orG

FEE FOR

SERVICE

ANDREA LITTLE ANDREA L LITTLE

DMD

GENERAL

DENTISTRY

120 HIGHWAY 80 HYDEN KY 41749 606 672 8800 COVENTRY


DMD

GENERAL

DENTISTRY

120 HIGHWAY 80 HYDEN KY 41749 606 672 8800 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

120 HIGHWAY 80 HYDEN KY 41749 606 672 8800 WELLCARE

FREDERICK RATLIFF FREDERICK C

RATLIFF DMD

GENERAL

DENTISTRY

22728 HIGHWAY

421

HYDEN KY 41749 606 672 2274 COVENTRY


RATLIFF DMD

GENERAL

DENTISTRY

22728 HIGHWAY

421

HYDEN KY 41749 606 672 2274 FEE FOR

SERVICE


RATLIFF DMD

GENERAL

DENTISTRY

22728 HIGHWAY

421

HYDEN KY 41749 606 672 2274 WELLCARE

171



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

CLINIC

GENERAL

DENTISTRY

8 DOGWOOD

STREET

HYDEN KY ##### 606 672 3550 COVENTRY


DENTISTRY

CLINIC

GENERAL

DENTISTRY

8 DOGWOOD

STREET

HYDEN KY ##### 606 672 3550 FEE FOR

SERVICE


DENTISTRY

CLINIC

GENERAL

DENTISTRY

8 DOGWOOD

STREET

HYDEN KY ##### 606 672 3550 WELLCARE

JANICE STRUCKHOFF STRUCKHOFF

ORTHODONTICS

ORTHODONTIST 1986 WALTON

NICHOLSON

INDEPENDENCE KY 41051 859 356 6630 http://www.str

uckhoffortho.c

om/

FEE FOR

SERVICE

JANICE STRUCKHOFF STRUCKHOFF

ORTHODONTICS

ORTHODONTIST 1986 WALTON

NICHOLSON

INDEPENDENCE KY 41051 859 356 6630 http://www.str

uckhoffortho.c

om/

WELLCARE

CHARLES SWORD INEZ MEDICAL

CLINIC

GENERAL

DENTISTRY

101 MAIN

STREET

INEZ KY 41224 606 298 3283 COVENTRY


CLINIC

GENERAL

DENTISTRY

101 MAIN

STREET

INEZ KY 41224 606 298 3283 FEE FOR

SERVICE


CLINIC

GENERAL

DENTISTRY

101 MAIN

STREET

INEZ KY 41224 606 298 3283 WELLCARE

SHARON NEELEY SHARON N

NEELEY DMD PSC

GENERAL

DENTISTRY

144

ROCKCASTLE

ROAD

INEZ KY 41224 606 298 7758 COVENTRY

172



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


NEELEY DMD PSC

GENERAL

DENTISTRY

144

ROCKCASTLE

ROAD

INEZ KY 41224 606 298 7758 FEE FOR

SERVICE


NEELEY DMD PSC

GENERAL

DENTISTRY

144

ROCKCASTLE

ROAD

INEZ KY 41224 606 298 7758 WELLCARE

BIG SANDY

HEALTH

CARE INC

MARTIN

COUNTY

COMMUNITY

HEALTH

CENTER

MEDICAL CLINIC 6500 HIGHWAY

645 SUITE 110

INEZ KY 41224 606 298 3412 http://www.bs

hc.org/

COVENTRY

BIG SANDY

HEALTH

CARE INC

MARTIN

COUNTY

COMMUNITY

HEALTH

CENTER


645 SUITE 110


hc.org/

FEE FOR

SERVICE

BIG SANDY

HEALTH

CARE INC

MARTIN

COUNTY

COMMUNITY

HEALTH

CENTER


645 SUITE 110


hc.org/

WELLCARE

173



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON GAY IRVINE FAMILY

DENTISTRY

GENERAL

DENTISTRY

10 RIVER DRIVE IRVINE KY 40336 606 723 1000 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

10 RIVER DRIVE IRVINE KY 40336 606 723 1000 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

10 RIVER DRIVE IRVINE KY 40336 606 723 1000 WELLCARE

DAVID MONSON IRVINE FAMILY

DENTISTRY

GENERAL

DENTISTRY

10 RIVER DRIVE IRVINE KY 40336 606 723 1000 COVENTRY


DENTISTRY

GENERAL

DENTISTRY


SERVICE


DENTISTRY

GENERAL

DENTISTRY

10 RIVER DRIVE IRVINE KY 40336 606 723 1000 WELLCARE

IRVINE FAMILY

DENTISTRY

GENERAL

DENTISTRY


SERVICE

SARA ASGARI KENTUCKY RIVER

DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD

IRVINE KY 40336 606 723 4112 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD

IRVINE KY 40336 606 723 4112 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD

IRVINE KY 40336 606 723 4112 WELLCARE

174



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JANE JORDAN KENTUCKY RIVER

DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD

IRVINE KY 40336 606 723 4112 http://www.ke

ntuckyriverden

tistry.com/publ

ic/home/index/

#home

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD


ntuckyriverden

tistry.com/publ

ic/home/index/

#home

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD


ntuckyriverden

tistry.com/publ

ic/home/index/

#home

WELLCARE

KENTUCKY RIVER

DENTISTRY

GENERAL

DENTISTRY

161 RICHMOND

ROAD


ntuckyriverden

tistry.com/publ

ic/home/index/

#home

FEE FOR

SERVICE

JIMMIE JOHNSON JIMMIE LEE

JOHNSON DMD

GENERAL

DENTISTRY

87 WILDWOOD

PLACE

IRVINE KY 40336 606 723 3213 COVENTRY


JOHNSON DMD

GENERAL

DENTISTRY

87 WILDWOOD

PLACE

IRVINE KY 40336 606 723 3213 FEE FOR

SERVICE


JOHNSON DMD

GENERAL

DENTISTRY

87 WILDWOOD

PLACE

IRVINE KY 40336 606 723 3213 HUMANA

175



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


JOHNSON DMD

GENERAL

DENTISTRY

87 WILDWOOD

PLACE

IRVINE KY 40336 606 723 3213 WELLCARE

DANIEL YOUNG ROBERT A

YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 FEE FOR

SERVICE


YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 HUMANA


YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 PASSPORT

ROBERT YOUNG JR ROBERT A

YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 FEE FOR

SERVICE


YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 HUMANA


YOUNG DDS

GENERAL

DENTISTRY

413 HIGHWAY 60

EAST

IRVINGTON KY 40146 270 547 2911 PASSPORT

GARRY OLIVER GARRY L OLIVER

DMD

GENERAL

DENTISTRY

437 SOUTH

KENTUCKY

ROUTE 706

ISONVILLE KY 41149 606 738 6904 COVENTRY


DMD

GENERAL

DENTISTRY

437 SOUTH

KENTUCKY

ROUTE 706

ISONVILLE KY 41149 606 738 6904 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

437 SOUTH

KENTUCKY

ROUTE 706

ISONVILLE KY 41149 606 738 6904 WELLCARE

176



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ROGER CAMPBELL BREATHITT

DENTAL CLINIC

GENERAL

DENTISTRY

221 KENTUCKY

HIGHWAY 15

SOUTH

JACKSON KY 41339 606 666 4020 COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

221 KENTUCKY

HIGHWAY 15

SOUTH

JACKSON KY 41339 606 666 4020 FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

221 KENTUCKY

HIGHWAY 15

SOUTH

JACKSON KY 41339 606 666 4020 WELLCARE

RODNEY GRIFFITH RODNEY B

GRIFFITH DMD

GENERAL

DENTISTRY

1462 HIGHWAY

15 NORTH



GRIFFITH DMD

GENERAL

DENTISTRY

1462 HIGHWAY

15 NORTH


SERVICE


GRIFFITH DMD

GENERAL

DENTISTRY

1462 HIGHWAY

15 NORTH


CARLA RODRIGUEZ CARLA

RODRIGEUEZ

DMD

GENERAL

DENTISTRY

726 HIGHWAY 15

NORTH



RODRIGEUEZ

DMD

GENERAL

DENTISTRY

726 HIGHWAY 15

NORTH


SERVICE


RODRIGEUEZ

DMD

GENERAL

DENTISTRY

726 HIGHWAY 15

NORTH


177



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

HOWARD POPPLEWELL POPPLEWELL

DENTISTRY

GENERAL

DENTISTRY

108 TOWN

SQUARE

JAMESTOWN KY 42629 270 343 3324 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

108 TOWN

SQUARE

JAMESTOWN KY 42629 270 343 3324 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

108 TOWN

SQUARE

JAMESTOWN KY 42629 270 343 3324 WELLCARE

MELANIE LOY FLANAGAN MELANIE LOY

FLANAGAN DMD

GENERAL

DENTISTRY

43 FRUIT OF THE

LOOM DRIVE

JAMESTOWN KY 42629 270 866 4422 COVENTRY


FLANAGAN DMD

GENERAL

DENTISTRY

43 FRUIT OF THE

LOOM DRIVE

JAMESTOWN KY 42629 270 866 4422 FEE FOR

SERVICE


FLANAGAN DMD

GENERAL

DENTISTRY

43 FRUIT OF THE

LOOM DRIVE

JAMESTOWN KY 42629 270 866 4422 WELLCARE

CHRIS HOWARD CHRIS T HOWARD

DMD

GENERAL

DENTISTRY

148 EAST

KENTUCKY

DRIVE

LA CENTER KY 42056 270 665 9557 COVENTRY


DMD

GENERAL

DENTISTRY

148 EAST

KENTUCKY

DRIVE

LA CENTER KY 42056 270 665 9557 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

148 EAST

KENTUCKY

DRIVE

LA CENTER KY 42056 270 665 9557 WELLCARE

ERIC BAUGHER BRACES BRACES

BRACES

LAGRANGE


HIGHWAY 53

SUITE B

LA GRANGE KY 40031 502 222 4613 http://bracesbr

acesbraces.co

m/

COVENTRY

178



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BRACES

LAGRANGE


HIGHWAY 53

SUITE B


acesbraces.co

m/

FEE FOR

SERVICE


BRACES

LAGRANGE


HIGHWAY 53

SUITE B


acesbraces.co

m/

HUMANA


BRACES

LAGRANGE


HIGHWAY 53

SUITE B


acesbraces.co

m/

PASSPORT


BRACES

LAGRANGE


HIGHWAY 53

SUITE B


acesbraces.co

m/

WELLCARE

MONICA BINGHAM KIDS DENTISTREE

LAGRANGE

GENERAL

DENTISTRY

2005 SOUTH

HIGHWAY 53

SUITE D

LA GRANGE KY 40031 502 225 6820 http://kidsdenti

stree.com/inde

x.php

COVENTRY


LAGRANGE

GENERAL

DENTISTRY

2005 SOUTH

HIGHWAY 53

SUITE D


stree.com/inde

x.php

FEE FOR

SERVICE


LAGRANGE

GENERAL

DENTISTRY

2005 SOUTH

HIGHWAY 53

SUITE D


stree.com/inde

x.php

PASSPORT


LAGRANGE

GENERAL

DENTISTRY

2005 SOUTH

HIGHWAY 53

SUITE D


stree.com/inde

x.php

WELLCARE

JAMES SPARKS JAMES R SPARKS

DMD

GENERAL

DENTISTRY

205 NORTH 1ST

STREET

LA GRANGE KY 40031 502 222 7070 COVENTRY

179



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

205 NORTH 1ST

STREET

LA GRANGE KY 40031 502 222 7070 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

205 NORTH 1ST

STREET

LA GRANGE KY 40031 502 222 7070 HUMANA


DMD

GENERAL

DENTISTRY

205 NORTH 1ST

STREET

LA GRANGE KY 40031 502 222 7070 PASSPORT


DMD

GENERAL

DENTISTRY

205 NORTH 1ST

STREET

LA GRANGE KY 40031 502 222 7070 WELLCARE

ALFRED GERNERT ALFRED R

GERNERT DMD

PSC

ORTHODONTIST 604 CRYSTAL

PLACE SUITE 2A

LA GRANGE KY 40031 502 222 6202 FEE FOR

SERVICE

ALFRED GERNERT ALFRED R

GERNERT DMD

PSC

ORTHODONTIST 604 CRYSTAL

PLACE SUITE 2A

LA GRANGE KY 40031 502 222 6202 HUMANA

STACIE MOORE MARTIN MARTIN

DENTISTRY

GENERAL

DENTISTRY

27 TURKEY

CREEK ROAD

LANGLEY KY 41645 606 285 9444 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

27 TURKEY

CREEK ROAD

LANGLEY KY 41645 606 285 9444 FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

27 TURKEY

CREEK ROAD

LANGLEY KY 41645 606 285 9444 WELLCARE

CHRISTOPHE

R

BYERS BYERS FAMILY

DENTISTRY

GENERAL

DENTISTRY

1012 EAGLE

LAKE DRIVE

LAWRENCEBURG KY 40342 502 839 5991 COVENTRY

CHRISTOPHE

R

BYERS BYERS FAMILY

DENTISTRY

GENERAL

DENTISTRY

1012 EAGLE

LAKE DRIVE

LAWRENCEBURG KY 40342 502 839 5991 FEE FOR

SERVICE

180



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

BYERS BYERS FAMILY

DENTISTRY

GENERAL

DENTISTRY

1012 EAGLE

LAKE DRIVE

LAWRENCEBURG KY 40342 502 839 5991 HUMANA

CHRISTOPHE

R

BYERS BYERS FAMILY

DENTISTRY

GENERAL

DENTISTRY

1012 EAGLE

LAKE DRIVE

LAWRENCEBURG KY 40342 502 839 5991 WELLCARE

ROBERT WEBSTER LEBANON

FAMILY DENTAL

CENTER


PROCTOR

KNOTT AVENUE

LEBANON KY 40033 270 692 4339 http://www.leb

anonfamilyden

talcare.com/lfd

chome.htm

COVENTRY


FAMILY DENTAL

CENTER


PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

FEE FOR

SERVICE


FAMILY DENTAL

CENTER


PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

HUMANA


FAMILY DENTAL

CENTER


PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

PASSPORT


FAMILY DENTAL

CENTER


PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

WELLCARE

181



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PHILIP ZINK LEBANON

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

219 SOUTH

PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

FEE FOR

SERVICE

PHILIP ZINK LEBANON

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

219 SOUTH

PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

HUMANA

PHILIP ZINK LEBANON

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

219 SOUTH

PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

PASSPORT

PHILLIP H ZINK LEBANON

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

219 SOUTH

PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

FEE FOR

SERVICE

PHILLIP H ZINK LEBANON

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

219 SOUTH

PROCTOR

KNOTT AVENUE


anonfamilyden

talcare.com/lfd

chome.htm

PASSPORT

WILLIAM DULEY III BILL DULEY III

DMD

GENERAL

DENTISTRY

219 WEST MAIN

STREET

LEBANON KY 40033 270 692 3314 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

219 WEST MAIN

STREET

LEBANON KY 40033 270 692 3314 HUMANA

182



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

219 WEST MAIN

STREET

LEBANON KY 40033 270 692 3314 PASSPORT

ROBERT SMITH ROBERT SMITH

DMD

GENERAL

DENTISTRY

503 NORTH

SPALDING

AVENUE

LEBANON KY 40033 270 692 3265 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

503 NORTH

SPALDING

AVENUE

LEBANON KY 40033 270 692 3265 HUMANA


DMD

GENERAL

DENTISTRY

503 NORTH

SPALDING

AVENUE

LEBANON KY 40033 270 692 3265 PASSPORT


DMD

GENERAL

DENTISTRY

503 NORTH

SPALDING

AVENUE

LEBANON KY 40033 270 692 3265 WELLCARE

LUKE DERHAKE MORTENSON

FAMILY DENTAL

LEBANON

JUNCTION

GENERAL

DENTISTRY

11737 SOUTH

PRESTON

HIGHWAY

LEBANON

JUNCTION

KY 40150 502 833 4664 http://mortenso

ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

LEBANON

JUNCTION

GENERAL

DENTISTRY

11737 SOUTH

PRESTON

HIGHWAY

LEBANON

JUNCTION

KY 40150 502 833 4664 http://mortenso

ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

LEBANON

JUNCTION

GENERAL

DENTISTRY

11737 SOUTH

PRESTON

HIGHWAY

LEBANON

JUNCTION

KY 40150 502 833 4664 http://mortenso

ndental.com/D

efault.asp

HUMANA

183



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

LEBANON

JUNCTION

GENERAL

DENTISTRY

11737 SOUTH

PRESTON

HIGHWAY

LEBANON

JUNCTION

KY 40150 502 833 4664 http://mortenso

ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

LEBANON

JUNCTION

GENERAL

DENTISTRY

11737 SOUTH

PRESTON

HIGHWAY

LEBANON

JUNCTION

KY 40150 502 833 4664 http://mortenso

ndental.com/D

efault.asp

WELLCARE

PAUL KING TWIN LAKES

FAMILY DENTAL

GENERAL

DENTISTRY

1919

ELIZABETHTOW

N ROAD

LEITCHFIELD KY 42754 270 259 3232 FEE FOR

SERVICE


FAMILY DENTAL

GENERAL

DENTISTRY

1919

ELIZABETHTOW

N ROAD

LEITCHFIELD KY 42754 270 259 3232 HUMANA


FAMILY DENTAL

GENERAL

DENTISTRY

1919

ELIZABETHTOW

N ROAD

LEITCHFIELD KY 42754 270 259 3232 PASSPORT

JAY NICHOLS NICHOLS DENTAL

CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD

LEITCHFIELD KY 42754 270 259 4008 COVENTRY


CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD


SERVICE

184



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD



CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD



CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD

LEITCHFIELD KY 42754 270 259 4008 WELLCARE

MICHELLE NICHOLS NICHOLS DENTAL

CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD

LEITCHFIELD KY 42754 270 259 4008 COVENTRY


CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD


SERVICE


CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD



CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD


185



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER

GENERAL

DENTISTRY

2471

ELZABETHTOWN

ROAD

LEITCHFIELD KY 42754 270 259 4008 WELLCARE

MICHAEL KOLLER MICHAEL KOLLER

DMD

GENERAL

DENTISTRY

288 NORTH MAIN

STREET

LEWISBURG KY 42256 270 755 4899 COVENTRY


DMD

GENERAL

DENTISTRY

288 NORTH MAIN

STREET

LEWISBURG KY 42256 270 755 4899 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

288 NORTH MAIN

STREET

LEWISBURG KY 42256 270 755 4899 WELLCARE

CHOCTAW BADGETT BADGETT

DENTAL CLINIC

GENERAL

DENTISTRY

8340 US 60 WEST LEWISPORT KY 42351 270 926 1229 COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

8340 US 60 WEST LEWISPORT KY 42351 270 926 1229 FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

8340 US 60 WEST LEWISPORT KY 42351 270 926 1229 HUMANA


DENTAL CLINIC

GENERAL

DENTISTRY

8340 US 60 WEST LEWISPORT KY 42351 270 926 1229 PASSPORT


DENTAL CLINIC

GENERAL

DENTISTRY

8340 US 60 WEST LEWISPORT KY 42351 270 926 1229 WELLCARE

186



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DON

MICHAEL

HENDRICKS HENDRICKS

FAMILY AND

COSMENTIC

DENTISTRY

GENERAL

DENTISTRY

1025 DOVE RUN

ROAD SUITE 208

LEXINGTON KY 40502 859 368 8618 http://www.he

ndricksfamilyd

entistry.net/

COVENTRY

DON

MICHAEL

HENDRICKS HENDRICKS

FAMILY AND

COSMENTIC

DENTISTRY

GENERAL

DENTISTRY

1025 DOVE RUN

ROAD SUITE 208


ndricksfamilyd

entistry.net/

FEE FOR

SERVICE

DON

MICHAEL

HENDRICKS HENDRICKS

FAMILY AND

COSMENTIC

DENTISTRY

GENERAL

DENTISTRY

1025 DOVE RUN

ROAD SUITE 208


ndricksfamilyd

entistry.net/

WELLCARE

KATHRINE GREENE SIEVERS AND

GREENE

GENERAL

DENTISTRY

1081 DOVE RUN

ROAD SUITE 106

LEXINGTON KY 40502 859 269 7135 COVENTRY


GREENE

GENERAL

DENTISTRY

1081 DOVE RUN

ROAD SUITE 106

LEXINGTON KY 40502 859 269 7135 FEE FOR

SERVICE


GREENE

GENERAL

DENTISTRY

1081 DOVE RUN

ROAD SUITE 106

LEXINGTON KY 40502 859 269 7135 WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD

LEXINGTON KY 40505 859 309 7274 http://www.my

koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE

187



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KARA FORD KOOL SMILES

LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

HUMANA


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE

MEGAN JACKSON KOOL SMILES

LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE

188



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

HUMANA


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

PASSPORT

189



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

1301

WINCHESTER

ROAD


koolsmiles.co

m/

WELLCARE

KOOL SMILES

LEXINGTON

MULTI

SPECIALTY

GROUP

1301

WINCHESTER

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

KOOL SMILES

LEXINGTON

MULTI

SPECIALTY

GROUP

1301

WINCHESTER

ROAD


koolsmiles.co

m/

PASSPORT

SUSAN KLEIER SUSAN KLEIER

DMD

GENERAL

DENTISTRY

145 WALTON

AVENUE


190



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SUSAN KLEIER SUSAN KLEIER

DMD

GENERAL

DENTISTRY

145 WALTON

AVENUE


SERVICE

JEFFREY KLEIN SUSAN KLEIER

DMD

GENERAL

DENTISTRY

145 WALTON

AVENUE


XIA FEHR MASTERSON

DENTISTRY PSC

GENERAL

DENTISTRY

1500 LEESTOWN

ROAD SUITE 100

LEXINGTON KY 40511 859 243 0332 http://www.ma

stersondentistr

y.com/

COVENTRY

XIA FEHR MASTERSON

DENTISTRY PSC

GENERAL

DENTISTRY

1500 LEESTOWN

ROAD SUITE 100


stersondentistr

y.com/

FEE FOR

SERVICE

XIA FEHR MASTERSON

DENTISTRY PSC

GENERAL

DENTISTRY

1500 LEESTOWN

ROAD SUITE 100


stersondentistr

y.com/

WELLCARE

CHERICE HOLLINGSWORT

H

HOLLINGSWORTH

DENTAL

GENERAL

DENTISTRY

1517

NICHOLASVILLE

ROAD SUITE 301



H

HOLLINGSWORTH

DENTAL

GENERAL

DENTISTRY

1517

NICHOLASVILLE

ROAD SUITE 301


SERVICE

191



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


H

HOLLINGSWORTH

DENTAL

GENERAL

DENTISTRY

1517

NICHOLASVILLE

ROAD SUITE 301


DICKSON UFOMATA LEESTOWN

DENTAL CENTER

GENERAL

DENTISTRY

1600 LEESTOWN

ROAD SUITE 138

LEXINGTON KY 40511 859 232 8883 http://www.the

dentistinlexing

tonky.com/

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

1600 LEESTOWN

ROAD SUITE 138


dentistinlexing

tonky.com/

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

1600 LEESTOWN

ROAD SUITE 138


dentistinlexing

tonky.com/

WELLCARE

JESSICA KRESS COMMONWEALT

H SMILES

GENERAL

DENTISTRY

1636

NICHOLASVILLE

ROAD SUITE 5

LEXINGTON KY 40503 859 276 4537 http://www.co

mmonwealths

miles.com/

COVENTRY

JESSICA KRESS COMMONWEALT

H SMILES

GENERAL

DENTISTRY

1636

NICHOLASVILLE

ROAD SUITE 5

LEXINGTON KY 40503 859 276 4537 http://www.co

mmonwealths

miles.com/

FEE FOR

SERVICE

JOHN GRAY III GRAY MCLAURIN

AND PETERSON

ORAL SURGEON 1640

NICHOLASVILLE

ROAD


192



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND PETERSON

ORAL SURGEON 1640

NICHOLASVILLE

ROAD


SERVICE


AND PETERSON

ORAL SURGEON 1640

NICHOLASVILLE

ROAD


GRAY MCLAURIN

AND PETERSON

MULTI

SPECIALTY

GROUP

1640

NICHOLASVILLE

ROAD


SERVICE

CHRISTOPHE

R

DAVIS GARDENSIDE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1

LEXINGTON KY 40504 859 277 1180 http://www.lex

dentistry.com/

doctor.htm

COVENTRY

CHRISTOPHE

R

DAVIS GARDENSIDE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

FEE FOR

SERVICE

CHRISTOPHE

R

DAVIS GARDENSIDE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

WELLCARE

GREGORY EDENS GARDENSIDE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

COVENTRY

193



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

WELLCARE

JAMES STAMBAUGH GARDENSIDE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1750

ALEXANDRIA

DRIVE SUITE 1


dentistry.com/

doctor.htm

WELLCARE

RICHARD RUBELING RICHARD

RUBELING DMD

GENERAL

DENTISTRY

200 EAST

REYNOLDS

ROAD

LEXINGTON KY 40517 859 727 8812 http://drrubelin

g.com/

COVENTRY


RUBELING DMD

GENERAL

DENTISTRY

200 EAST

REYNOLDS

ROAD


g.com/

FEE FOR

SERVICE


RUBELING DMD

GENERAL

DENTISTRY

200 EAST

REYNOLDS

ROAD


g.com/

WELLCARE

194



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JEFFREY EDWARDS JEFFREY L

EDWARDS PSC

GENERAL

DENTISTRY

2134

NICHOLASVILLE

ROAD SUITE 112



EDWARDS PSC

GENERAL

DENTISTRY

2134

NICHOLASVILLE

ROAD SUITE 112


SERVICE


EDWARDS PSC

GENERAL

DENTISTRY

2134

NICHOLASVILLE

ROAD SUITE 112


JEFFREY L

EDWARDS PSC

MULTI

SPECIALTY

GROUP

2134

NICHOLASVILLE

ROAD SUITE 112


SERVICE

JEFFREY L

EDWARDS PSC

MULTI

SPECIALTY

GROUP

2134

NICHOLASVILLE

ROAD SUITE 112


MICHAEL CHILD MICHAEL E CHILD

DMD

ORTHODONTIST 2134

NICHOLASVILLE

ROAD SUITE 13


195



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

ORTHODONTIST 2134

NICHOLASVILLE

ROAD SUITE 13


SERVICE


DMD

ORTHODONTIST 2134

NICHOLASVILLE

ROAD SUITE 13


AARON BALDWIN JENKINS AND

MORROW

ORAL SURGEON 216 FOUNTAIN

COURT SUITE

110

LEXINGTON KY 40509 859 264 1898 http://www.jen

kinsandmorro

w.com/

COVENTRY


MORROW


COURT SUITE

110


kinsandmorro

w.com/

FEE FOR

SERVICE


MORROW


COURT SUITE

110


kinsandmorro

w.com/

WELLCARE

WILLIAM JENKINS JENKINS AND

MORROW


COURT SUITE

110


kinsandmorro

w.com/

COVENTRY


MORROW


COURT SUITE

110


kinsandmorro

w.com/

FEE FOR

SERVICE

196



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MORROW


COURT SUITE

110


kinsandmorro

w.com/

WELLCARE

NICK MORROW JENKINS AND

MORROW


COURT SUITE

110


kinsandmorro

w.com/

COVENTRY


MORROW


COURT SUITE

110


kinsandmorro

w.com/

FEE FOR

SERVICE


MORROW


COURT SUITE

110


kinsandmorro

w.com/

WELLCARE

JENKINS AND

MORROW

MULTI

SPECIALTY

GROUP

216 FOUNTAIN

COURT SUITE

110


kinsandmorro

w.com/

FEE FOR

SERVICE


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150

LEXINGTON KY 40509 859 543 2242 http://dentistry

forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE

197



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

WELLCARE


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

WELLCARE


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

LEXINGTON

PEDIATRIC

DENTIST

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

WELLCARE

198



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DENTISTRY FOR

CHILDREN

LEXINGTON

MULTI

SPECIALTY

GROUP

216 FOUNTAIN

COURT SUITE

150


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE

UKHC POLK

DALTON

CLINIC

MEDICAL CLINIC 217 ELM TREE

LANE

LEXINGTON KY 40508 859 257 8801 http://ukhealth

care.uky.edu/lo

cations/polk

dalton/

FEE FOR

SERVICE

WENDY HUMPHREY KENTUCKY

DENTISTRY FOR

KIDS

PEDIATRIC

DENTIST

2201 REGENCY

ROAD SUITE 503

LEXINGTON KY 40503 859 277 5437 http://kydentist

ry4kids.com/co

ntact_us.html

COVENTRY


DENTISTRY FOR

KIDS

PEDIATRIC

DENTIST

2201 REGENCY

ROAD SUITE 503


ry4kids.com/co

ntact_us.html

FEE FOR

SERVICE


DENTISTRY FOR

KIDS

PEDIATRIC

DENTIST

2201 REGENCY

ROAD SUITE 503


ry4kids.com/co

ntact_us.html

WELLCARE

LARRY HERMAN HERMAN AND

HERMAN

GENERAL

DENTISTRY

228 NORTH

UPPER STREET



HERMAN

GENERAL

DENTISTRY

228 NORTH

UPPER STREET


SERVICE


HERMAN

GENERAL

DENTISTRY

228 NORTH

UPPER STREET


199



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHANNA BURRESS BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE



KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE

LEXINGTON KY 40504 800 409 2563 HUMANA


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SANDRA CRUM STEVENS BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE

LEXINGTON KY 40504 800 409 2563 HUMANA


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


CANDACE FLENER BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE



KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


200



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MARCUS GIBSON BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE



KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


PHILLIP KISSINGER BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE



KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


CHRISTINA STOWE BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE



KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


RANA ZAKHARIA BIG SMILES

KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


201



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


SERVICE


KENTUCKY PSC

GENERAL

DENTISTRY

2333

ALEXANDRIA

DRIVE


BIG SMILES

KENTUCKY PSC

MULTI

SPECIALTY

GROUP

2333

ALEXANDRIA

DRIVE


SERVICE

MARY JAY BEAM IMMEDIAENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156

LEXINGTON KY 40503 859 381 0680 http://www.im

mediadent.com

/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

WELLCARE

PIL HAN IMMEDIAENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

COVENTRY

202



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PIL HAN IMMEDIAENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

FEE FOR

SERVICE

PIL HAN IMMEDIAENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

WELLCARE

JOHN LANDIS IMMEDIADENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

COVENTRY


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

WELLCARE

MARC SCHNEIDER IMMEDIADENT

LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

COVENTRY

203



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

FEE FOR

SERVICE


LEXINGTON

GENERAL

DENTISTRY

2358

NICHOLASVILLE

ROAD SUITE 156


mediadent.com

/

WELLCARE

KELLY ARNOLD ARNOLD FAMILY

DENTISTRY

GENERAL

DENTISTRY

2393 ALUMNI

DRIVE SUITE 102



DENTISTRY

GENERAL

DENTISTRY

2393 ALUMNI

DRIVE SUITE 102


SERVICE


DENTISTRY

GENERAL

DENTISTRY

2393 ALUMNI

DRIVE SUITE 102



AND MAGGARD

ORTHODONTICS

ORTHODONTIST 2443 SIR BARTON

WAY SUITE 225

LEXINGTON KY 40509 859 543 9200 http://www.wg

mortho.com/H

ome.aspx

COVENTRY

204



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

WELLCARE

205



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


WAY SUITE 225


mortho.com/H

ome.aspx

WELLCARE

ROBERT S ADKINS ROBERT S

ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD



ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD


SERVICE


ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD


RANA ZAKHARIA ROBERT S

ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD



ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD


SERVICE

206



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD


ROBERT S

ADKINS DMD PSC

GENERAL

DENTISTRY

2505 LARKIN

ROAD


SERVICE


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200

LEXINGTON KY 40509 859 543 2456 http://www.kid

steethofky.com

/index.html

COVENTRY


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

WELLCARE


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

COVENTRY


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

WELLCARE

207



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

COVENTRY


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

FEE FOR

SERVICE


DENTISTRY OF

HAMBURG

PEDIATRIC

DENTIST

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

WELLCARE

PEDIATRIC

DENTISTRY OF

HAMBURG

MULTI

SPECIALTY

GROUP

2517 SIR BARTON

WAY SUITE 200


steethofky.com

/index.html

FEE FOR

SERVICE

JOHN WAHLE III WAHLE AND

CHALOTHORN

ORTHODONTICS

ORTHODONTIST 2533 LARKIN RD LEXINGTON KY 40503 859 277 6113 http://www.kw

corthodontics.c

om/

FEE FOR

SERVICE

JOHN WAHLE III WAHLE AND

CHALOTHORN

ORTHODONTICS

ORTHODONTIST 2533 LARKIN RD LEXINGTON KY 40503 859 277 6113 http://www.kw

corthodontics.c

om/

WELLCARE


CENTER FOR

ORAL SURGERY

ORAL SURGEON 2533 LARKIN

ROAD SUITE 101

LEXINGTON KY 40503 859 278 9376 http://www.ke

ntuckyoms.co

m/index.html

COVENTRY

208



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

WELLCARE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

COVENTRY

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

209



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

WELLCARE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

COVENTRY

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

HUMANA

210



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


ROAD SUITE 101


ntuckyoms.co

m/index.html

WELLCARE

KENTUCKY

CENTER FOR

ORAL SURGERY

MULTI

SPECIALTY

GROUP

2533 LARKIN

ROAD SUITE 101


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

FAHED HISHMEH GENTLE CARE

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

2558 LARKIN

ROAD SUITE 110



COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

2558 LARKIN

ROAD SUITE 110


SERVICE


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

2558 LARKIN

ROAD SUITE 110


GENTLE CARE

COSMETIC AND

FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

2558 LARKIN

ROAD SUITE 110


SERVICE

RUTH ADKINS ADKINS FAMILY

AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

2704 OLD

ROSEBUD ROAD

SUITE 210

LEXINGTON KY 40509 859 543 0333 http://www.ad

kinsfamilydent

istry.com/

COVENTRY

211



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

2704 OLD

ROSEBUD ROAD

SUITE 210


kinsfamilydent

istry.com/

FEE FOR

SERVICE


AND COSMETIC

DENTISTRY

GENERAL

DENTISTRY

2704 OLD

ROSEBUD ROAD

SUITE 210


kinsfamilydent

istry.com/

WELLCARE

WILLIAM BARKER BLUEGRASS

ORAL AND

MAXILLOFACIAL

SURGERY PSC

ORAL SURGEON 3080

HARRODSBURG

ROAD SUITE 275

LEXINGTON KY 40503 859 278 5377 http://www.bg

oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY PSC

ORAL SURGEON 3080

HARRODSBURG

ROAD SUITE 275


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY PSC

ORAL SURGEON 3080

HARRODSBURG

ROAD SUITE 275


oms.com/

WELLCARE

BLUEGRASS

ORAL AND

MAXILLOFACIAL

SURGERY PSC

GENERAL

DENTISTRY

3080

HARRODSBURG

ROAD SUITE 275


oms.com/

FEE FOR

SERVICE

212



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RONALD GRAVIL BEAUMONT

CENTRE DENTAL

GROUP

GENERAL

DENTISTRY

3111 WALL

STREET

LEXINGTON KY 40513 859 223 1833 http://www.drg

ravil.com/

COVENTRY


CENTRE DENTAL

GROUP

GENERAL

DENTISTRY

3111 WALL

STREET


ravil.com/

FEE FOR

SERVICE


CENTRE DENTAL

GROUP

GENERAL

DENTISTRY

3111 WALL

STREET


ravil.com/

WELLCARE

WILLIAM SHORES JR WILLIAM E

SHORES JR DDS

GENERAL

DENTISTRY

3122 CUSTER

DRIVE SUITE B



SHORES JR DDS

GENERAL

DENTISTRY

3122 CUSTER

DRIVE SUITE B


SERVICE


SHORES JR DDS

GENERAL

DENTISTRY

3122 CUSTER

DRIVE SUITE B



CENTER FOR

ORAL SURGERY

ORAL SURGEON 3141 BEAUMONT

CENTER CIRCLE


ntuckyoms.co

m/index.html

COVENTRY

213



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

WELLCARE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

COVENTRY

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

214



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

WELLCARE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

COVENTRY

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

HUMANA

215



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


CENTER CIRCLE


ntuckyoms.co

m/index.html

WELLCARE

KENTUCKY

CENTER FOR

ORAL SURGERY

MULTI

SPECIALTY

GROUP

3141 BEAUMONT

CENTER CIRCLE


SERVICE

JACKIE BANAHAN JACKIE L

BANAHAN DMD

PEDIATRIC

DENTIST

3141 BEAUMONT

CENTER CIRCLE

SUITE 100

LEXINGTON KY 40513 859 223 4888 http://www.jac

kiebanahandm

d.com/index.ht

ml

COVENTRY


BANAHAN DMD

PEDIATRIC

DENTIST

3141 BEAUMONT

CENTER CIRCLE

SUITE 100


kiebanahandm

d.com/index.ht

ml

FEE FOR

SERVICE


BANAHAN DMD

PEDIATRIC

DENTIST

3141 BEAUMONT

CENTER CIRCLE

SUITE 100


kiebanahandm

d.com/index.ht

ml

WELLCARE


AND MAGGARD

ORTHODONTICS

ORTHODONTIST 3141 BEAUMONT

CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

COVENTRY

216



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

WELLCARE

217



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


CENTRE CIRCLE

SUITE 200


mortho.com/H

ome.aspx

WELLCARE

MARYLOU HEAD MARYLOU S

HEAD PSC

GENERAL

DENTISTRY

3225 SUMMIT

SQUARE PLACE

SUITE 150



HEAD PSC

GENERAL

DENTISTRY

3225 SUMMIT

SQUARE PLACE

SUITE 150


SERVICE


HEAD PSC

GENERAL

DENTISTRY

3225 SUMMIT

SQUARE PLACE

SUITE 150


218



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JEFFREY KING TAKES CREEK

DENTAL

GENERAL

DENTISTRY

4071 TATES

CREEK CENTER

DRIVE SUITE 210

LEXINGTON KY 40517 859 273 3139 http://www.tat

escreekdental.c

om/

COVENTRY


DENTAL

GENERAL

DENTISTRY

4071 TATES

CREEK CENTER

DRIVE SUITE 210


escreekdental.c

om/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

4071 TATES

CREEK CENTER

DRIVE SUITE 210


escreekdental.c

om/

WELLCARE

LISA KOCHIS KOCHIS ORTHO ORTHODONTIST 4071 TATES

CREEK CENTER

DRIVE SUITE 306



CREEK CENTER

DRIVE SUITE 306


SERVICE


CREEK CENTER

DRIVE SUITE 306


219



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LESLIE LOUIS TERESA BOYD

DMD

GENERAL

DENTISTRY

4071 TATES

CREEK CENTRE

DRIVE

LEXINGTON KY 40517 859 245 7127 http://www.bo

ydthorntondent

al.com/

COVENTRY


DMD

GENERAL

DENTISTRY

4071 TATES

CREEK CENTRE

DRIVE


ydthorntondent

al.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

4071 TATES

CREEK CENTRE

DRIVE


ydthorntondent

al.com/

HUMANA


DMD

GENERAL

DENTISTRY

4071 TATES

CREEK CENTRE

DRIVE


ydthorntondent

al.com/

WELLCARE

VALERIE JUSTICE SOUTH FARM

FAMILY

DENTISTRY

GENERAL

DENTISTRY

4097 NICHOLS

PARK DRIVE

SUITE 112

LEXINGTON KY 40503 859 971 9238 http://www.so

uthfarmdental.

com/index.cfm

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4097 NICHOLS

PARK DRIVE

SUITE 112


uthfarmdental.

com/index.cfm

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4097 NICHOLS

PARK DRIVE

SUITE 112


uthfarmdental.

com/index.cfm

WELLCARE

220



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SUSAN BURTON SUSAN BURTON

DMD

GENERAL

DENTISTRY

431 SOUTH

BROADWAY

SUITE 112

LEXINGTON KY 40508 859 255 6161 http://www.drs

usiburton.com/

COVENTRY


DMD

GENERAL

DENTISTRY

431 SOUTH

BROADWAY

SUITE 112


usiburton.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

431 SOUTH

BROADWAY

SUITE 112


usiburton.com/

WELLCARE


ORTHODONTICS

ORTHODONTIST 535

WELLINGTON

WAY SUITE 180

LEXINGTON KY 40503 859 234 5523 http://www.sm

ileearly.com/in

dex.asp

COVENTRY


ORTHODONTICS

ORTHODONTIST 535

WELLINGTON

WAY SUITE 180


ileearly.com/in

dex.asp

FEE FOR

SERVICE


ORTHODONTICS

ORTHODONTIST 535

WELLINGTON

WAY SUITE 180


ileearly.com/in

dex.asp

WELLCARE

MICHAEL BUCHART JR BUCHART

ORTHODONTICS

ORTHODONTIST 540 EAST MAIN

STREET

LEXINGTON KY 40508 859 233 1431 http://www.bu

chartorthodont

ics.com/

COVENTRY


ORTHODONTICS


STREET


chartorthodont

ics.com/

FEE FOR

SERVICE


ORTHODONTICS


STREET


chartorthodont

ics.com/

WELLCARE

221



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

APRILLE NELSON BROADWAY

FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

556 NORTH

BROADWAY


lexingtonkyde

ntist.com/

COVENTRY


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

556 NORTH

BROADWAY


lexingtonkyde

ntist.com/

FEE FOR

SERVICE


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

556 NORTH

BROADWAY


lexingtonkyde

ntist.com/

WELLCARE

GREGORY ERNEA ERENA AND

PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST

ORAL SURGEON 620 PERIMETER

DRIVE SUITE 100

LEXINGTON KY 40517 859 268 4423 http://www.ere

napeterson.co

m/

COVENTRY

GREGORY ERNEA ERENA AND

PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST


DRIVE SUITE 100


napeterson.co

m/

FEE FOR

SERVICE

GILMAN PETERSON III ERENA AND

PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST


DRIVE SUITE 100


napeterson.co

m/

COVENTRY

222



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST


DRIVE SUITE 100


napeterson.co

m/

FEE FOR

SERVICE


PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST


DRIVE SUITE 100


napeterson.co

m/

HUMANA


PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST


DRIVE SUITE 100


napeterson.co

m/

WELLCARE

ERENA AND

PETERSON PLLC

ORAL AND

MAXILLOFACIAL

DENTIST

MULTI

SPECIALTY

GROUP

620 PERIMETER

DRIVE SUITE 100


napeterson.co

m/

FEE FOR

SERVICE

LINDA LARKIN SCOTT AND

LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY



LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY


SERVICE

223



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY


MICHAEL SCOTT SCOTT AND

LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY



LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY


SERVICE


LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY


SCOTT AND

LARKIN

GENERAL

DENTISTRY

624 NORTH

BROADWAY


SERVICE

HEALTHFIRS

T

BLUEGRASS

INC

MEDICAL CLINIC 650 NEWTOWN

PIKE


HEALTHFIRS

T

BLUEGRASS

INC


PIKE


SERVICE

HEALTHFIRS

T

BLUEGRASS

INC


PIKE

LEXINGTON KY 40508 859 288 2488 PASSPORT

HEALTHFIRS

T

BLUEGRASS

INC


PIKE


224



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORTHODONTICS

ORTHODONTIST 698 PERIMETER

DRIVE SUITE 200


chartorthodont

ics.com/

COVENTRY


ORTHODONTICS


DRIVE SUITE 200


chartorthodont

ics.com/

FEE FOR

SERVICE


ORTHODONTICS


DRIVE SUITE 200


chartorthodont

ics.com/

WELLCARE

KENTUCKY

CLINIC

DENTISTRY

GENERAL

DENTISTRY

740 SOUTH

LIMESTONE


care.uky.edu/lo

cations/directi

ons KYC

Dentistry/

FEE FOR

SERVICE

UK COLLEGE

OF

DENTISTRY

URGENT

CARE CLINIC

GENERAL

DENTISTRY

800 ROSE

STREET


care.uky.edu/lo

cations/dentistr

y clinics/

FEE FOR

SERVICE

UK DENTAL

CLINIC ORAL

AND

MAXILLOFAC

IAL SURGERY

ORAL SURGEON 800 ROSE

STREET 5TH

FLOOR


care.uky.edu/lo

cations/dentistr

y clinics/

FEE FOR

SERVICE

225



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS

ORTHODONTIST 860 CORPORATE

DRIVE

LEXINGTON KY 40503 859 223 3939 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


DRIVE


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


DRIVE


ortho.com/

WELLCARE

THE KENTUCKY

CENTER FOR

ORTHODONTICS


DRIVE


ortho.com/

FEE FOR

SERVICE

CINDY MUNOZ GENTLE DENTAL

TOUCH LLC

GENERAL

DENTISTRY

860 CORPORATE

DRIVE SUITE 101

LEXINGTON KY 40504 859 225 5281 http://www.ge

ntledentaltouc

h.com/

COVENTRY


TOUCH LLC

GENERAL

DENTISTRY

860 CORPORATE

DRIVE SUITE 101


ntledentaltouc

h.com/

FEE FOR

SERVICE

226



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


TOUCH LLC

GENERAL

DENTISTRY

860 CORPORATE

DRIVE SUITE 101


ntledentaltouc

h.com/

WELLCARE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

FEE FOR

SERVICE

227



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


DRIVE SUITE 201


ortho.com/

WELLCARE

GRETCHEN KINCHEN GRETCHEN

KINCHEN DMD

GENERAL

DENTISTRY

989 GOVERNORS

LANE SUITE 120

LEXINGTON KY 40513 859 296 0296 http://www.de

ntalcarebygretc

hen.com/

COVENTRY


KINCHEN DMD

GENERAL

DENTISTRY

989 GOVERNORS

LANE SUITE 120


ntalcarebygretc

hen.com/

FEE FOR

SERVICE


KINCHEN DMD

GENERAL

DENTISTRY

989 GOVERNORS

LANE SUITE 120


ntalcarebygretc

hen.com/

WELLCARE

MICHELE BEELER MICHELE BELLER

DMD PLLC

GENERAL

DENTISTRY

650 WHIPP

AVENUE

LIBERTY KY 42539 606 787 5222 COVENTRY


DMD PLLC

GENERAL

DENTISTRY

650 WHIPP

AVENUE

LIBERTY KY 42539 606 787 5222 FEE FOR

SERVICE


DMD PLLC

GENERAL

DENTISTRY

650 WHIPP

AVENUE

LIBERTY KY 42539 606 787 5222 HUMANA


DMD PLLC

GENERAL

DENTISTRY

650 WHIPP

AVENUE

LIBERTY KY 42539 606 787 5222 WELLCARE

228



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RALPH THACKER JR RALPH THACKER

DMD FAMIY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

222 MAIN

STREET

LIVERMORE KY 42352 270 278 2385 http://www.tha

ckerdental.com

/

COVENTRY


DMD FAMIY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

222 MAIN

STREET


ckerdental.com

/

FEE FOR

SERVICE


DMD FAMIY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

222 MAIN

STREET


ckerdental.com

/

WELLCARE

MICHAEL HERREN MICHAEL C

HERREN DMD

GENERAL

DENTISTRY

1221 WEST 5TH

STREET

LONDON KY 40741 606 864 4744 COVENTRY


HERREN DMD

GENERAL

DENTISTRY

1221 WEST 5TH

STREET

LONDON KY 40741 606 864 4744 FEE FOR

SERVICE


HERREN DMD

GENERAL

DENTISTRY

1221 WEST 5TH

STREET

LONDON KY 40741 606 864 4744 WELLCARE

BARRY BINGHAM LAUREL DENTAL

CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD

LONDON KY 40744 606 877 2700 http://www.lau

reldentalcare.c

om/

COVENTRY

229



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

FEE FOR

SERVICE


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

WELLCARE

HENRY HAYS LAUREL DENTAL

CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

COVENTRY


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

FEE FOR

SERVICE


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

WELLCARE

SHERA NEWCOMB LAUREL DENTAL

CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

COVENTRY


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

FEE FOR

SERVICE


CARE

GENERAL

DENTISTRY

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

WELLCARE

LAUREL DENTAL

CARE

MULTI

SPECIALTY

GROUP

1303 SOUTH

LAUREL ROAD


reldentalcare.c

om/

FEE FOR

SERVICE

KIMBERLY BROWN KIMBERLY

BROWN DMD

PEDIATRIC

DENTIST

1368 EAST

HIGHWAY 192

LONDON KY 40741 606 864 6680 http://www.drb

rown4kids.com

/

COVENTRY

230



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BROWN DMD

PEDIATRIC

DENTIST

1368 EAST

HIGHWAY 192


rown4kids.com

/

FEE FOR

SERVICE


BROWN DMD

PEDIATRIC

DENTIST

1368 EAST

HIGHWAY 192


rown4kids.com

/

WELLCARE

STEVEN ANDERSON ANDERSON ORAL

AND

MAXIOLLOFACIA

L SURGERY PSC

ORAL SURGEON 1675 SOUTH

MAIN STREET

LONDON KY 40741 606 878 6126 http://www.seo

msky.com/

COVENTRY


AND

MAXIOLLOFACIA

L SURGERY PSC


MAIN STREET


msky.com/

FEE FOR

SERVICE


AND

MAXIOLLOFACIA

L SURGERY PSC


MAIN STREET


msky.com/

WELLCARE

MICHAEL MAGGARD WHITE AND

MAGGARD

ORTHODONTICS

ORTHODONTIST 200 CITY HILL

DRIVE SUITE 101

LONDON KY 40741 606 877 1900 http://www.wh

iteandmaggard.

com/

COVENTRY


MAGGARD

ORTHODONTICS


DRIVE SUITE 101


iteandmaggard.

com/

FEE FOR

SERVICE

231



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MAGGARD

ORTHODONTICS


DRIVE SUITE 101


iteandmaggard.

com/

WELLCARE

JAMES WHITE WHITE AND

MAGGARD

ORTHODONTICS


DRIVE SUITE 101


iteandmaggard.

com/

COVENTRY


MAGGARD

ORTHODONTICS


DRIVE SUITE 101


iteandmaggard.

com/

FEE FOR

SERVICE


MAGGARD

ORTHODONTICS


DRIVE SUITE 101


iteandmaggard.

com/

WELLCARE


MORROW

ORAL SURGEON 200 CITY HILL

DRIVE SUITE 102



MORROW


DRIVE SUITE 102

LONDON KY 40741 606 877 8811 FEE FOR

SERVICE


MORROW


DRIVE SUITE 102



MORROW


DRIVE SUITE 102



MORROW


DRIVE SUITE 102

LONDON KY 40741 606 877 8811 FEE FOR

SERVICE

232



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MORROW


DRIVE SUITE 102



MORROW


DRIVE SUITE 102



MORROW


DRIVE SUITE 102

LONDON KY 40741 606 877 8811 FEE FOR

SERVICE


MORROW


DRIVE SUITE 102


JENKINS AND

MORROW


DRIVE SUITE 102

LONDON KY 40741 606 877 8811 FEE FOR

SERVICE

ERNEST PARROTT ERNEST W

PARROTT DMD

GENERAL

DENTISTRY

307 NORTH

BROAD STREET



PARROTT DMD

GENERAL

DENTISTRY

307 NORTH

BROAD STREET

LONDON KY 40741 606 878 9755 FEE FOR

SERVICE


PARROTT DMD

GENERAL

DENTISTRY

307 NORTH

BROAD STREET


TERRI BROWN TERRI BROWN

DMD

GENERAL

DENTISTRY

39 WACO DRIVE LONDON KY 40741 606 877 3002 COVENTRY


DMD

GENERAL

DENTISTRY

39 WACO DRIVE LONDON KY 40741 606 877 3002 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

39 WACO DRIVE LONDON KY 40741 606 877 3002 WELLCARE

233



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CYNTHIA COUCH MODERN FAMILY

SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD

LONDON KY 40741 606 864 1441 http://www.mo

derndentalsolu

tionsky.com/

COVENTRY


SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD


derndentalsolu

tionsky.com/

FEE FOR

SERVICE


SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD


derndentalsolu

tionsky.com/

WELLCARE

KAYLA FIELDS MODERN FAMILY

SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD


derndentalsolu

tionsky.com/

COVENTRY


SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD


derndentalsolu

tionsky.com/

FEE FOR

SERVICE


SOLUTIONS

GENERAL

DENTISTRY

735 MEYERS

BUCKER ROAD


derndentalsolu

tionsky.com/

WELLCARE

JERRY MAYES LONDON DENTAL

CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET

LONDON KY 40741 606 878 7251 http://www.lon

dondentalcente

r.com/

COVENTRY


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

FEE FOR

SERVICE

234



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

WELLCARE

TINA MCGEORGE LONDON DENTAL

CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

COVENTRY


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

WELLCARE

GREGORY POWELL LONDON DENTAL

CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

COVENTRY


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

WELLCARE

MICHAEL WOOD LONDON DENTAL

CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

COVENTRY


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

WELLCARE

235



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LONDON DENTAL

CENTER

GENERAL

DENTISTRY

828 SOUTH MAIN

STREET


dondentalcente

r.com/

FEE FOR

SERVICE

JEREMY ALLEN JEREMY W

ALLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

908 WEST 5TH

STREET SUITE

114



ALLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

908 WEST 5TH

STREET SUITE

114

LONDON KY 40741 606 330 0330 FEE FOR

SERVICE


ALLEN FAMILY

DENTISTRY

GENERAL

DENTISTRY

908 WEST 5TH

STREET SUITE

114


L. KEITH WOODY L KEITH WOODY

DMD

GENERAL

DENTISTRY

108 NORTH

LOCK AVENUE

LOUISA KY 41230 606 638 9094 COVENTRY


DMD

GENERAL

DENTISTRY

108 NORTH

LOCK AVENUE

LOUISA KY 41230 606 638 9094 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

108 NORTH

LOCK AVENUE

LOUISA KY 41230 606 638 9094 WELLCARE

CHARLES SAMMONS CHARLES E

SAMMONS DDS

PLLC

GENERAL

DENTISTRY

202 WATER

STREET



SAMMONS DDS

PLLC

GENERAL

DENTISTRY

202 WATER

STREET

LOUISA KY 41230 606 638 3400 FEE FOR

SERVICE

236



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SAMMONS DDS

PLLC

GENERAL

DENTISTRY

202 WATER

STREET


WALTER ARRINGTON WALTER L

ARRINGTON DDS

GENERAL

DENTISTRY

203 WATER

STREET



ARRINGTON DDS

GENERAL

DENTISTRY

203 WATER

STREET

LOUISA KY 41230 606 638 4689 FEE FOR

SERVICE


ARRINGTON DDS

GENERAL

DENTISTRY

203 WATER

STREET


WILLIAM PHILLIPS DUPONT

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

1001 DUPONT

SQUARE NORTH

LOUISVILLE KY 40207 502 897 0625 http://dupontpe

diatricdentistry

.com/

COVENTRY


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

1001 DUPONT

SQUARE NORTH


diatricdentistry

.com/

FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

1001 DUPONT

SQUARE NORTH


diatricdentistry

.com/

HUMANA


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

1001 DUPONT

SQUARE NORTH


diatricdentistry

.com/

PASSPORT

237



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

1001 DUPONT

SQUARE NORTH


diatricdentistry

.com/

WELLCARE

ROY FOSTER FOSTER AND

FOSTER FAMILY

DENTISTRY

GENERAL

DENTISTRY

10017 DIXIE

HIGHWAY

LOUISVILLE KY 40272 502 933 7250 http://www.fos

tersmiles.com/

FEE FOR

SERVICE

ROY FOSTER FOSTER AND

FOSTER FAMILY

DENTISTRY

GENERAL

DENTISTRY

10017 DIXIE

HIGHWAY

LOUISVILLE KY 40272 502 933 7250 http://www.fos

tersmiles.com/

PASSPORT

JAMES ELIAS JR MORTENSON

FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD

LOUISVILLE KY 40223 502 412 7587 http://mortenso

ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

HUMANA

238



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

WELLCARE

MATTHEW MORTENSON MORTENSON

FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

PASSPORT

239



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/de

fault.asp

WELLCARE

VITALIA KADYLAK MORTENSON

FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

WELLCARE

240



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KIMBERLY OWEN MORTENSON

FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

FORREST GREEN

GENERAL

DENTISTRY

10031 FOREST

GREEN BLVD


ndental.com/D

efault.asp

WELLCARE

241



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

TIMOTHY ACORD EAST LOUISVILLE

ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 1013 DUPONT

SQUARE NORTH

SUITE B

LOUISVILLE KY 40207 502 897 5282 http://www.eas

tlouisvilleorals

urgery.com/

fee FOR

SERVICE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

HUMANA


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

WELLCARE

242



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

W RONALD HARRIS EAST LOUISVILLE

ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

COVENTRY


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

FEE FOR

SERVICE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/

WELLCARE

243



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

THAD SCHULTEN EAST LOUISVILLE

ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

COVENTRY


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

FEE FOR

SERVICE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC


SQUARE NORTH

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

WELLCARE

244



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

THERESA HAYWARD FOURTH STREET

DENTAL CENTER

GENERAL

DENTISTRY

1018 SOUTH 4TH

STREET SUITE

250

LOUISVILLE KY 40203 502 585 4320 http://www.fou

rthstreetdental

center.com/

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

1018 SOUTH 4TH

STREET SUITE

250


rthstreetdental

center.com/

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

1018 SOUTH 4TH

STREET SUITE

250


rthstreetdental

center.com/

HUMANA


DENTAL CENTER

GENERAL

DENTISTRY

1018 SOUTH 4TH

STREET SUITE

250


rthstreetdental

center.com/

PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

1018 SOUTH 4TH

STREET SUITE

250


rthstreetdental

center.com/

WELLCARE

BETH BENNETT BETH A BENNETT

DMD

GENERAL

DENTISTRY

1039 EAST

BURNETT

AVENUE

LOUISVILLE KY 40217 502 634 9005 COVENTRY


DMD

GENERAL

DENTISTRY

1039 EAST

BURNETT

AVENUE

LOUISVILLE KY 40217 502 634 9005 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1039 EAST

BURNETT

AVENUE

LOUISVILLE KY 40217 502 634 9005 HUMANA

245



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

1039 EAST

BURNETT

AVENUE

LOUISVILLE KY 40217 502 634 9005 PASSPORT


DMD

GENERAL

DENTISTRY

1039 EAST

BURNETT

AVENUE

LOUISVILLE KY 40217 502 634 9005 WELLCARE

JENNIFER BOARD KIDS SMILE

DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE

LOUISVILLE KY 40203 502 426 9594 http://www.kid

zsmiledentistry

.com/

COVENTRY


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

FEE FOR

SERVICE


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

HUMANA


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

PASSPORT


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

WELLCARE

MYRON SHUSTER KIDS SMIE

DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

COVENTRY

246



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

FEE FOR

SERVICE


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

HUMANA


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

PASSPORT


DENTISTRY

PEDIATRIC

DENTIST

10500 FISCHER

PARK DRIVE


zsmiledentistry

.com/

WELLCARE

NILIMA HORLANDER MORTENSON

FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/de

fault.asp

WELLCARE

247



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JEAN JENSEN BRACES BRACES

BRACES DIXIE

HIGHWAY

ORTHODONTIST 10640 DIXIE

HIGHWAY

LOUISVILLE KY 40202 502 933 4454 http://bracesbr

acesbraces.co

m/index.php

COVENTRY


BRACES DIXIE

HIGHWAY


HIGHWAY


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES DIXIE

HIGHWAY


HIGHWAY


acesbraces.co

m/index.php

HUMANA


BRACES DIXIE

HIGHWAY


HIGHWAY


acesbraces.co

m/index.php

PASSPORT


BRACES DIXIE

HIGHWAY


HIGHWAY


acesbraces.co

m/index.php

WELLCARE


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

COVENTRY

248



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

WELLCARE

HEATHER WALKER MORTENSON

FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

FEE FOR

SERVICE

249



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

VALLEY STATION

GENERAL

DENTISTRY

10640 DIXIE

HIGHWAY


ndental.com/D

efault.asp

WELLCARE

MICHAEL BECHT BECHT

ORTHODONTICS


WATTERSON

TRAIL SUITE 103

LOUISVILLE KY 40243 502 245 2175 http://www.be

chtortho.com/

COVENTRY

MICHAEL BECHT BECHT

ORTHODONTICS


WATTERSON

TRAIL SUITE 103


chtortho.com/

FEE FOR

SERVICE

MICHAEL BECHT BECHT

ORTHODONTICS


WATTERSON

TRAIL SUITE 103


chtortho.com/

HUMANA

MICHAEL BECHT BECHT

ORTHODONTICS


WATTERSON

TRAIL SUITE 103


chtortho.com/

PASSPORT

250



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MICHAEL BECHT BECHT

ORTHODONTICS


WATTERSON

TRAIL SUITE 103


chtortho.com/

WELLCARE

HOME OF

THE

INNOCENTS

INC OPEN

ARMS

CHILDRENS

HEALTH

MULTI

SPECIALTY

GROUP

1100 EAST

MARKET

STREET

LOUISVILLE KY 40206 502 596 1040 http://www.op

enarmschildren

shealth.org/

FEE FOR

SERVICE

HOME OF

THE

INNOCENTS

INC OPEN

ARMS

CHILDRENS

HEALTH

MULTI

SPECIALTY

GROUP

1100 EAST

MARKET

STREET

LOUISVILLE KY 40206 502 596 1040 http://www.op

enarmschildren

shealth.org/

PASSPORT

ROBERT COOPER A CHOICE

DENTAL CARE

GENERAL

DENTISTRY

111 FAIRFAX

AVENUE

LOUISVILLE KY 40207 502 895 1171 http://www.ac

hoicedentalcar

e.com/#

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

111 FAIRFAX

AVENUE


hoicedentalcar

e.com/#

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

111 FAIRFAX

AVENUE


hoicedentalcar

e.com/#

HUMANA


DENTAL CARE

GENERAL

DENTISTRY

111 FAIRFAX

AVENUE


hoicedentalcar

e.com/#

PASSPORT

251



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

111 FAIRFAX

AVENUE


hoicedentalcar

e.com/#

WELLCARE

ANN

MARGARET

LUCKETT GARY GRIFFIN

DMD

GENERAL

DENTISTRY

114 SOUTH

SHERRIN

AVENUE

LOUISVILLE KY 40216 502 694 5283 http://www.lou

isvilledentalpr

actice.com/

COVENTRY

ANN

MARGARET


DMD

GENERAL

DENTISTRY

114 SOUTH

SHERRIN

AVENUE


isvilledentalpr

actice.com/

FEE FOR

SERVICE

ANN

MARGARET


DMD

GENERAL

DENTISTRY

114 SOUTH

SHERRIN

AVENUE


isvilledentalpr

actice.com/

PASSPORT

ANN

MARGARET


DMD

GENERAL

DENTISTRY

114 SOUTH

SHERRIN

AVENUE


isvilledentalpr

actice.com/

WELLCARE

DONALD FEENEY DENTAL FEAR

TREATMENT

CENTER

GENERAL

DENTISTRY

1169 EASTERN

PARKWAY SUITE

1152



TREATMENT

CENTER

GENERAL

DENTISTRY

1169 EASTERN

PARKWAY SUITE

1152


SERVICE


TREATMENT

CENTER

GENERAL

DENTISTRY

1169 EASTERN

PARKWAY SUITE

1152



TREATMENT

CENTER

GENERAL

DENTISTRY

1169 EASTERN

PARKWAY SUITE

1152


252



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


TREATMENT

CENTER

GENERAL

DENTISTRY

1169 EASTERN

PARKWAY SUITE

1152


WILLIAM EPSTEIN GREATER

LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 1169 EASTERN

PARKWAY SUITE

2265

LOUISVILLE KY 40217 502 459 8012 http://www.ora

lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

PASSPORT

RICHARD PAPE GREATER

LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

COVENTRY


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE

253



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/default

.htm

WELLCARE

JAMES SALMAN GREATER

LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/Defaul

t.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/Defaul

t.htm

HUMANA

254



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


PARKWAY SUITE

2265


lsurgerylouisvi

lle.com/Defaul

t.htm

PASSPORT

MICHAEL BECKER HILLVIEW

FAMILY

DENTISTRY

GENERAL

DENTISTRY

119 TOPFIELD

ROAD

LOUISVILLE KY 40299 502 957 4408 http://www.hill

viewsmiles.co

m/

FEE FOR

SERVICE

MICHAEL BECKER HILLVIEW

FAMILY

DENTISTRY

GENERAL

DENTISTRY

119 TOPFIELD

ROAD

LOUISVILLE KY 40299 502 957 4408 http://www.hill

viewsmiles.co

m/

PASSPORT

JENNIFER BOARD KOOL SMILES

LOUISVILLE

PEDIATRIC

DENTIST

1211 WEST

BROADWAY

LOUISVILLE KY 40203 502 410 0311 http://www.my

koolsmiles.co

m/

COVENTRY


LOUISVILLE

PEDIATRIC

DENTIST

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

PEDIATRIC

DENTIST

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

PEDIATRIC

DENTIST

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

PEDIATRIC

DENTIST

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY

255



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE

CHRISTOPHE

R

CORDER KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY

CHRISTOPHE

R

CORDER KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

CHRISTOPHE

R

CORDER KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA

CHRISTOPHE

R

CORDER KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT

CHRISTOPHE

R

CORDER KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY

256



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m

WELLCARE

MICHAEL KIRK KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

257



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT

JENNIFER MAPLE KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY

258



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE

SARA PAIGE

TROMBETTI

KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

SARA PAIGE

TROMBETTI

KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA

SARA PAIGE

TROMBETTI

KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT

SARA PAIGE

TROMBETTI

KOOL SMILES

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

259



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

260



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE

261



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

1211 WEST

BROADWAY


koolsmiles.co

m/

WELLCARE

BRYAN LAWRENCE PARKLAND

DENTAL CENTER

GENERAL

DENTISTRY

1220 SOUTH

28TH STREET



DENTAL CENTER

GENERAL

DENTISTRY

1220 SOUTH

28TH STREET


SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

1220 SOUTH

28TH STREET


262



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

1220 SOUTH

28TH STREET



DENTAL CENTER

GENERAL

DENTISTRY

1220 SOUTH

28TH STREET



ORTHODONTICS


SHELBYVILLE

ROAD

LOUISVILLE KY 40243 502 244 0204 http://www.akr

idgeorthodonti

cs.com/

COVENTRY


ORTHODONTICS


SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

fee FOR

SERVICE


ORTHODONTICS


SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

HUMANA


ORTHODONTICS


SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

PASSPORT


ORTHODONTICS


SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

WELLCARE

AKRIDGE

ORTHODONTICS

MULTI

SPECIALTY

GROUP

12405 OLD

SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

FEE FOR

SERVICE

AKRIDGE

ORTHODONTICS

MULTI

SPECIALTY

GROUP

12405 OLD

SHELBYVILLE

ROAD


idgeorthodonti

cs.com/

PASSPORT

GABOR VARGO HIGHLANDS

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1250

BARDSTOWN

ROAD

LOUISVILLE KY 40204 502 459 2424 http://www.hig

hlandsdentistry

.com/

COVENTRY

263



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1250

BARDSTOWN

ROAD


hlandsdentistry

.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1250

BARDSTOWN

ROAD


hlandsdentistry

.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1250

BARDSTOWN

ROAD


hlandsdentistry

.com/

PASSPORT


FAMILY

DENTISTRY

GENERAL

DENTISTRY

1250

BARDSTOWN

ROAD


hlandsdentistry

.com/

WELLCARE

NADER POUR GHASEMI PREMIER DENTAL

CENTER

GENERAL

DENTISTRY

12563

SHELBYVILLE

ROAD


isvillepremierd

entalcare.com/

FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

12563

SHELBYVILLE

ROAD


isvillepremierd

entalcare.com/

HUMANA


CENTER

GENERAL

DENTISTRY

12563

SHELBYVILLE

ROAD


isvillepremierd

entalcare.com/

PASSPORT

NADER EHSANI MIDDLETOWN

DENTAL

GENERAL

DENTISTRY

12601

TOWNEPARK

WAY SUITE 100

LOUISVILLE KY 40222 502 384 7000 http://www.dre

hsanidmd.com/

index.htm

COVENTRY

264



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY

12601

TOWNEPARK

WAY SUITE 100


hsanidmd.com/

index.htm

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

12601

TOWNEPARK

WAY SUITE 100


hsanidmd.com/

index.htm

HUMANA


DENTAL

GENERAL

DENTISTRY

12601

TOWNEPARK

WAY SUITE 100


hsanidmd.com/

index.htm

PASSPORT


DENTAL

GENERAL

DENTISTRY

12601

TOWNEPARK

WAY SUITE 100


hsanidmd.com/

index.htm

WELLCARE

MICHAEL WAHL MICHAEL J WAHL

DMD

PEDIATRIC

DENTIST

129 EVERGREEN

ROAD SUITE A


louisvillepedia

tricdentist.com

/

FEE FOR

SERVICE


DMD

PEDIATRIC

DENTIST

129 EVERGREEN

ROAD SUITE A


louisvillepedia

tricdentist.com

/

HUMANA


DMD

PEDIATRIC

DENTIST

129 EVERGREEN

ROAD SUITE A


louisvillepedia

tricdentist.com

/

PASSPORT

265



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BRACES

MIDDLETOWN

ORTHODONTIST 130 EVERGREEN

ROAD SUTIE 100


acesbraces.co

m/

COVENTRY


BRACES

MIDDLETOWN


ROAD SUTIE 100


acesbraces.co

m/

FEE FOR

SERVICE


BRACES

MIDDLETOWN


ROAD SUTIE 100


acesbraces.co

m/

HUMANA


BRACES

MIDDLETOWN


ROAD SUTIE 100


acesbraces.co

m/

PASSPORT


BRACES

MIDDLETOWN


ROAD SUTIE 100


acesbraces.co

m/

WELLCARE

KIMBERLY HANSFORD KIDS DENTISTREE

MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100

LOUISVILLE KY 40243 502 410 1710 http://kidsdenti

stree.com/inde

x.php

COVENTRY

266



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

FEE FOR

SERVICE


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

HUMANA


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

PASSPORT


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

WELLCARE

JASON LIPOFF KIDS DENTISTREE

MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

COVENTRY


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

FEE FOR

SERVICE


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

HUMANA

267



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

PASSPORT


MIDDLETOWN

PEDIATRIC

DENTIST

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

WELLCARE

KELLY UNDERWOOD KIDS DENTISTREE

MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

COVENTRY


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

FEE FOR

SERVICE


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

HUMANA


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

PASSPORT


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/Inde

x.php

WELLCARE

268



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LYDIA WINTERS KIDS DENTISTREE

MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

COVENTRY


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

FEE FOR

SERVICE


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

HUMANA


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

PASSPORT


MIDDLETOWN

GENERAL

DENTISTRY

130 NORTH

EVERGREEN

ROAD SUITE 100


stree.com/inde

x.php

WELLCARE


FACIAL SURGERY

GROUP

MIDDLETOWN


EVERGREEN

ROAD

LOUISVILLE KY 40243 502 410 1702 http://www.the

ofsgroup.com/i

ndex.php

COVENTRY

269



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FACIAL SURGERY

GROUP

MIDDLETOWN


EVERGREEN

ROAD


ofsgroup.com/i

ndex.php

FEE FOR

SERVICE


FACIAL SURGERY

GROUP

MIDDLETOWN


EVERGREEN

ROAD


ofsgroup.com/i

ndex.php

HUMANA


FACIAL SURGERY

GROUP

MIDDLETOWN


EVERGREEN

ROAD


ofsgroup.com/i

ndex.php

PASSPORT


FACIAL SURGERY

GROUP

MIDDLETOWN


EVERGREEN

ROAD


ofsgroup.com/i

ndex.php

WELLCARE

ORAL AND

FACIAL SURGERY

GROUP

MIDDLETOWN

MULTI

SPECIALTY

GROUP

134 NORTH

EVERGREEN

ROAD


ofsgroup.com/i

ndex.php

FEE FOR

SERVICE

270



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

WILLIAM ENGILMAN BRACES BRACES

BRACES

MIDDLETOWN


EVERGREEN

ROAD SUITE 1


acesbraces.co

m/index.php

COVENTRY


BRACES

MIDDLETOWN


EVERGREEN

ROAD SUITE 1


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES

MIDDLETOWN


EVERGREEN

ROAD SUITE 1


acesbraces.co

m/index.php

HUMANA


BRACES

MIDDLETOWN


EVERGREEN

ROAD SUITE 1


acesbraces.co

m/index.php

PASSPORT


BRACES

MIDDLETOWN


EVERGREEN

ROAD SUITE 1


acesbraces.co

m/index.php

WELLCARE

KAREN NATION KAREN K NATION

DMD DENTISTRY

GENERAL

DENTISTRY

13819 ENGLISH

VILLA DRIVE

LOUISVILLE KY 40245 502 244 6886 http://drkarenn

ation.com/

FEE FOR

SERVICE

271



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KAREN NATION KAREN K NATION

DMD DENTISTRY

GENERAL

DENTISTRY

13819 ENGLISH

VILLA DRIVE

LOUISVILLE KY 40245 502 244 6886 http://drkarenn

ation.com/

PASSPORT

SCOTT EBERLE EBERLE

ORTHODONTICS

ORTHODONTIST 13913

SHELBYVILLE

ROAD

LOUISVILLE KY 40245 502 245 3112 http://www.eb

erleorthodontic

s.com/

FEE FOR

SERVICE

SCOTT EBERLE EBERLE

ORTHODONTICS

ORTHODONTIST 13913

SHELBYVILLE

ROAD


erleorthodontic

s.com/

HUMANA

SCOTT EBERLE EBERLE

ORTHODONTICS

ORTHODONTIST 13913

SHELBYVILLE

ROAD


erleorthodontic

s.com/

PASSPORT

DAVID WAUGH DIXIE DENTAL

CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY



CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY


SERVICE


CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY



CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY



CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY


DIXIE DENTAL

CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY


SERVICE

272



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DIXIE DENTAL

CENTER PSC

GENERAL

DENTISTRY

1480 DIXIE

HIGHWAY


STEPHANIE ALLEN 7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


SERVICE


FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


CHARLES BARRETT JR 7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


SERVICE

CHARLES BARRETT JR 7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


273



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MICHELLE CARMAN 7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


SERVICE


FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


JOHN MASON JR 7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


SERVICE

274



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET



FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


7TH AND HILL

FAMILY DENTAL

CENTER

GENERAL

DENTISTRY

1504 SOUTH 7TH

STREET


SERVICE

JEFFREY KLEIN KLEIN DENTAL

GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE

LOUISVILLE KY 40207 502 896 2822 http://www.rea

lpagessites.co

m/klein/index.

html

COVENTRY


GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

FEE FOR

SERVICE


GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

HUMANA

275



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

PASSPORT


GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

WELLCARE

KLEIN DENTAL

GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

FEE FOR

SERVICE

KLEIN DENTAL

GROUP

GENERAL

DENTISTRY

156 THIERMAN

LANE


lpagessites.co

m/klein/index.

html

PASSPORT


ORTHODONTICS

ORTHODONTIST 165 OUTER LOOP

SUITE 121


idgeorthodonti

cs.com/

COVENTRY


ORTHODONTICS


SUITE 121


idgeorthodonti

cs.com/

FEE FOR

SERVICE


ORTHODONTICS


SUITE 121


idgeorthodonti

cs.com/

HUMANA


ORTHODONTICS


SUITE 121


idgeorthodonti

cs.com/

PASSPORT


ORTHODONTICS


SUITE 121


idgeorthodonti

cs.com/

WELLCARE

276



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KIM GOLDMAN UNDERWOOD

AND LEE CLINIC


AVENUE SUITE A

LOUISVILLE KY 402I5 502 368 2348 http://www.un

derwoodandlee

.com/index.ht

ml

FEE FOR

SERVICE


AND LEE CLINIC


AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

HUMANA


AND LEE CLINIC


AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

PASSPORT

LINEL HOLWAGER UNDERWOOD

AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

COVENTRY


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

FEE FOR

SERVICE


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

HUMANA


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

PASSPORT

277



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

WELLCARE

HENRY HOOD UNDERWOOD

AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

COVENTRY


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

FEE FOR

SERVICE


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

HUMANA


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

PASSPORT


AND LEE CLINIC

GENERAL

DENTISTRY

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

WELLCARE

UNDERWOOD

AND LEE CLINIC

MULTI

SPECIALTY

GROUP

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

FEE FOR

SERVICE

278



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

UNDERWOOD

AND LEE CLINIC

MULTI

SPECIALTY

GROUP

1800 BLUEGRASS

AVENUE SUITE A


derwoodandlee

.com/index.ht

ml

PASSPORT

HUGO PAVON BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY

LOUISVILLE KY 40212 502 778 0296 http://drhugop

avon.com/inde

x.htm

COVENTRY

HUGO PAVON BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY


avon.com/inde

x.htm

FEE FOR

SERVICE

HUGO PAVON BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY


avon.com/inde

x.htm

HUMANA

HUGO PAVON BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY


avon.com/inde

x.htm

PASSPORT

HUGO PAVON BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY


avon.com/inde

x.htm

WELLCARE

BROADWAY

DENTAL CENTER

MULTI

SPECIALTY

GROUP

1813 WEST

BROADWAY


avon.com/inde

x.htm

FEE FOR

SERVICE

BROADWAY

DENTAL CENTER

MULTI

SPECIALTY

GROUP

1813 WEST

BROADWAY


avon.com/inde

x.htm

PASSPORT

JONATHAN MITCHELL BROADWAY

DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY

STREET


avon.com/inde

x.htm

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY

STREET


avon.com/inde

x.htm

FEE FOR

SERVICE

279



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

1813 WEST

BROADWAY

STREET


avon.com/inde

x.htm

PASSPORT

HEIDI YANG HEIDI D YANG

DMD

PEDIATRIC

DENTIST

2015 HERR LANE

SUITE D

LOUISVILLE KY 40222 502 426 0705 HTTP://www.

drheidiyang.co

m/?

FEE FOR

SERVICE


DMD

PEDIATRIC

DENTIST

2015 HERR LANE

SUITE D


drheidiyang.co

m/?

HUMANA


DMD

PEDIATRIC

DENTIST

2015 HERR LANE

SUITE D


drheidiyang.co

m/?

WELLCARE

KIM GOLDMAN ASSOCIATES IN

ORAL DENTISTRY

ORAL SURGEON 210 EAST GRAY

STREET SUITE

800

LOUISVILLE KY 40202 502 582 3750 http://dr.kimgo

ldman.com/

FEE FOR

SERVICE


ORAL DENTISTRY


STREET SUITE

800


ldman.com/

HUMANA


ORAL DENTISTRY


STREET SUITE

800


ldman.com/

PASSPORT

JOELLEN GERLACH GERLACH

FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE

LOUISVILLE KY 40214 502 368 5529 http://www.ger

lachfamilydent

istry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

FEE FOR

SERVICE

280



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

PASSPORT


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

WELLCARE

HAROLD GERLACH JR GERLACH

FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

PASSPORT


FAMILY

DENTISTRY

GENERAL

DENTISTRY

210 WEST

WOODLAND

AVENUE


lachfamilydent

istry.com/

WELLCARE

TYSON PERRERO MORTENSON

FAMILY DENTAL

HIGHLANDS

GENERAL

DENTISTRY

2105 WEBER

AVENUE


ndental.com/de

fault.asp

COVENTRY

281



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

HIGHLANDS

GENERAL

DENTISTRY

2105 WEBER

AVENUE


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

HIGHLANDS

GENERAL

DENTISTRY

2105 WEBER

AVENUE


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

HIGHLANDS

GENERAL

DENTISTRY

2105 WEBER

AVENUE


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

HIGHLANDS

GENERAL

DENTISTRY

2105 WEBER

AVENUE


ndental.com/de

fault.asp

WELLCARE

KORIE ACORD DERBY CITY

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2120 HIGH

WICKHAM

PLACE SUITE 103

LOUISVILLE KY 40245 502 254 6097 http://www.der

bycitypediatric

dentistry.com/

COVENTRY


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2120 HIGH

WICKHAM

PLACE SUITE 103


bycitypediatric

dentistry.com/

FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2120 HIGH

WICKHAM

PLACE SUITE 103


bycitypediatric

dentistry.com/

HUMANA

282



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2120 HIGH

WICKHAM

PLACE SUITE 103


bycitypediatric

dentistry.com/

PASSPORT


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2120 HIGH

WICKHAM

PLACE SUITE 103


bycitypediatric

dentistry.com/

WELLCARE

FAMILY

HEALTH

CENTER

PORTLAND

DENTAL

CLINIC

MEDICAL CLINIC 2215 PORTLAND

AVENUE

LOUISVILLE KY 40212 502 772 8860 http://www.fhc

louisville.org/

COVENTRY

FAMILY

HEALTH

CENTER

PORTLAND

DENTAL

CLINIC


AVENUE


louisville.org/

FEE FOR

SERVICE

FAMILY

HEALTH

CENTER

PORTLAND

DENTAL

CLINIC


AVENUE


louisville.org/

HUMANA

283



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

FAMILY

HEALTH

CENTER

PORTLAND

DENTAL

CLINIC


AVENUE


louisville.org/

PASSPORT

FAMILY

HEALTH

CENTER

PORTLAND

DENTAL

CLINIC


AVENUE


louisville.org/

WELLCARE

NANDAKA JAYAWEERA SHAWNEE

DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE



DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE


SERVICE


DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE



DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE



DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE


HERBERT LABORDEAUX SHAWNEE

DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE



DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE


SERVICE


DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE



DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE


284



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY

222 AMY

AVENUE


SHAWNEE

DENTAL PLLC

GENERAL

DENTISTRY

222 AMY

AVENUE


SERVICE

SHAWNEE

DENTAL PLLC

GENERAL

DENTISTRY

222 AMY

AVENUE


WILLIAM ALLEN JR KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 225 ABRAHAM

FLEXNER WAY

SUITE 302

LOUISVILLE KY 40202 502 587 7874 http://www.ky

oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

285



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

COVENTRY

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

286



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

GEOFFREY MILLS KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

287



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

COVENTRY

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

288



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

NATHAN WALTERS KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

289



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

JAMIE WARREN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

290



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


FLEXNER WAY

SUITE 302


oms.com/

WELLCARE

KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

MULTI

SPECIALTY

GROUP

225 ABRAHAM

FLEXNER WAY

SUITE 302


oms.com/

FEE FOR

SERVICE

KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

MULTI

SPECIALTY

GROUP

225 ABRAHAM

FLEXNER WAY

SUITE 302


oms.com/

PASSPORT

CHRISTOPHE

R

WILLIAMS CHRISTOPHER L

WILLIAMS DMD

AND KIM

SCHIAVONE DMD

GENERAL

DENTISTRY

2300 DIXIE

HIGHWAY


SERVICE

CHRISTOPHE

R

WILLIAMS CHRISTOPHER L

WILLIAMS DMD

AND KIM

SCHIAVONE DMD

GENERAL

DENTISTRY

2300 DIXIE

HIGHWAY


291



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RODERICK ABANG CHILDRENS

SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/

COVENTRY


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/

FEE FOR

SERVICE


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/

HUMANA


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/

PASSPORT


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/

WELLCARE


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

COVENTRY


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

FEE FOR

SERVICE

292



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

HUMANA


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

PASSPORT


SPECIAL CARE

DENTISTRY

PEDIATRIC

DENTIST

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

WELLCARE


SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

COVENTRY


SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

FEE FOR

SERVICE


SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

2301 MEADOW

DRIVE


smouth.com/de

fault.asp

PASSPORT

CHILDRENS

SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

2301 MEADOW

DRIVE


smouth.com/

FEE FOR

SERVICE

293



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHILDRENS

SPECIAL CARE

DENTISTRY

GENERAL

DENTISTRY

2301 MEADOW

DRIVE


smouth.com/

PASSPORT


HOWELL

ORTHODONTICS

PSC

ORTHODONTIST 2317 STONY

BROOK DRIVE

LOUISVILLE KY 40220 502 895 3473 http://www.ma

ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


BROOK DRIVE


ndhortho.com/l

ocations.aspx

PASSPORT


HOWELL

ORTHODONTICS

PSC


BROOK DRIVE


ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


BROOK DRIVE


ndhortho.com/l

ocations.aspx

PASSPORT

LEELA TUMMALA WEST END

FAMILY DENTAL

CLINIC LLC

GENERAL

DENTISTRY

2418 WEST

MARKET

STREET

LOUISVILLE KY 40212 502 772 0704 http://www.we

stendfamilyden

talclinic.net/in

dex.html

COVENTRY


FAMILY DENTAL

CLINIC LLC

GENERAL

DENTISTRY

2418 WEST

MARKET

STREET


stendfamilyden

talclinic.net/in

dex.html

FEE FOR

SERVICE

294



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

CLINIC LLC

GENERAL

DENTISTRY

2418 WEST

MARKET

STREET


stendfamilyden

talclinic.net/in

dex.html

HUMANA


FAMILY DENTAL

CLINIC LLC

GENERAL

DENTISTRY

2418 WEST

MARKET

STREET


stendfamilyden

talclinic.net/in

dex.html

PASSPORT


FAMILY DENTAL

CLINIC LLC

GENERAL

DENTISTRY

2418 WEST

MARKET

STREET


stendfamilyden

talclinic.net/in

dex.html

WELLCARE

SHERRY BABBAGE WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

COVENTRY

SHERRY BABBAGE WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

FEE FOR

SERVICE

SHERRY BABBAGE WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

HUMANA

SHERRY BABBAGE WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

PASSPORT

295



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHERRY BABBAGE WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

WELLCARE

MARYANA HILAL WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

COVENTRY

MARYANA HILAL WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

FEE FOR

SERVICE

MARYANA HILAL WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

HUMANA

MARYANA HILAL WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

WELLCARE

KWANE WATSON WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

COVENTRY

KWANE WATSON WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

FEE FOR

SERVICE

296



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KWANE WATSON WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

HUMANA

KWANE WATSON WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

PASSPORT

KWANE WATSON WEST

LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

2500 WEST

BROADWAY


stlouisvilledent

al.com/

WELLCARE

WEST

LOUISVILLE

DENTAL CENTER

MULTI

SPECIALTY

GROUP

2500 WEST

BROADWAY


stlouisvilledent

al.com/

FEE FOR

SERVICE

WEST

LOUISVILLE

DENTAL CENTER

MULTI

SPECIALTY

GROUP

2500 WEST

BROADWAY


stlouisvilledent

al.com/

PASSPORT

DARREN GREENWELL GENERATIONS

FAMILY

DENTISTRY

GENERAL

DENTISTRY

254 MARKET

PLACE DRIVE

LOUISVILLE KY 40229 502 955 6134 http://www.ge

nerationsfamil

ydentistry.com

/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

254 MARKET

PLACE DRIVE


nerationsfamil

ydentistry.com

/

PASSPORT

297



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

HUMANA


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

PASSPORT


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

COVENTRY

298



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

HUMANA


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

PASSPORT

299



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


HURSTBOURNE

PARKWAY SUITE

106


ortho.com/

WELLCARE

SU KANG THE SMILE

LOUSIVILLE

GENERAL

DENTISTRY

2902

TAYLORSVILLE

ROAD


smileky.com/

FEE FOR

SERVICE

SU KANG THE SMILE

LOUSIVILLE

GENERAL

DENTISTRY

2902

TAYLORSVILLE

ROAD


smileky.com/

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

COVENTRY


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

FEE FOR

SERVICE

300



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

HUMANA


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

WELLCARE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

COVENTRY

301



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

FEE FOR

SERVICE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/

WELLCARE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

COVENTRY

302



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

FEE FOR

SERVICE


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

PASSPORT


ORAL SURGERY

AND DENTAL

IMPLANTS PLLC

ORAL SURGEON 300

MIDDLETOWN

PARK PLACE

SUITE B


tlouisvilleorals

urgery.com/ind

ex.html

WELLCARE

BREACYA WASHINGTON ALLIANCE

FAMILY DENTAL

GENERAL

DENTISTRY

3000

BRECKENRIDGE

LANE SUITE A



FAMILY DENTAL

GENERAL

DENTISTRY

3000

BRECKENRIDGE

LANE SUITE A


SERVICE

303



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

GENERAL

DENTISTRY

3000

BRECKENRIDGE

LANE SUITE A



FAMILY DENTAL

GENERAL

DENTISTRY

3000

BRECKENRIDGE

LANE SUITE A



FAMILY DENTAL

GENERAL

DENTISTRY

3000

BRECKENRIDGE

LANE SUITE A


PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC

MEDICAL CLINIC 3015 WILSON

AVENUE

LOUISVILLE KY 40211 502 774 4401 http://www.pd

chc.org/

COVENTRY

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

FEE FOR

SERVICE

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

PASSPORT

304



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

WELLCARE

RAYMOND MCMILLON JR. MCMILLON

FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

3023 CRUMS

LANE


isvillekydentist

ry.com/

FEE FOR

SERVICE


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

3023 CRUMS

LANE


isvillekydentist

ry.com/

HUMANA


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

3023 CRUMS

LANE


isvillekydentist

ry.com/

PASSPORT

PAMELA ASSEFF PAMELA J ASSEFF

DDS PSC

GENERAL

DENTISTRY

3046

BRECKENRIDGE

LANE SUITE 101

LOUISVILLE KY 40220 502 493 4154 http://www.pa

melaasseffdds.

com/

COVENTRY


DDS PSC

GENERAL

DENTISTRY

3046

BRECKENRIDGE

LANE SUITE 101


melaasseffdds.

com/

FEE FOR

SERVICE


DDS PSC

GENERAL

DENTISTRY

3046

BRECKENRIDGE

LANE SUITE 101


melaasseffdds.

com/

HUMANA

305



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DDS PSC

GENERAL

DENTISTRY

3046

BRECKENRIDGE

LANE SUITE 101


melaasseffdds.

com/

PASSPORT


DDS PSC

GENERAL

DENTISTRY

3046

BRECKENRIDGE

LANE SUITE 101


melaasseffdds.

com/

WELLCARE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

COVENTRY

306



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/default

.htm

WELLCARE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/Defaul

t.htm

FEE FOR

SERVICE

307



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/Defaul

t.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 3101

BRECKENRIDGE

LANE SUITE 2D


lsurgerylouisvi

lle.com/Defaul

t.htm

PASSPORT


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKENRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

COVENTRY


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKENRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

FEE FOR

SERVICE


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKENRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

HUMANA


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKENRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

PASSPORT

308



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKENRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

WELLCARE


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKINRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

COVENTRY


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKINRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

FEE FOR

SERVICE


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKINRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

HUMANA


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKINRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

PASSPORT


DENTISTRY

PEDIATRIC

DENTIST

3101

BRECKINRIDGE

LANE SUITE 4B


zsmiledentistry

.com/

WELLCARE

SARATH BACHALI SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD

LOUISVILLE KY 40215 502 366 4442 http://www.sm

allsmilesusa.co

m/index.php

COVENTRY

309



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

MONICA BINGHAM SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT

310



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

ELIZABETH GEIER SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

MITISHA MARTIN SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

COVENTRY

311



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

SARA PAIGE

TROMBETTI

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE

SARA PAIGE

TROMBETTI

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA

SARA PAIGE

TROMBETTI

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT

SARA PAIGE

TROMBETTI

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

PRACTICE

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

312



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ELIZABETH SCHULER SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

LEELA TUMMALA SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE

313



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

WELLCARE

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

FEE FOR

SERVICE

SMALL SMILES OF

LOUISVILLE

GENERAL

DENTISTRY

3438 TAYLOR

BLVD


allsmilesusa.co

m/index.php

PASSPORT

JOSEPH LYVERS JOSEPH D LYVERS

DMD

GENERAL

DENTISTRY

3448 TAYLOR

BLVD



DMD

GENERAL

DENTISTRY

3448 TAYLOR

BLVD


SERVICE


DMD

GENERAL

DENTISTRY

3448 TAYLOR

BLVD


314



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

3448 TAYLOR

BLVD



DMD

GENERAL

DENTISTRY

3448 TAYLOR

BLVD


JAMES HAZARD JAMES HAZARD

AND ASSOCIATES

GENERAL

DENTISTRY

347 WEST

KENWOOD WAY


SERVICE

JAMES HAZARD JAMES HAZARD

AND ASSOCIATES

GENERAL

DENTISTRY

347 WEST

KENWOOD WAY


MICHELLE NICHOLS DENTAL CARE GENERAL

DENTISTRY

3500

BARDSTO0WN

ROAD



DENTISTRY

3500

BARDSTO0WN

ROAD


SERVICE


DENTISTRY

3500

BARDSTO0WN

ROAD



DENTISTRY

3500

BARDSTO0WN

ROAD



DENTISTRY

3500

BARDSTO0WN

ROAD



BASHFORD

PEDIATRIC

DENTIST

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY

315



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

PEDIATRIC

DENTIST

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

PEDIATRIC

DENTIST

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

PEDIATRIC

DENTIST

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

PEDIATRIC

DENTIST

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE

CHRISTOPHE

R

CORDER KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY

316



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

CORDER KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

CHRISTOPHE

R

CORDER KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA

CHRISTOPHE

R

CORDER KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT

CHRISTOPHE

R

CORDER KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m

COVENTRY

317



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT

318



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE

SARA PAIGE

TROMBETTI

KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

PRACTICE

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

319



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SARA PAIGE

TROMBETTI

KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

PRACTICE

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA

SARA PAIGE

TROMBETTI

KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

PRACTICE

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT

SARA PAIGE

TROMBETTI

KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

PRACTICE

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

320



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

321



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE

LEELA TUMMALA KOOL SMILES

BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE

322



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

HUMANA


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

COVENTRY


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

FEE FOR

SERVICE


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

PASSPORT


BASHFORD

GENERAL

DENTISTRY

3510

BARDSTOWN

ROAD


koolsmiles.co

m/

WELLCARE

ANN MUDD ANN B MUDD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

3516

FRANKFORT

AVENUE


SERVICE

ANN MUDD ANN B MUDD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

3516

FRANKFORT

AVENUE


ANN MUDD ANN B MUDD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

3516

FRANKFORT

AVENUE


323



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JOLANTA SAUER SPRINGHURST

ENDODONTICS

PSC

ENDODONTIST 3801

SPRINGHURST

BLVD SUITE 108

LOUISVILLE KY 40241 502 618 1200 http://www.spr

inghurstendo.c

om/

FEE FOR

SERVICE


ENDODONTICS

PSC

ENDODONTIST 3801

SPRINGHURST

BLVD SUITE 108


inghurstendo.c

om/

HUMANA


ENDODONTICS

PSC

ENDODONTIST 3801

SPRINGHURST

BLVD SUITE 108


inghurstendo.c

om/

PASSPORT

R DOUGLAS EDWARDS R DOUGLAS

EDWARDS JR

DMD PSC

GENERAL

DENTISTRY

3807 FREEDOM

WAY


SERVICE

R DOUGLAS EDWARDS R DOUGLAS

EDWARDS JR

DMD PSC

GENERAL

DENTISTRY

3807 FREEDOM

WAY


GREGORY LORD LORD FAMILY

DENTAL

GENERAL

DENTISTRY

3841

RUCKRIEGEL

PARKWAY SUITE

100

LOUISVILLE KY 40299 502 267 4141 http://www.lor

dfamilydental.

com/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

3841

RUCKRIEGEL

PARKWAY SUITE

100


dfamilydental.

com/

HUMANA

324



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY

3841

RUCKRIEGEL

PARKWAY SUITE

100


dfamilydental.

com/

PASSPORT

DAVID ROUGEUX PAINTER AND

ROUGEUX

GENERAL

DENTISTRY

3934 DIXIE

HIGHWAY SUITE

430



ROUGEUX

GENERAL

DENTISTRY

3934 DIXIE

HIGHWAY SUITE

430


SERVICE


ROUGEUX

GENERAL

DENTISTRY

3934 DIXIE

HIGHWAY SUITE

430



ROUGEUX

GENERAL

DENTISTRY

3934 DIXIE

HIGHWAY SUITE

430



ROUGEUX

GENERAL

DENTISTRY

3934 DIXIE

HIGHWAY SUITE

430


ANDREW BYRNE OCEAN DENTAL

OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD

LOUISVILLE KY 40216 502 449 1961 http://www.oc

eandental.net/

COVENTRY


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

FEE FOR

SERVICE

325



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

HUMANA


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

PASSPORT


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

WELLCARE

SHANA DEAN OCEAN DENTAL

OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

COVENTRY


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

FEE FOR

SERVICE


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

HUMANA


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

PASSPORT

326



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

WELLCARE

GRETCHEN KRATZ OCEAN DENTAL

OF KENTUCKY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

COVENTRY


OF KENTUCKY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

FEE FOR

SERVICE


OF KENTUCKY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

HUMANA


OF KENTUCKY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

PASSPORT


OF KENTUCKY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

WELLCARE

AARON VICKERS OCEAN DENTAL

GENERAL

DENTISTRY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

COVENTRY


GENERAL

DENTISTRY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

FEE FOR

SERVICE


GENERAL

DENTISTRY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

HUMANA

327



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


GENERAL

DENTISTRY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

PASSPORT


GENERAL

DENTISTRY

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

WELLCARE

OCEAN DENTAL

OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

FEE FOR

SERVICE

OCEAN DENTAL

OF KENTUCKY

PSC

GENERAL

DENTISTRY

3977 7TH STREET

ROAD


eandental.net/

PASSPORT

OCEAN DENTAL

OF KENTUCKY PC

3977 SEVENTH

STREET ROAD


SERVICE

DONALD BAUMANN DONALD T

BAUMANN DMD

GENERAL

DENTISTRY

4007 VALLEY

VIEW DRIVE



BAUMANN DMD

GENERAL

DENTISTRY

4007 VALLEY

VIEW DRIVE


SERVICE

328



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BAUMANN DMD

GENERAL

DENTISTRY

4007 VALLEY

VIEW DRIVE



BAUMANN DMD

GENERAL

DENTISTRY

4007 VALLEY

VIEW DRIVE



BAUMANN DMD

GENERAL

DENTISTRY

4007 VALLEY

VIEW DRIVE


WILLIAM JOHNSON WILLIAM R

JOHNSON DMD

PEDIATRIC

DENTIST

4007 VALLEY

VIEW DRIVE



JOHNSON DMD

PEDIATRIC

DENTIST

4007 VALLEY

VIEW DRIVE


SERVICE


JOHNSON DMD

PEDIATRIC

DENTIST

4007 VALLEY

VIEW DRIVE



JOHNSON DMD

PEDIATRIC

DENTIST

4007 VALLEY

VIEW DRIVE


329



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


JOHNSON DMD

PEDIATRIC

DENTIST

4007 VALLEY

VIEW DRIVE


FREDERICK SWAIN JUST KIDS

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

4010 DUPONT

CIRCLE SUITE

529

LOUISVILLE KY 40207 502 897 3239 http://www.jus

tkidspediatricd

entistry.com/

FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

4010 DUPONT

CIRCLE SUITE

529


tkidspediatricd

entistry.com/

HUMANA


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

4010 DUPONT

CIRCLE SUITE

529


tkidspediatricd

entistry.com/

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 4040 DIXIE

HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

PASSPORT

330



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

COVENTRY


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/default

.htm

WELLCARE

331



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/Defaul

t.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/Defaul

t.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY SUITE

103


lsurgerylouisvi

lle.com/Defaul

t.htm

PASSPORT

NANDAKA JAYAWEERA GENERAL

EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

COVENTRY


EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

FEE FOR

SERVICE


EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

HUMANA


EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

PASSPORT

332



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

WELLCARE

GENERAL

EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

FEE FOR

SERVICE

GENERAL

EXCELLENCE

DENTAL

GENERAL

DENTISTRY

4133 TAYLOR

BLVD


ntleexcellence.

com/

PASSPORT

NANDAKA JAYAWEERA LOUISVILLE

DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

COVENTRY


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

FEE FOR

SERVICE


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

HUMANA


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

PASSPORT


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

WELLCARE

AARON MCLEMORE LOUISVILLE

DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

COVENTRY


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

FEE FOR

SERVICE

333



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

PASSPORT


DENTAL AT

SHIVELY

GENERAL

DENTISTRY

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

WELLCARE

LOUISVILLE

DENTAL AT

SHIVELY

MULTI

SPECIALTY

GROUP

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

FEE FOR

SERVICE

LOUISVILLE

DENTAL AT

SHIVELY

MULTI

SPECIALTY

GROUP

4215 HILLVIEW

AVENUE


louisvilledenta

l.com/

FEE FOR

SERVICE

SUSAN VLAHOS MORTENSON

FAMILY DENTAL

BUECHEL

GENERAL

DENTISTRY

4311

BARDSTOWN

ROAD SUITE 102


ndental.com

COVENTRY


FAMILY DENTAL

BUECHEL

GENERAL

DENTISTRY

4311

BARDSTOWN

ROAD SUITE 102


ndental.com

FEE FOR

SERVICE


FAMILY DENTAL

BUECHEL

GENERAL

DENTISTRY

4311

BARDSTOWN

ROAD SUITE 102


ndental.com

HUMANA


FAMILY DENTAL

BUECHEL

GENERAL

DENTISTRY

4311

BARDSTOWN

ROAD SUITE 102


ndental.com

PASSPORT

334



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

BUECHEL

GENERAL

DENTISTRY

4311

BARDSTOWN

ROAD SUITE 102


ndental.com

WELLCARE

JIHAAD ABDUL MAJID IMMEDIADENT

LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110

LOUISVILLE KY 40218 502 447 3223 http://www.im

mediadent.com

/

FEE FOR

SERVICE


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

HUMANA


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

COVENTRY


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

WELLCARE


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

COVENTRY

335



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

FEE FOR

SERVICE


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

HUMANA


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

PASSPORT


LOUISVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

WELLCARE


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

COVENTRY


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

FEE FOR

SERVICE


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

HUMANA


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

PASSPORT


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

WELLCARE

ADAM STOWE IMMEDIADENT

LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

COVENTRY

336



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

FEE FOR

SERVICE


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

HUMANA


LOUSIVILLE

GENERAL

DENTISTRY

4420 DIXIE

HIGHWAY SUITE

110


mediadent.com

/

WELLCARE

REBECCA WERNER SHIVELY FAMILY

DENTAL CARE

GENERAL

DENTISTRY

4436 DIXIE

HIGHWAY



DENTAL CARE

GENERAL

DENTISTRY

4436 DIXIE

HIGHWAY


SERVICE


DENTAL CARE

GENERAL

DENTISTRY

4436 DIXIE

HIGHWAY



DENTAL CARE

GENERAL

DENTISTRY

4436 DIXIE

HIGHWAY



SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE

LOUISVILLE KY 40215 502 361 0134 http://www.ke

ntuckyoralsurg

ery.com/

COVENTRY

337



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

HUMANA


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

WELLCARE


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

COVENTRY

338



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

WELLCARE


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE

339



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

WELLCARE

KENTUCKY ORAL

SURGERY AND

DENTAL IMPLANT

CENTER

GENERAL

DENTISTRY

4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE

KENTUCKY ORAL

SURGERY AND

DENTAL IMPLANT

CENTER

GENERAL

DENTISTRY

4515

CHURCHMAN

AVENUE


ntuckyoralsurg

ery.com/

PASSPORT

CAROL MUTH SCHULTE DENTAL GENERAL

DENTISTRY

4515

CHURCHMAN

AVENUE

LOUISVILLE KY 40215 502 361 0637 http://www.sch

ultedental.com

/

COVENTRY

340



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

FEE FOR

SERVICE


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

HUMANA


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

WELLCARE

DAVID SCHULTE SCHULTE DENTAL GENERAL

DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

COVENTRY


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

FEE FOR

SERVICE


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

HUMANA


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

PASSPORT

341



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

WELLCARE

MARK SCHULTE SCHULTE DENTAL GENERAL

DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

COVENTRY


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

FEE FOR

SERVICE


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

HUMANA


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

PASSPORT


DENTISTRY

4515

CHURCHMAN

AVENUE


ultedental.com

/

WELLCARE

CHRISTOPHE

R

COOK SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD

LOUISVILLE KY 40216 502 448 1003 http://smilecen

terprofessional

s.com/index.ph

p?page=home

COVENTRY

342



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

COOK SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

FEE FOR

SERVICE

CHRISTOPHE

R

COOK SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

HUMANA

CHRISTOPHE

R

COOK SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

PASSPORT

CHRISTOPHE

R

COOK SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

WELLCARE

SUSIE RILEY SMILE CENTER

PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

FEE FOR

SERVICE


PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

HUMANA

343



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

PASSPORT


PROFESSIONALS

GENERAL

DENTISTRY

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

WELLCARE

SMILE CENTER

PROFESSIONALS

MULTI

SPECIALTY

GROUP

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

FEE FOR

SERVICE

SMILE CENTER

PROFESSIONALS

MULTI

SPECIALTY

GROUP

4516 CANE RUN

ROAD


terprofessional

s.com/index.ph

p?page=home

PASSPORT

BRUCE HASKELL HASKELL

ORTHODONTICS

ORTHODONTIST 4516 OUTER

LOOP

LOUISVILLE KY 40219 502 964 9094 http://www.has

kellbraces.com

/okolona

FEE FOR

SERVICE


ORTHODONTICS


LOOP


kellbraces.com

/okolona

PASSPORT


ORTHODONTICS


LOOP


kellbraces.com

/okolona

WELLCARE

344



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BRETT LEUCHT LEUCHT FAMILY

DENTISTRY

GENERAL

DENTISTRY

4544

TAYLORSVILLE

ROAD


SERVICE


DENTISTRY

GENERAL

DENTISTRY

4544

TAYLORSVILLE

ROAD



DENTISTRY

GENERAL

DENTISTRY

4544

TAYLORSVILLE

ROAD



DENTISTRY

GENERAL

DENTISTRY

4544

TAYLORSVILLE

ROAD


CRAIG BULT CRAIG B BULT

DMD

GENERAL

DENTISTRY

4602 SOUTHERN

PARKWAY SUITE

2E



DMD

GENERAL

DENTISTRY

4602 SOUTHERN

PARKWAY SUITE

2E


SERVICE


DMD

GENERAL

DENTISTRY

4602 SOUTHERN

PARKWAY SUITE

2E



DMD

GENERAL

DENTISTRY

4602 SOUTHERN

PARKWAY SUITE

2E


345



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

4602 SOUTHERN

PARKWAY SUITE

2E


ARLENE BALUYUT SIGNATURE

SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252

LOUISVILLE KY 40241 502 326 1800 http://www.sig

naturesmileslo

uisville.com/co

ntact/

COVENTRY


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/co

ntact/

FEE FOR

SERVICE


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/co

ntact/

HUMANA


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/co

ntact/

PASSPORT


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/co

ntact/

WELLCARE

BRIAN DEATON SIGNATURE

SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/

COVENTRY

346



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/

FEE FOR

SERVICE


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/

HUMANA


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/

PASSPORT


SMILES AT

CHAMBERLAIN

POINTER

GENERAL

DENTISTRY

4642

CHAMBERLAIN

LANE SUITE 252


naturesmileslo

uisville.com/

WELLCARE

JOHN BURNETTE BURNETTE

FAMILY

DENTISTRY

GENERAL

DENTISTRY

4645 OUTER

LOOP

LOUISVILLE KY 40219 502 962 3337 http://www.bur

nettefamilyden

tistry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4645 OUTER

LOOP


nettefamilyden

tistry.com/

HUMANA


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4645 OUTER

LOOP


nettefamilyden

tistry.com/

PASSPORT

JONATHAN MITCHELL PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

COVENTRY

347



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

PASSPORT

HUGO PAVON PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

COVENTRY

HUGO PAVON PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

FEE FOR

SERVICE

HUGO PAVON PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

HUMANA

HUGO PAVON PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

PASSPORT

HUGO PAVON PORTLAND

DENTAL CENTER

GENERAL

DENTISTRY

465 NORTH 26TH

STREET


avon.com/inde

x.htm

WELLCARE

ANDREW BYRNE BYRNE DENTAL GENERAL

DENTISTRY

4739 SOUTH 3RD

STREET



DENTISTRY

4739 SOUTH 3RD

STREET


SERVICE


DENTISTRY

4739 SOUTH 3RD

STREET


348



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

4739 SOUTH 3RD

STREET



DENTISTRY

4739 SOUTH 3RD

STREET


DANIEL BYRNE JR BYRNE DENTAL GENERAL

DENTISTRY

4739 SOUTH 3RD

STREET



DENTISTRY

4739 SOUTH 3RD

STREET


SERVICE


DENTISTRY

4739 SOUTH 3RD

STREET



DENTISTRY

4739 SOUTH 3RD

STREET


MARK MORTENSON MORTENSON

FAMILY DENTAL

JEFFERSON MALL

GENERAL

DENTISTRY

4801 OUTER

LOOP


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

JEFFERSON MALL

GENERAL

DENTISTRY

4801 OUTER

LOOP


ndental.com/de

fault.asp

FEE FOR

SERVICE

349



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

JEFFERSON MALL

GENERAL

DENTISTRY

4801 OUTER

LOOP


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

JEFFERSON MALL

GENERAL

DENTISTRY

4801 OUTER

LOOP


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

JEFFERSON MALL

GENERAL

DENTISTRY

4801 OUTER

LOOP


ndental.com/de

fault.asp

WELLCARE

ANNE MARIE ABELL BRACES BRACES

BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

COVENTRY


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

HUMANA


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

PASSPORT

350



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

WELLCARE

MARCUS WOODS BRACES BRACES

BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

COVENTRY


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

HUMANA


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

PASSPORT


BRACES OUTER

LOOP


LOOP SUITE A206


acesbraces.co

m/index.php

WELLCARE

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


LOOP

LOUISVILLE KY 40219 502 969 6229 http://www.ze

hbraces.com/

COVENTRY

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


LOOP


hbraces.com/

FEE FOR

SERVICE

351



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


LOOP


hbraces.com/

PASSPORT

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


LOOP


hbraces.com/

WELLCARE

AMY SMITH AMY L SMITH

DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

4814 PRESTON

HIGHWAY SUITE

1

LOUISVILLE KY 40213 502 969 4206 http://www.dra

mylsmith.com/

COVENTRY


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

4814 PRESTON

HIGHWAY SUITE

1


mylsmith.com/

FEE FOR

SERVICE


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

4814 PRESTON

HIGHWAY SUITE

1


mylsmith.com/

HUMANA


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

4814 PRESTON

HIGHWAY SUITE

1


mylsmith.com/

PASSPORT


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

4814 PRESTON

HIGHWAY SUITE

1


mylsmith.com/

WELLCARE

GERALD MITCHELL PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET

LOUISVILLE KY 40214 502 366 6362 http://www.pie

rceandmitchell

.com/home/

COVENTRY

352



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

FEE FOR

SERVICE


MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

HUMANA


MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

WELLCARE

LOUISVILLE

DENTAL

SPECIALISTS

MULTI

SPECIALTY

GROUP

4825 SOUTH 3RD

STREET


isvilledentalsp

ecialists.com/

FEE FOR

SERVICE

LOUISVILLE

DENTAL

SPECIALISTS

MULTI

SPECIALTY

GROUP

4825 SOUTH 3RD

STREET


isvilledentalsp

ecialists.com/

PASSPORT

PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

FEE FOR

SERVICE

PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

FEE FOR

SERVICE

FRED LOOK LOUISVILLE

DENTAL

SPECIALISTS

ORAL SURGEON 4825 SOUTH 3RD

STREET


isvilledentalsp

ecialists.com/

COVENTRY


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

FEE FOR

SERVICE

353



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

HUMANA


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

PASSPORT


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

WELLCARE

NGOC AN

KHAN

NGIYEN PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

COVENTRY

NGOC AN

KHAN

NGIYEN PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

FEE FOR

SERVICE

NGOC AN

KHAN

NGIYEN PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

HUMANA

NGOC AN

KHAN

NGIYEN PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

PASSPORT

NGOC AN

KHAN

NGIYEN PIERCE AND

MITCHELL PSC

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


rceandmitchell

.com/home/

WELLCARE

ARTHUR WICKSON LOUISVILLE

DENTAL

SPECIALISTS

ORTHODONTIST 4825 SOUTH 3RD

STREET


isvilledentalsp

ecialists.com/

COVENTRY

354



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

FEE FOR

SERVICE


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

HUMANA


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

PASSPORT


DENTAL

SPECIALISTS


STREET


isvilledentalsp

ecialists.com/

WELLCARE

ERIN WILSON ERIN A WILSON

DDS

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET



DDS

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


SERVICE


DDS

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET



DDS

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET



DDS

GENERAL

DENTISTRY

4825 SOUTH 3RD

STREET


355



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DANIEL YOUNG YOUNG AND

YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106


SERVICE


YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106



YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106


ROBERT YOUNG JR YOUNG AND

YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106


SERVICE


YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106



YOUNG DENTAL

GENERAL

DENTISTRY

4906

BARDSTOWN

ROAD SUITE 106


JOHN SKINNER DENTAL CENTER

ONE

GENERAL

DENTISTRY

4919 DIXIE

HIGHWAY SUITE

J



ONE

GENERAL

DENTISTRY

4919 DIXIE

HIGHWAY SUITE

J


SERVICE

356



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ONE

GENERAL

DENTISTRY

4919 DIXIE

HIGHWAY SUITE

J



ONE

GENERAL

DENTISTRY

4919 DIXIE

HIGHWAY SUITE

J



ONE

GENERAL

DENTISTRY

4919 DIXIE

HIGHWAY SUITE

J


U OF L

SCHOOL OF

DENTISTRY

GENERAL

DENTISTRY

501 SOUTH

PRESTON

STREET

LOUISVILLE KY 40202 502 852 5096 https://louisvill

e.edu/dental

FEE FOR

SERVICE

U OF L

SCHOOL OF

DENTISTRY

GENERAL

DENTISTRY

501 SOUTH

PRESTON

STREET

LOUISVILLE KY 40202 502 852 5096 https://louisvill

e.edu/dental

PASSPORT

TIMOTHY RAMPENTHAL LOUISVILLE

DENTAL CENTER

GENERAL

DENTISTRY

5010 PRESTON

HIGHWAY


isvilledentalce

nter.net/index.

html

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

5010 PRESTON

HIGHWAY


isvilledentalce

nter.net/index.

html

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

5010 PRESTON

HIGHWAY


isvilledentalce

nter.net/index.

html

PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

5010 PRESTON

HIGHWAY


isvilledentalce

nter.net/index.

html

WELLCARE

357



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ALI NAVIGAR ALI NAVIGAR

DMD

GENERAL

DENTISTRY

5014 PRESTON

HIGHWAY



DMD

GENERAL

DENTISTRY

5014 PRESTON

HIGHWAY


SERVICE


DMD

GENERAL

DENTISTRY

5014 PRESTON

HIGHWAY



DMD

GENERAL

DENTISTRY

5014 PRESTON

HIGHWAY



DMD

GENERAL

DENTISTRY

5014 PRESTON

HIGHWAY


KENNETH REEVES KENNETH H

REEVES DMD

GENERAL

DENTISTRY

5057 POPLAR

LEVEL ROAD

SUITE 7



REEVES DMD

GENERAL

DENTISTRY

5057 POPLAR

LEVEL ROAD

SUITE 7


SERVICE


REEVES DMD

GENERAL

DENTISTRY

5057 POPLAR

LEVEL ROAD

SUITE 7


358



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


REEVES DMD

GENERAL

DENTISTRY

5057 POPLAR

LEVEL ROAD

SUITE 7


MANEESH MOHAN ORAL AND

FACIAL SURGERY

GROUP OUTER

LOOP

ORAL SURGEON 5100 OUTER

LOOP SUITE B


ofsgroup.com/l

ocations.php

COVENTRY


FACIAL SURGERY

GROUP OUTER

LOOP


LOOP SUITE B


ofsgroup.com/l

ocations.php

FEE FOR

SERVICE


FACIAL SURGERY

GROUP OUTER

LOOP


LOOP SUITE B


ofsgroup.com/l

ocations.php

HUMANA


FACIAL SURGERY

GROUP OUTER

LOOP


LOOP SUITE B


ofsgroup.com/l

ocations.php

PASSPORT


FACIAL SURGERY

GROUP OUTER

LOOP


LOOP SUITE B


ofsgroup.com/l

ocations.php

WELLCARE

359



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MELANIE ABRAMS KIDS DENTISTREE

OUTER LOOP

GENERAL

DENTISTRY

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

COVENTRY


OUTER LOOP

GENERAL

DENTISTRY

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

FEE FOR

SERVICE


OUTER LOOP

GENERAL

DENTISTRY

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

HUMANA


OUTER LOOP

GENERAL

DENTISTRY

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

PASSPORT


OUTER LOOP

GENERAL

DENTISTRY

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

WELLCARE


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

COVENTRY


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

FEE FOR

SERVICE


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

HUMANA


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

PASSPORT


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

WELLCARE

360



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DAVID LUBBE KIDS DENTISTREE

OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

COVENTRY


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

FEE FOR

SERVICE


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

HUMANA


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

PASSPORT


OUTER LOOP

PEDIATRIC

DENTIST

5100 OUTER

LOOP SUITE C


stree.com/Inde

x.php

WELLCARE

BLAIR BROWN MORTENSON

FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

HUMANA

361



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

WELLCARE


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

PASSPORT

362



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

WELLCARE


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

DIXIE HIGHWAY

GENERAL

DENTISTRY

5220 DIXIE

HIGHWAY


ndental.com/de

fault.asp

WELLCARE

363



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MAXILOFACI

AL

ONCOLOGIC

DENTISTRY

MULTI

SPECIALTY

GROUP

529 SOUTH

JACKSON

STREET SUITE

125


SERVICE

MAXILOFACI

AL

ONCOLOGIC

DENTISTRY

MULTI

SPECIALTY

GROUP

529 SOUTH

JACKSON

STREET SUITE

125


GEORGE OCHS HERMAN AND

OCHS

GENERAL

DENTISTRY

5349 MITSCHER

AVENUE



OCHS

GENERAL

DENTISTRY

5349 MITSCHER

AVENUE


SERVICE


OCHS

GENERAL

DENTISTRY

5349 MITSCHER

AVENUE



OCHS

GENERAL

DENTISTRY

5349 MITSCHER

AVENUE



OCHS

GENERAL

DENTISTRY

5349 MITSCHER

AVENUE


GREG WITTE A WINNING SMILE

DENTISTRY

GENERAL

DENTISTRY

5417 ROBBS

LANE

LOUISVILLE KY 40219 502 969 9897 http://www.per

fectwinningsm

ile.com/default

.aspx

FEE FOR

SERVICE

364



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

5417 ROBBS

LANE


fectwinningsm

ile.com/default

.aspx

HUMANA


DENTISTRY

GENERAL

DENTISTRY

5417 ROBBS

LANE


fectwinningsm

ile.com/default

.aspx

PASSPORT

KEITH RAY GREAT GRINS

CHILDRENS

DENTISTRY

PEDIATRIC

DENTIST

5713

BARDSTOWN

ROAD

LOUISVILLE KY 40291 502 231 1418 http://www.gre

atgrinskids.co

m/index.asp

FEE FOR

SERVICE

KEITH RAY GREAT GRINS

CHILDRENS

DENTISTRY

PEDIATRIC

DENTIST

5713

BARDSTOWN

ROAD

LOUISVILLE KY 40291 502 231 1418 http://www.gre

atgrinskids.co

m/index.asp

PASSPORT

PATRICK KENNEDY KENNEDY

DENTAL CARE

LLC

GENERAL

DENTISTRY

5751 PRESTON

HIGHWAY SUITE

104



DENTAL CARE

LLC

GENERAL

DENTISTRY

5751 PRESTON

HIGHWAY SUITE

104


SERVICE


DENTAL CARE

LLC

GENERAL

DENTISTRY

5751 PRESTON

HIGHWAY SUITE

104


ERNEST ENTIN ERNEST M ENTIN

DMD

GENERAL

DENTISTRY

607 WEST

ORMSBY

AVENUE


365



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

607 WEST

ORMSBY

AVENUE


SERVICE


DMD

GENERAL

DENTISTRY

607 WEST

ORMSBY

AVENUE



DMD

GENERAL

DENTISTRY

607 WEST

ORMSBY

AVENUE



DMD

GENERAL

DENTISTRY

607 WEST

ORMSBY

AVENUE


JONATHAN HIEMER JONATHAN W

HIEMER DMD

GENERAL

DENTISTRY

6604

BARDSTOWN

ROAD SUITE B


SERVICE

JONATHAN HIEMER JONATHAN W

HIEMER DMD

GENERAL

DENTISTRY

6604

BARDSTOWN

ROAD SUITE B



HOWELL

ORTHODONTICS

PSC


HIGHWAY


ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


HIGHWAY


ndhortho.com/l

ocations.aspx

PASSPORT

366



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


HOWELL

ORTHODONTICS

PSC


HIGHWAY


ndhortho.com/l

ocations.aspx

FEE FOR

SERVICE


HOWELL

ORTHODONTICS

PSC


HIGHWAY


ndhortho.com/l

ocations.aspx

PASSPORT

RAMIN KAZEMI HIGHVIEW

FAMILY

DENTISTRY

GENERAL

DENTISTRY

7230

PEPPERMILL

LANE



FAMILY

DENTISTRY

GENERAL

DENTISTRY

7230

PEPPERMILL

LANE


SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

7230

PEPPERMILL

LANE



FAMILY

DENTISTRY

GENERAL

DENTISTRY

7230

PEPPERMILL

LANE



FAMILY

DENTISTRY

GENERAL

DENTISTRY

7230

PEPPERMILL

LANE



LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES

ORAL SURGEON 7908 PRESTON

HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE

367



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

PASSPORT


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

COVENTRY


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

PASSPORT

368



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/default

.htm

WELLCARE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/Defaul

t.htm

FEE FOR

SERVICE


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/Defaul

t.htm

HUMANA


LOUISVILLE

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES


HIGHWAY


lsurgerylouisvi

lle.com/Defaul

t.htm

PASSPORT

MARKS EWING

EPSTEIN LOGAN

PSC

7908 PRESTON

HIGHWAY


SERVICE

SANDRA PAYNE RAKUTT PAYNE

DENTAL

GENERAL

DENTISTRY

801 BURRET

AVENUE SUITE

107

LOUISVILLE KY 40204 502 582 2004 http://www.rak

uttpaynedental.

com/

FEE FOR

SERVICE

369



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SANDRA PAYNE RAKUTT PAYNE

DENTAL

GENERAL

DENTISTRY

801 BURRET

AVENUE SUITE

107

LOUISVILLE KY 40204 502 582 2004 http://www.rak

uttpaynedental.

com/

PASSPORT

MARK MCGRATH MARK MCGRATH

DMD

GENERAL

DENTISTRY

8401

BROWNSBORO

ROAD

LOUISVILLE KY 40241 502 425 2964 http://www.mc

grathdentistry.

com/

FEE FOR

SERVICE

MARK MCGRATH MARK MCGRATH

DMD

GENERAL

DENTISTRY

8401

BROWNSBORO

ROAD

LOUISVILLE KY 40241 502 425 2964 http://www.mc

grathdentistry.

com/

PASSPORT

MICHAEL ARNETT MICHAEL R

ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

8401

SHELBYVILLE

ROAD

LOUISVILLE KY 40222 502 412 1124 http://www.mi

chaelarnettdmd

.com/

COVENTRY


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

8401

SHELBYVILLE

ROAD


chaelarnettdmd

.com/

FEE FOR

SERVICE


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

8401

SHELBYVILLE

ROAD


chaelarnettdmd

.com/

HUMANA


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

8401

SHELBYVILLE

ROAD


chaelarnettdmd

.com/

PASSPORT


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

8401

SHELBYVILLE

ROAD


chaelarnettdmd

.com/

WELLCARE

370



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MICHAEL HUNZINGER ADVANCED

DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

WELLCARE

RANIA KASHLAN ADVANCED

DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

HUMANA


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

WELLCARE

RACHEL TALIS ADVANCED

DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

COVENTRY

371



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

FEE FOR

SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

PASSPORT


DENTAL CENTER

GENERAL

DENTISTRY

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

WELLCARE

ADVANCED

DENTAL CENTER

MULTI

SPECIALTY

GROUP

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

FEE FOR

SERVICE

ADVANCED

DENTAL CENTER

MULTI

SPECIALTY

GROUP

8517 PRESTON

HIGHWAY


isvilleadvance

ddental.com/

PASSPORT

MARK CANNON COMFORT

DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY

LOUISVILLE KY 40258 502 935 0505 http://www.co

mfortdental.co

m/

COVENTRY

MARK CANNON COMFORT

DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

FEE FOR

SERVICE

MARK CANNON COMFORT

DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

HUMANA

MARK CANNON COMFORT

DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

WELLCARE

MIKAL LINDMAN COMFORT

DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

COVENTRY

372



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

HUMANA


DENTAL

GENERAL

DENTISTRY

8700 DIXIE

HIGHWAY


mfortdental.co

m/

WELLCARE


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

WELLCARE

373



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

GWINN VONNAHME MORTENSON

FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com

COVENTRY


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com

FEE FOR

SERVICE


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com

HUMANA


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com

PASSPORT


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com

WELLCARE


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

FEE FOR

SERVICE

374



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

GLENMARY

GENERAL

DENTISTRY

8711 OLD

BARDSTOWN

ROAD


ndental.com/D

efault.asp

WELLCARE

THOMAS JEWELL WESTPORT ROAD

DENTAL CENTER

GENERAL

DENTISTRY

8730 WESTPORT

ROAD



DENTAL CENTER

GENERAL

DENTISTRY

8730 WESTPORT

ROAD


SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

8730 WESTPORT

ROAD



DENTAL CENTER

GENERAL

DENTISTRY

8730 WESTPORT

ROAD


375



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

8730 WESTPORT

ROAD


CARL BEARD MORTENSON

FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/

COVENTRY


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/

FEE FOR

SERVICE


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/

HUMANA


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/

PASSPORT


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/

WELLCARE

376



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

WELLCARE

GARRY MEEKS JR MORTENSON

FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/de

fault.asp

COVENTRY

377



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

IROQUOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/de

fault.asp

WELLCARE


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

FEE FOR

SERVICE

378



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

IROQOIS PARK

GENERAL

DENTISTRY

911 PALATKA

ROAD


ndental.com/D

efault.asp

WELLCARE

CLARENCE KEY SCOTT KEY

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9413 SMYRNA

PARKWAY



FAMILY

DENTISTRY

GENERAL

DENTISTRY

9413 SMYRNA

PARKWAY


SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

9413 SMYRNA

PARKWAY



FAMILY

DENTISTRY

GENERAL

DENTISTRY

9413 SMYRNA

PARKWAY


DAVID PERELLIS DAVID H

PERELLIS DMD

GENERAL

DENTISTRY

9467 WESTPORT

ROAD


SERVICE

379



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DAVID PERELLIS DAVID H

PERELLIS DMD

GENERAL

DENTISTRY

9467 WESTPORT

ROAD



ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

380



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

381



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

382



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

383



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

384



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

COVENTRY


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

PASSPORT

385



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 9488

BROWNSBORO

ROAD


oms.com/

WELLCARE

WILLIAM KEMPER WILLIAM E

KEMPER DMD

PEDIATRIC

DENTIST

9610

TAYLORSVILLE

ROAD



KEMPER DMD

PEDIATRIC

DENTIST

9610

TAYLORSVILLE

ROAD


SERVICE


KEMPER DMD

PEDIATRIC

DENTIST

9610

TAYLORSVILLE

ROAD



KEMPER DMD

PEDIATRIC

DENTIST

9610

TAYLORSVILLE

ROAD



KEMPER DMD

PEDIATRIC

DENTIST

9610

TAYLORSVILLE

ROAD


DAREN PEACE KIDS DENTISTREE

DIXIE HIGHWAY

PEDIATRIC

DENTIST

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

COVENTRY


DIXIE HIGHWAY

PEDIATRIC

DENTIST

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

FEE FOR

SERVICE

386



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DIXIE HIGHWAY

PEDIATRIC

DENTIST

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

HUMANA


DIXIE HIGHWAY

PEDIATRIC

DENTIST

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

PASSPORT


DIXIE HIGHWAY

PEDIATRIC

DENTIST

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

WELLCARE


DIXIE HIGHWAY

GENERAL

DENTISTRY

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

COVENTRY


DIXIE HIGHWAY

GENERAL

DENTISTRY

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

FEE FOR

SERVICE


DIXIE HIGHWAY

GENERAL

DENTISTRY

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

HUMANA


DIXIE HIGHWAY

GENERAL

DENTISTRY

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

PASSPORT

387



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DIXIE HIGHWAY

GENERAL

DENTISTRY

9709 DIXIE

HIGHWAY


stree.com/inde

x.php

WELLCARE

THOMAS ISON PEDIATRIC

DENTISTRY OF

LOUISIVILLE

PEDIATRIC

DENTIST

9710 PARK

PLAZA AVENUE

SUITE 101

LOUISVILLE KY 40241 502 327 6380 http://www.pe

diatricdentalgr

ouplouisville.c

om/default.asp

FEE FOR

SERVICE

THOMAS ISON PEDIATRIC

DENTISTRY OF

LOUISIVILLE

PEDIATRIC

DENTIST

9710 PARK

PLAZA AVENUE

SUITE 101

LOUISVILLE KY 40241 502 327 6380 http://www.pe

diatricdentalgr

ouplouisville.c

om/default.asp

PASSPORT

SU KANG THE SMILE

CENTER

GENERAL

DENTISTRY

9780 ORMSBY

STATION ROAD

SUITE 1200


smileky.com/

FEE FOR

SERVICE

SU KANG THE SMILE

CENTER

GENERAL

DENTISTRY

9780 ORMSBY

STATION ROAD

SUITE 1200


smileky.com/

PASSPORT

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST

ORTHODONTIST 9844 LINN

STATION ROAD


hbraces.com/

COVENTRY

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


STATION ROAD


hbraces.com/

FEE FOR

SERVICE

388



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


STATION ROAD


hbraces.com/

PASSPORT

JAMES ZEH ZEH

ORTHODONTIC

SPECIALIST


STATION ROAD


hbraces.com/

WELLCARE


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9847 3RD STREET

ROAD


chaelarnettdmd

.com/

COVENTRY


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9847 3RD STREET

ROAD


chaelarnettdmd

.com/

FEE FOR

SERVICE


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9847 3RD STREET

ROAD


chaelarnettdmd

.com/

HUMANA


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9847 3RD STREET

ROAD


chaelarnettdmd

.com/

PASSPORT


ARNETT DMD

FAMILY

DENTISTRY

GENERAL

DENTISTRY

9847 3RD STREET

ROAD


chaelarnettdmd

.com/

WELLCARE

JAMES HAAG JAMES G HAAG

DMD

GENERAL

DENTISTRY

1250

THORNBERRY

DRIVE

MADISONVILLE KY 42431 270 825 9616 COVENTRY

389



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JAMES HAAG JAMES G HAAG

DMD

GENERAL

DENTISTRY

1250

THORNBERRY

DRIVE

MADISONVILLE KY 42431 270 825 9616 FEE FOR

SERVICE

RICHARD CRIST CRIST DENTISTRY GENERAL

DENTISTRY

1340 SOUTH

MAIN STREET



DENTISTRY

1340 SOUTH

MAIN STREET


SERVICE


DENTISTRY

1340 SOUTH

MAIN STREET

MADISONVILLE KY 42431 270 825 0676 WELLCARE

VAUGHN BRUMMER DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE



CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE


SERVICE


CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE


RANDY TRAVIS DENTISTRY FOR

CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE



CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE


SERVICE


CHILDREN

PEDIATRIC

DENTIST

1400 PRIDE

AVENUE


390



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JOHN ROY JOHN A ROY DMD GENERAL

DENTISTRY

1410 PRIDE

AVENUE SUITE C



DENTISTRY

1410 PRIDE

AVENUE SUITE C


SERVICE


DENTISTRY

1410 PRIDE

AVENUE SUITE C



SURGERY AND

DENTAL IMPLANT

CENTER

ORAL SURGEON 200 CLINIC

DRIVE 3RD

FLOOR

MADISONVILLE KY ##### 270 825 7441 http://www.ke

ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

HUMANA

391



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

WELLCARE


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR

MADISONVILLE KY 42431 270 825 7441 http://www.ke

ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

PASSPORT

392



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

WELLCARE


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

COVENTRY


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

FEE FOR

SERVICE


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

PASSPORT


SURGERY AND

DENTAL IMPLANT

CENTER


DRIVE 3RD

FLOOR


ntuckyoralsurg

ery.com/

WELLCARE

393



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KIMBERLY HILL KIMBERLY K HILL

DMD

GENERAL

DENTISTRY

344 EAST ARCH

STREET



DMD

GENERAL

DENTISTRY

344 EAST ARCH

STREET


SERVICE


DMD

GENERAL

DENTISTRY

344 EAST ARCH

STREET


TERRY BROWN BROWN AND

LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET



LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET


SERVICE


LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET


RANDY LITTLEPAGE BROWN AND

LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET



LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET


SERVICE


LITTLEPAGE

GENERAL

DENTISTRY

77 EAST NORTH

STREET


TERRY BRYANT TERRY L BRYANT

DMD

GENERAL

DENTISTRY

1476 SOUTH

HIGHWAY 421

MANCHESTER KY 40962 606 599 8856 COVENTRY

394



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

1476 SOUTH

HIGHWAY 421

MANCHESTER KY 40962 606 599 8856 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1476 SOUTH

HIGHWAY 421

MANCHESTER KY 40962 606 599 8856 WELLCARE

BEN HENSLEY BEN H HENSLEY

DMD PSC

GENERAL

DENTISTRY

269 WHITE

STREET



DMD PSC

GENERAL

DENTISTRY

269 WHITE

STREET


SERVICE


DMD PSC

GENERAL

DENTISTRY

269 WHITE

STREET


JAMES RICE JAMES C RICE

DMD

GENERAL

DENTISTRY

936 NORTH

HIGHWAY 421



DMD

GENERAL

DENTISTRY

936 NORTH

HIGHWAY 421


SERVICE


DMD

GENERAL

DENTISTRY

936 NORTH

HIGHWAY 421


OLIN ELLIOTT ANDY ELLIOT

DMD

GENERAL

DENTISTRY

205 KENTUCKY

HIGHWAY 3188

MARTIN KY 41649 606 285 9317 http://www.flo

ydcountydentis

t.com/

COVENTRY

395



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

205 KENTUCKY

HIGHWAY 3188


ydcountydentis

t.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

205 KENTUCKY

HIGHWAY 3188


ydcountydentis

t.com/

HUMANA


DMD

GENERAL

DENTISTRY

205 KENTUCKY

HIGHWAY 3188


ydcountydentis

t.com/

WELLCARE

DONALD DOWDY DONALD DOWDY

DDS

GENERAL

DENTISTRY

236 NORTH 6TH

STREET

MAYFIELD KY 42066 270 247 7173 FEE FOR

SERVICE

DONALD DOWDY DONALD DOWDY

DDS

GENERAL

DENTISTRY

236 NORTH 6TH

STREET

MAYFIELD KY 42066 270 247 7173 WELLCARE

BRYAN FREEMAN MAYFIELD

FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE

MAYFIELD KY 42066 270 247 1966 http://www.ma

rshandfreeman

dentistry.com/

COVENTRY


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE


rshandfreeman

dentistry.com/

FEE FOR

SERVICE


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE


rshandfreeman

dentistry.com

WELLCARE

396



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DANIEL MARSH MAYFIELD

FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE


rshandfreeman

dentistry.com

COVENTRY


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE


rshandfreeman

dentistry.com

FEE FOR

SERVICE


FAMILY AND

COSMETIC

DENTISTRY

GENERAL

DENTISTRY

312 WYATT

DRIVE


rshandfreeman

dentistry.com

WELLCARE

SALENA POAT SALENA POAT

DMD

GENERAL

DENTISTRY

315 SOUTH 6TH

STREET

MAYFIELD KY 42066 270 247 2552 COVENTRY


DMD

GENERAL

DENTISTRY

315 SOUTH 6TH

STREET

MAYFIELD KY 42066 270 247 2552 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

315 SOUTH 6TH

STREET

MAYFIELD KY 42066 270 247 2552 WELLCARE

DEBORAH DUNKER DUNCAN

ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 COVENTRY


ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 FEE FOR

SERVICE


ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 WELLCARE

397



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MATTHEW MILLINER MAYFIELD

ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 COVENTRY


ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 FEE FOR

SERVICE


ORTHODONTICS

ORTHODONTIST 822 PARIS ROAD MAYFIELD KY 42066 270 247 0751 WELLCARE

JO ANN LEWIS JO ANN LEWIS

DMD

GENERAL

DENTISTRY

123 WEST 2ND

STREET

MAYSVILLE KY 41056 606 564 6841 FEE FOR

SERVICE

ROBERT FRENCH FRENCH DENTAL

OFFICE

GENERAL

DENTISTRY

124 WEST 3RD

STREET


SERVICE

ROBERT FRENCH FRENCH DENTAL

OFFICE

GENERAL

DENTISTRY

124 WEST 3RD

STREET

MAYSVILLE KY 41056 606 564 4024 WELLCARE

FRENCH DENTAL

OFFICE

GENERAL

DENTISTRY

124 WEST 3RD

STREET

MAYSVILLE KY 41056 606 564 4024 COVENTRY

FRENCH DENTAL

OFFICE

GENERAL

DENTISTRY

124 WEST 3RD

STREET


SERVICE

FRENCH DENTAL

OFFICE

GENERAL

DENTISTRY

124 WEST 3RD

STREET


JAMES ADAMS JAMES E ADAMS

DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


398



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


SERVICE


DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


JAMES E ADAMS

DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


JAMES E ADAMS

DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


SERVICE

JAMES E ADAMS

DMD

GENERAL

DENTISTRY

19 EAST 3RD

STREET


JOHN BURNS BURNS AND

BURNS FAMILY

DENTISRTY

GENERAL

DENTISTRY

1907 OLD MAIN

STREET



BURNS FAMILY

DENTISRTY

GENERAL

DENTISTRY

1907 OLD MAIN

STREET


SERVICE


BURNS FAMILY

DENTISRTY

GENERAL

DENTISTRY

1907 OLD MAIN

STREET


BURNS AND

BURNS FAMILY

DENTISRTY

MULTI

SPECIALTY

GROUP

1907 OLD MAIN

STREET


SERVICE

399



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

RACHEL NAYLOR NAYLOR

ORTHODONTICS

ORTHODONTIST 399 MAPLE LEAF

ROAD WEST

MAYSVILLE KY 41056 606 564 9494 http://www.na

ylororthodonti

cs.com/

COVENTRY


ORTHODONTICS


ROAD WEST


ylororthodonti

cs.com/

FEE FOR

SERVICE


ORTHODONTICS


ROAD WEST


ylororthodonti

cs.com/

WELLCARE

BALLARD SMITH BALLARD SMITH

DMD

ORAL SURGEON 399 MAPLELEAF

ROAD



DMD


ROAD


SERVICE


DMD


ROAD


JOHN CRAMER BALLARD SMITH

DMD

ORAL SURGEON 399 WEST MAPLE

LEAF ROAD



DMD


LEAF ROAD


SERVICE


DMD


LEAF ROAD


BALLARD SMITH

DMD

GENERAL

DENTISTRY

399 WEST MAPLE

LEAF ROAD


SERVICE

400



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DENVER TACKETT DENVER

TACKETT DMD

GENERAL

DENTISTRY

9759 KENTUCKY

ROUTE 122

MCDOWELL KY 41647 606 377 2801 COVENTRY


TACKETT DMD

GENERAL

DENTISTRY

9759 KENTUCKY

ROUTE 122

MCDOWELL KY 41647 606 377 2801 FEE FOR

SERVICE


TACKETT DMD

GENERAL

DENTISTRY

9759 KENTUCKY

ROUTE 122

MCDOWELL KY 41647 606 377 2801 WELLCARE

HEALTH

HELP WHITE

HOUSE

CLINIC

MEDICAL CLINIC 1010 MAIN

STREET SOUTH

MCKEE KY 40447 606 287 7104 http://www.wh

itehouseclinics

.com/index.ht

m

COVENTRY

HEALTH

HELP WHITE

HOUSE

CLINIC


STREET SOUTH


itehouseclinics

.com/index.ht

m

FEE FOR

SERVICE

HEALTH

HELP WHITE

HOUSE

CLINIC


STREET SOUTH


itehouseclinics

.com/index.ht

m

WELLCARE

RICHARD BARNETT RICHARD

BARNETT DMD

GENERAL

DENTISTRY

1001

CUMBERLAND

AVENUE

MIDDLESBORO KY 40965 606 248 7505 COVENTRY

401



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BARNETT DMD

GENERAL

DENTISTRY

1001

CUMBERLAND

AVENUE

MIDDLESBORO KY 40965 606 248 7505 FEE FOR

SERVICE


BARNETT DMD

GENERAL

DENTISTRY

1001

CUMBERLAND

AVENUE

MIDDLESBORO KY 40965 606 248 7505 WELLCARE

BRUCE WILSON BRUCE T WILSON

DMD PSC

ORAL SURGEON 123 NORTH 19TH

STREET



DMD PSC


STREET


SERVICE


DMD PSC


STREET


JAMES MADDOX JAMES G

MADDOX PSC

DMD

GENERAL

DENTISTRY

1517

CUMBERLAND

AVENUE

MIDDLESBORO KY 40965 606 248 7661 http://jamesgm

addoxdmdky.c

om/

COVENTRY


MADDOX PSC

DMD

GENERAL

DENTISTRY

1517

CUMBERLAND

AVENUE


addoxdmdky.c

om/

FEE FOR

SERVICE


MADDOX PSC

DMD

GENERAL

DENTISTRY

1517

CUMBERLAND

AVENUE


addoxdmdky.c

om/

WELLCARE

402



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ALISON LANCASTER MOUNTAIN CARE

DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333



DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333


SERVICE


DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333


WILLIAM LANCASTER MOUNTAIN CARE

DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333



DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333


SERVICE


DENTAL

GENERAL

DENTISTRY

2004

CUMBERLAND

AVENUE SUITE

333


403



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MOUNTAIN CARE

DENTAL

MULTI

SPECIALTY

GROUP

2004

CUMBERLAND

AVENUE SUITE

333


SERVICE

JOSEPH BOSTER JOSEPH M

BOSTER DMD

GENERAL

DENTISTRY

2205

CUMBERLAND

AVENUE



BOSTER DMD

GENERAL

DENTISTRY

2205

CUMBERLAND

AVENUE


SERVICE


BOSTER DMD

GENERAL

DENTISTRY

2205

CUMBERLAND

AVENUE


BRENT PURSIFULL BRENT

PURSIFULL DMD

GENERAL

DENTISTRY

PRACTIONER

3604 WEST

CUMBERLAND

AVENUE



PURSIFULL DMD

GENERAL

DENTISTRY

PRACTIONER

3604 WEST

CUMBERLAND

AVENUE


SERVICE


PURSIFULL DMD

GENERAL

DENTISTRY

PRACTIONER

3604 WEST

CUMBERLAND

AVENUE


404



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CORDELL TOLLIVER CORDELL W

TOLLIVER DMD

GENERAL

DENTISTRY

714 EXETER

AVENUE



TOLLIVER DMD

GENERAL

DENTISTRY

714 EXETER

AVENUE


SERVICE


TOLLIVER DMD

GENERAL

DENTISTRY

714 EXETER

AVENUE


JAMES OCONNNOR EMBRY AND

OCONNER

GENERAL

DENTISTRY

25 AGIN WAY MILTON KY 40045 502 268 3192 COVENTRY


OCONNER

GENERAL

DENTISTRY

25 AGIN WAY MILTON KY 40045 502 268 3192 FEE FOR

SERVICE


OCONNER

GENERAL

DENTISTRY

25 AGIN WAY MILTON KY 40045 502 268 3192 HUMANA


OCONNER

GENERAL

DENTISTRY

25 AGIN WAY MILTON KY 40045 502 268 3192 PASSPORT

MICHAEL MCKINNEY FLOYD COUNTY

SMILES

GENERAL

DENTISTRY

JCT ROUTE 680

HIGHWAY 122

MINNIE KY 41651 606 377 0170 http://www.flo

ydcountysmile

s.com/

FEE FOR

SERVICE

MICHAEL MCKINNEY FLOYD COUNTY

SMILES

GENERAL

DENTISTRY

JCT ROUTE 680

HIGHWAY 122


ydcountysmile

s.com/

WELLCARE

FLOYD COUNTY

SMILES

GENERAL

DENTISTRY

JCT ROUTE 680

HIGHWAY 122


ydcountysmile

s.com/

FEE FOR

SERVICE

405



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DANIEL BRUMMETT BRUMMETT

COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET

MONTICELLO KY 42633 606 340 0740 COVENTRY


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET

MONTICELLO KY 42633 606 340 0740 FEE FOR

SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET

MONTICELLO KY 42633 606 340 0740 WELLCARE

DAVID BRUMMETT BRUMMETT

COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET



COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


DENNY BRUMMETT BRUMMETT

COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


406



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


LISA KOCHIS BRUMMETT

COSMETIC AND

FAMILY

DENTISTRY


MAIN STREET



COSMETIC AND

FAMILY

DENTISTRY


MAIN STREET


SERVICE


COSMETIC AND

FAMILY

DENTISTRY


MAIN STREET


STEVEN TALLENT II BRUMMETT

COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET



COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


SERVICE

407



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1313 NORTH

MAIN STREET


WILLIAM BREEDING WILLIAM G

BREEDING DMD

GENERAL

DENTISTRY

1500 NORTH

MAIN STREET

SUITE 162


SERVICE

WILLIAM BREEDING WILLIAM G

BREEDING DMD

GENERAL

DENTISTRY

1500 NORTH

MAIN STREET

SUITE 162


PHILIP HARDIN SMILES FAMILY

DENTISTRY

GENERAL

DENTISTRY

169

CUMBERLAND

CROSSING



DENTISTRY

GENERAL

DENTISTRY

169

CUMBERLAND

CROSSING


SERVICE


DENTISTRY

GENERAL

DENTISTRY

169

CUMBERLAND

CROSSING


SMILES FAMILY

DENTISTRY

GENERAL

DENTISTRY

216

CUMBERLAND

CROSSING


SERVICE

408



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

FAHED HISHMEH FAHED B

HISHMEH DMD

GENERAL

DENTISTRY

650 NORTH MAIN

STREET

MONTICELLO KY 42633 606 348 5100 http://www.his

hmehdental.co

m/office.php

COVENTRY


HISHMEH DMD

GENERAL

DENTISTRY

650 NORTH MAIN

STREET


hmehdental.co

m/office.php

FEE FOR

SERVICE


HISHMEH DMD

GENERAL

DENTISTRY

650 NORTH MAIN

STREET


hmehdental.co

m/office.php

WELLCARE

KAREN SHAY KAREN E SHAY

DMD PSC

GENERAL

DENTISTRY

165 EAST MAIN

STREET

MOREHEAD KY 40351 606 784 4762 http://www.kar

enshaydmd.co

m/

COVENTRY


DMD PSC

GENERAL

DENTISTRY

165 EAST MAIN

STREET


enshaydmd.co

m/

FEE FOR

SERVICE


DMD PSC

GENERAL

DENTISTRY

165 EAST MAIN

STREET


enshaydmd.co

m/

WELLCARE

LARRY ARNETT ARNETTS

DENTAL CLINIC

GENERAL

DENTISTRY

204 MOREHEAD

PLAZA

MOREHEAD KY 40351 606 784 7033 COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

204 MOREHEAD

PLAZA

MOREHEAD KY 40351 606 784 7033 FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

204 MOREHEAD

PLAZA

MOREHEAD KY 40351 606 784 7033 WELLCARE

409



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHELIA ARNETT ARNETTS

DENTAL CLINIC

GENERAL

DENTISTRY

204 MOREHEAD

PLAZA


ARNETTS

DENTAL CLINIC

MULTI

SPECIALTY

GROUP

204 MOREHEAD

PLAZA


SERVICE

EMILY HUGHES BEACON HILL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE

MOREHEAD KY 40351 606 784 6631 http://www.be

aconhilldentist

ry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

WELLCARE

CARROLL LOY BEACON HILL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

WELLCARE

EMILY SETTLE BEACON HILL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

FEE FOR

SERVICE

410



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

WELLCARE

CHARLES TINGLE BEACON HILL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

WELLCARE

BEACON HILL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

255 BEACON

HILL DRIVE


aconhilldentist

ry.com/

FEE FOR

SERVICE

DOUGLAS MCLONEY JR MOREHEAD

DENTAL GROUP

GENERAL

DENTISTRY

309 EAST MAIN

STREET

MOREHEAD KY 40351 606 784 6436 http://www.mo

reheaddentalgr

oup.com/

COVENTRY


DENTAL GROUP

GENERAL

DENTISTRY

309 EAST MAIN

STREET


reheaddentalgr

oup.com/

FEE FOR

SERVICE


DENTAL GROUP

GENERAL

DENTISTRY

309 EAST MAIN

STREET


reheaddentalgr

oup.com/

WELLCARE

MOREHEAD

DENTAL GROUP

GENERAL

DENTISTRY

309 EAST MAIN

STREET


reheaddentalgr

oup.com/

FEE FOR

SERVICE

MITCHELL PATTON CAVE RUN

DENTAL

GENERAL

DENTISTRY

400 CLINIC

DRIVE



DENTAL

GENERAL

DENTISTRY

400 CLINIC

DRIVE


SERVICE

411



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

GENERAL

DENTISTRY

400 CLINIC

DRIVE



DMD

ORAL SURGEON 709 WEST MAIN

STREET



DMD


STREET


SERVICE


DMD


STREET



DMD


STREET



DMD


STREET


SERVICE


DMD


STREET


BALLARD SMITH

DMD

MULTI

SPECIALTY

GROUP

709 WEST MAIN

STREET


SERVICE

BRANDI COX COMMONWEALT

H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET



H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET


SERVICE

412



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET


JASON DOWLEN COMMONWEALT

H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET



H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET


SERVICE


H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET

MOREHEAD KY 40351 606 783 0182 HUMANA


H FAMILY

DENTISTRY

GENERAL

DENTISTRY

750 WEST MAIN

STREET


COMMONWEALT

H FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

750 WEST MAIN

STREET


SERVICE

NANCY RIGDON RIGDON FAMILY

DENTAL

GENERAL

DENTISTRY

124 SOUTH

BRADY STREET

MORGANFIELD KY 42437 270 826 2092 COVENTRY


DENTAL

GENERAL

DENTISTRY

124 SOUTH

BRADY STREET

MORGANFIELD KY 42437 270 826 2092 FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY

124 SOUTH

BRADY STREET

MORGANFIELD KY 42437 270 826 2092 WELLCARE

TARIN WILLLIAMS TARIN WILLIAMS

FAMILY PLLC

GENERAL

DENTISTRY

222 WEST

PORTER STREET

MORGANTOWN KY 42261 270 526 8500 COVENTRY

413



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY PLLC

GENERAL

DENTISTRY

222 WEST

PORTER STREET

MORGANTOWN KY 42261 270 526 8500 FEE FOR

SERVICE


FAMILY PLLC

GENERAL

DENTISTRY

222 WEST

PORTER STREET

MORGANTOWN KY 42261 270 526 8500 HUMANA


FAMILY PLLC

GENERAL

DENTISTRY

222 WEST

PORTER STREET

MORGANTOWN KY 42261 270 526 8500 WELLCARE


ORAL HEALTH

CENTER

ORAL SURGEON 304 WEST OHIO

STREET

MORGANTOWN KY 42261 270 526 3346 http://bgohc.co

m/default.asp

COVENTRY


ORAL HEALTH

CENTER


STREET


m/default.asp

FEE FOR

SERVICE


ORAL HEALTH

CENTER


STREET


m/default.asp

HUMANA


ORAL HEALTH

CENTER


STREET


m/default.asp

WELLCARE


ORAL HEALTH

CENTER


STREET


m/default.asp

COVENTRY

414



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER


STREET


m/default.asp

FEE FOR

SERVICE


ORAL HEALTH

CENTER


STREET


m/default.asp

HUMANA


ORAL HEALTH

CENTER


STREET


m/default.asp

WELLCARE


ORAL HEALTH

CENTER OF

MORGANTOWN


STREET


m/

COVENTRY


ORAL HEALTH

CENTER OF

MORGANTOWN


STREET


m/

FEE FOR

SERVICE


ORAL HEALTH

CENTER OF

MORGANTOWN


STREET


m/

HUMANA

415



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER OF

MORGANTOWN


STREET


m/

WELLCARE


ORAL HEALTH

CENTER OF

MORGANTOWN

GENERAL

DENTISTRY

304 WEST OHIO

STREET


m/

COVENTRY


ORAL HEALTH

CENTER OF

MORGANTOWN

GENERAL

DENTISTRY

304 WEST OHIO

STREET


m/

FEE FOR

SERVICE


ORAL HEALTH

CENTER OF

MORGANTOWN

GENERAL

DENTISTRY

304 WEST OHIO

STREET


m/

HUMANA


ORAL HEALTH

CENTER OF

MORGANTOWN

GENERAL

DENTISTRY

304 WEST OHIO

STREET


m/

PASSPORT

416



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER OF

MORGANTOWN

GENERAL

DENTISTRY

304 WEST OHIO

STREET


m/

WELLCARE

JON JOHNSON STERLING

FAMILY DENTAL

CARE

GENERAL

DENTISTRY

100 EAST HIGH

STREET

MOUNT STERLING KY 40353 859 498 7130 http://sterlingf

amilydental.co

m/

COVENTRY


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

100 EAST HIGH

STREET


amilydental.co

m/

FEE FOR

SERVICE


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

100 EAST HIGH

STREET


amilydental.co

m/

WELLCARE

KRISY CARTY MOUNT STERLING

SMILES

GENERAL

DENTISTRY

105 BRANDON

WAY SUITE A

MOUNT STERLING KY 40353 859 497 4444 http://www.car

tydmd.com/

COVENTRY


SMILES PSC

GENERAL

DENTISTRY

105 BRANDON

WAY SUITE A


tydmd.com/

FEE FOR

SERVICE


SMILES PSC

GENERAL

DENTISTRY

105 BRANDON

WAY SUITE A


tydmd.com/

WELLCARE

417



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MOUNT STERLING

SMILES PSC

MULTI

SPECIALTY

GROUP

105 BRANDON

WAY SUITE A


tydmd.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 105 BRUCE

PROFESSIONAL

PLAZA

MOUNT STERLING KY 40353 800 929 7733 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

FEE FOR

SERVICE

418



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


PROFESSIONAL

PLAZA


ortho.com/

WELLCARE

CHARLES RICE CHARLES RICE

DDS

GENERAL

DENTISTRY

134 NORTH

MAYSVILLE

STREET

MOUNT STERLING KY 40353 859 498 4155 COVENTRY


DDS

GENERAL

DENTISTRY

134 NORTH

MAYSVILLE

STREET

MOUNT STERLING KY 40353 859 498 4155 FEE FOR

SERVICE


DDS

GENERAL

DENTISTRY

134 NORTH

MAYSVILLE

STREET

MOUNT STERLING KY 40353 859 498 4155 WELLCARE

419



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KATHERINE BABER BABER AND

FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE



FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE


SERVICE


FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE


RICKEY FIELDS BABER AND

FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE



FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE


SERVICE


FIELDS

GENERAL

DENTISTRY

225 WINDSOR

DRIVE


ALISHA TACKITT ALISHA TACKITT

DMD PLLC

GENERAL

DENTISTRY

225 YOUNG

LANE

MOUNT STERLING KY 40353 859 498 2356 http://www.ali

shasmiles.com/

index.php?id=

54

COVENTRY


DMD PLLC

GENERAL

DENTISTRY

225 YOUNG

LANE


shasmiles.com/

index.php?id=

54

FEE FOR

SERVICE


DMD PLLC

GENERAL

DENTISTRY

225 YOUNG

LANE


shasmiles.com/

index.php?id=

54

WELLCARE

420



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JOHN CRAMER GRAY MCLAURIN

AND PETERSON

ORAL SURGEON 25 EAST HIGH

STREET SUITE 1



AND PETERSON


STREET SUITE 1


SERVICE


AND PETERSON


STREET SUITE 1



AND PETERSON


STREET SUITE 1



AND PETERSON


STREET SUITE 1


SERVICE


AND PETERSON


STREET SUITE 1


DONALD MCLAURIN GRAY MCLAURIN

AND PETERSON


STREET SUITE 1


421



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND PETERSON


STREET SUITE 1


SERVICE


AND PETERSON


STREET SUITE 1


GILMAN PETERSON III GRAY MCLAURIN

AND PETERSON


STREET SUITE 1



AND PETERSON


STREET SUITE 1


SERVICE


AND PETERSON


STREET SUITE 1

MOUNT STERLING KY 40353 859 498 6204 HUMANA


AND PETERSON


STREET SUITE 1


GRAY MCLAURIN

AND PETERSON


STREET SUITE 1


SERVICE

G SCOTT CAUDILL G SCOTT

CAUDILL DMD

GENERAL

DENTISTRY

508 NORTH

MAYSVILLE

ROAD


422



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CAUDILL DMD

GENERAL

DENTISTRY

508 NORTH

MAYSVILLE

ROAD


SERVICE


CAUDILL DMD

GENERAL

DENTISTRY

508 NORTH

MAYSVILLE

ROAD


RICHARD HENRY HENRY DENTAL GENERAL

DENTISTRY

541 WILLIN WAY MOUNT STERLING KY 40353 859 498 1347 http://www.he

nrydental.com/

COVENTRY


DENTISTRY


nrydental.com/

FEE FOR

SERVICE


DENTISTRY


nrydental.com/

WELLCARE

JENNIFER CHADWELL JENNIFER

CHANDWELL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

325 RICHMOND

STREET

MOUNT VERNON KY 40456 606 256 5812 COVENTRY


CHANDWELL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

325 RICHMOND

STREET

MOUNT VERNON KY 40456 606 256 5812 FEE FOR

SERVICE


CHANDWELL

FAMILY

DENTISTRY

GENERAL

DENTISTRY

325 RICHMOND

STREET

MOUNT VERNON KY 40456 606 256 5812 WELLCARE

GWENNA BATES ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET

MOUNT VERNON KY 40456 606 256 0288 http://www.sm

ilesouthky.com

/

COVENTRY

423



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

JESSICA HAMM ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

KENNETH LOSE ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

HAROLD MAYNARD ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE

424



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

ROBERT MILLAY ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

KYLE STEWART ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

940A WEST MAIN

STREET


ilesouthky.com

/

WELLCARE

NITA ISGRIGG MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 COVENTRY

NITA ISGRIGG MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 FEE FOR

SERVICE

425



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

NITA ISGRIGG MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 HUMANA

NITA ISGRIGG MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 PASSPORT

NITA ISGRIGG MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 WELLCARE

MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 FEE FOR

SERVICE

MOUNT

WASHINGTON

FAMILY

DENTISTRY

GENERAL

DENTISTRY

110 VILLAGE

LANE

MOUNT

WASHINGTON

KY 40047 502 538 3434 PASSPORT


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC

ORAL SURGEON 209 HIGH POINT

COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

426



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

427



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT

CHRISTOPHE

R

BABCOCK KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

428



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

429



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT

CHRISTOPHE

R

NOONAN KENTUCKIANA

ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

430



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

COVENTRY

431



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

FEE FOR

SERVICE


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

HUMANA


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

PASSPORT


ORAL AND

MAXILLOFACIAL

SURGERY

ASSOCIATES PSC


COURT SUITE

100

MOUNT

WASHINGTON

KY 40047 502 957 1250 http://www.ky

oms.com/

WELLCARE

BOBBI COLEMAN BOBBI D

COLEMAN DMD

GENERAL

DENTISTRY

184 NORTH

LEVISA ROAD

MOUTHCARD KY 41548 606 835 2167 COVENTRY


COLEMAN DMD

GENERAL

DENTISTRY

184 NORTH

LEVISA ROAD

MOUTHCARD KY 41548 606 835 2167 FEE FOR

SERVICE

432



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COLEMAN DMD

GENERAL

DENTISTRY

184 NORTH

LEVISA ROAD

MOUTHCARD KY 41548 606 835 2167 WELLCARE

KARL FORSTER KARL FORSTER

DDS

GENERAL

DENTISTRY

309 CALDWELL

STREET

MUNFORDVILLE KY 42765 270 524 3008 COVENTRY


DDS

GENERAL

DENTISTRY

309 CALDWELL

STREET

MUNFORDVILLE KY 42765 270 524 3008 FEE FOR

SERVICE


DDS

GENERAL

DENTISTRY

309 CALDWELL

STREET

MUNFORDVILLE KY 42765 270 524 3008 PASSPORT


DDS

GENERAL

DENTISTRY

309 CALDWELL

STREET

MUNFORDVILLE KY 42765 270 524 3008 WELLCARE

JASON SMITH JASON R SMITH

DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

663 MAIN

STREET



DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

663 MAIN

STREET


SERVICE


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

663 MAIN

STREET

MUNFORDVILLE KY 42765 270 524 5422 HUMANA


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

663 MAIN

STREET


433



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ALAN SHELTON ALAN T SHELTON

DMD

GENERAL

DENTISTRY

865 SOUTH DIXIE

HIGHWAY



DMD

GENERAL

DENTISTRY

865 SOUTH DIXIE

HIGHWAY


SERVICE


DMD

GENERAL

DENTISTRY

865 SOUTH DIXIE

HIGHWAY

MUNFORDVILLE KY 42765 270 524 5580 HUMANA


DMD

GENERAL

DENTISTRY

865 SOUTH DIXIE

HIGHWAY

MUNFORDVILLE KY 42765 270 524 5580 PASSPORT


DMD

GENERAL

DENTISTRY

865 SOUTH DIXIE

HIGHWAY


MICHAEL BOBO ORAL AND

MAXIOLLFACIAL

SURGERY

ORAL SURGEON 1109 POPLAR

STREET

MURRAY KY 42071 270 759 4063 http://www.kyt

noralsurgery.c

om/index.htm

COVENTRY


MAXIOLLFACIAL

SURGERY


STREET


noralsurgery.c

om/index.htm

FEE FOR

SERVICE


MAXIOLLFACIAL

SURGERY


STREET


noralsurgery.c

om/index.htm

WELLCARE

JAMES PLEDGER II ORAL AND

MAXILLOFACIAL

SURGERY


STREET


noralsurgery.c

om/index.html

COVENTRY

434



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MAXILLOFACIAL

SURGERY


STREET


noralsurgery.c

om/index.html

FEE FOR

SERVICE


MAXILLOFACIAL

SURGERY


STREET


noralsurgery.c

om/index.html

WELLCARE

BURTON YOUNG BURTON YOUNG

DMD INC

GENERAL

DENTISTRY

111 SOUTH 13TH

STREET

MURRAY KY 42071 270 753 1206 COVENTRY


DMD INC

GENERAL

DENTISTRY

111 SOUTH 13TH

STREET

MURRAY KY 42071 270 753 1206 FEE FOR

SERVICE


DMD INC

GENERAL

DENTISTRY

111 SOUTH 13TH

STREET

MURRAY KY 42071 270 753 1206 WELLCARE

ROBERT FITCH ROBERT G FITCH

DMD

GENERAL

DENTISTRY

1304 JOHNSON

BLVD



DMD

GENERAL

DENTISTRY

1304 JOHNSON

BLVD

MURRAY KY 42071 270 753 1691 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

1304 JOHNSON

BLVD



PASCO DMD

GENERAL

DENTISTRY

1653 CALLOWAY

AVENUE


435



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PASCO DMD

GENERAL

DENTISTRY

1653 CALLOWAY

AVENUE

MURRAY KY 42071 270 753 1914 FEE FOR

SERVICE


PASCO DMD

GENERAL

DENTISTRY

1653 CALLOWAY

AVENUE


STEVEN FARMER MURRAY FAMILY

DENTISTRY

GENERAL

DENTISTRY

1710A STATE

ROUTE 121

NORTH

MURRAY KY 42071 270 753 9479 http://www.mu

rrayfamilydent

istry.com/inde

x.html

FEE FOR

SERVICE

CHARLES ROBERTSON MURRAY FAMILY

DENTISTRY

GENERAL

DENTISTRY

1710A STATE

ROUTE 121

NORTH


rrayfamilydent

istry.com/inde

x.html

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

1710A STATE

ROUTE 121

NORTH


rrayfamilydent

istry.com/inde

x.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

PRACTICE

1710A STATE

ROUTE 121

NORTH


rrayfamilydent

istry.com/inde

x.html

WELLCARE

MURRAY FAMILY

DENTISTRY

GENERAL

DENTISTRY

1710A STATE

ROUTE 121

NORTH


rrayfamilydent

istry.com/inde

x.html

FEE FOR

SERVICE

JACKIE WEST DAN WEST DMD GENERAL

DENTISTRY

1711 121 NORTH

BYPASS


436



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

1711 121 NORTH

BYPASS

MURRAY KY 42071 270 759 4242 FEE FOR

SERVICE


DENTISTRY

1711 121 NORTH

BYPASS


JAMES WELLS III JAMES R WELLS

III DMD PSC

GENERAL

DENTISTRY

1712 EAST STATE

ROUTE 121

NORTH BYPASS

MURRAY KY 42071 270 753 1572 http://www.jay

wellsdmd.com/

COVENTRY


III DMD PSC

GENERAL

DENTISTRY

1712 EAST STATE

ROUTE 121

NORTH BYPASS


wellsdmd.com/

FEE FOR

SERVICE


III DMD PSC

GENERAL

DENTISTRY

1712 EAST STATE

ROUTE 121

NORTH BYPASS


wellsdmd.com/

WELLCARE

REBEKAH BRANSCUM REBEKAH

BRANSCUM DMD

PSC

GENERAL

DENTISTRY

8536 WEST

HIGHWAY 80

NANCY KY 42544 606 636 4311 COVENTRY


BRANSCUM DMD

PSC

GENERAL

DENTISTRY

8536 WEST

HIGHWAY 80

NANCY KY 42544 606 636 4311 FEE FOR

SERVICE


BRANSCUM DMD

PSC

GENERAL

DENTISTRY

8536 WEST

HIGHWAY 80

NANCY KY 42544 606 636 4311 WELLCARE

437



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

VANDERBILT

DENTAL

GENERAL

DENTISTRY

3601 THE

VANDERBILT

CLINIC

NASHVILLE TN 37232 615 322 2193 http://www.va

nderbilthealth.

com/dental/

FEE FOR

SERVICE

SAM QUILLEN JR SAM W QUILLEN

JR DMD

GENERAL

DENTISTRY

861 HIGHWAY

317

NEON KY 41840 606 855 7892 COVENTRY


JR DMD

GENERAL

DENTISTRY

861 HIGHWAY

317

NEON KY 41840 606 855 7892 FEE FOR

SERVICE


JR DMD

GENERAL

DENTISTRY

861 HIGHWAY

317

NEON KY 41840 606 855 7892 WELLCARE

MASOUD HEKMATYAR NEWPORT

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1847A

MONMOUTH

STREET

NEWPORT KY 41071 859 581 7678 http://newportf

amilydentistry.

com/

FEE FOR

SERVICE

MASOUD HEKMATYAR NEWPORT

FAMILY

DENTISTRY

GENERAL

DENTISTRY

1847A

MONMOUTH

STREET

NEWPORT KY 41071 859 581 7678 http://newportf

amilydentistry.

com/

WELLCARE

STAFFORD DAMRON SMILES ON YORK GENERAL

DENTISTRY

335 YORK

STREET

NEWPORT KY 41071 859 261 6116 http://www.sm

ilesonyork.com

/

COVENTRY


DENTISTRY

335 YORK

STREET


ilesonyork.com

/

FEE FOR

SERVICE


DENTISTRY

335 YORK

STREET


ilesonyork.com

/

WELLCARE

438



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS

ORTHODONTIST 100 JOHN

SUTHERLAND

DRIVE SUITE 5

NICHOLASVILLE KY 40356 800 929 7733 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

WELLCARE

439



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


SUTHERLAND

DRIVE SUITE 5


ortho.com/

WELLCARE


DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D

NICHOLASVILLE KY 40356 859 887 2431 COVENTRY


DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D

NICHOLASVILLE KY 40356 859 887 2431 FEE FOR

SERVICE


DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D

NICHOLASVILLE KY 40356 859 887 2431 HUMANA


DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D

NICHOLASVILLE KY 40356 859 887 2431 WELLCARE

440



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DAVID M SKAFF

DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D


DAVID M SKAFF

DDS

105 EDGEWOOD

PLAZA SUITE D


SERVICE

DAVID M SKAFF

DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D

NICHOLASVILLE KY 40356 859 887 2431 HUMANA

DAVID M SKAFF

DDS

PEDIATRIC

DENTIST

105 EDGEWOOD

PLAZA SUITE D


REBECCA WHEELER REBECCA F

WHEELER DMD

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

106 FAIRFIELD

DRIVE

NICHOLASVILLE KY 40356 859 885 0086 http://www.kyt

oothfairy.com/

COVENTRY


WHEELER DMD

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

106 FAIRFIELD

DRIVE


oothfairy.com/

FEE FOR

SERVICE


WHEELER DMD

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

106 FAIRFIELD

DRIVE


oothfairy.com/

WELLCARE

441



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CAROL WILSON NICHOLASVILLE

DENTAL CENTER

GENERAL

DENTISTRY

108 FAIRFIELD

DRIVE



DENTAL CENTER

GENERAL

DENTISTRY

108 FAIRFIELD

DRIVE


SERVICE


DENTAL CENTER

GENERAL

DENTISTRY

108 FAIRFIELD

DRIVE


BENJAMIN HECKMAN HECKMAN

DENTAL

GENERAL

DENTISTRY

117 BRYANT DR NICHOLASVILLE KY 40356 859 885 0100 http://www.he

ckmandental.c

om/

COVENTRY


DENTAL

GENERAL

DENTISTRY


ckmandental.c

om/

FEE FOR

SERVICE


DENTAL

GENERAL

DENTISTRY


ckmandental.c

om/

WELLCARE


CENTER FOR

ORAL SURGERY

ORAL SURGEON 203 FAIRFIELD

DRIVE

NICHOLASVILLE KY 40356 859 885 9139 http://www.ke

ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

442



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

443



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

HUMANA


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE


AND MAGGARD

ORTHODONTICS

ORTHODONTIST 207 FAIRFIELD

DRIVE

NICHOLASVILLE KY 40356 859 881 2050 http://www.wg

mortho.com/H

ome.aspx

COVENTRY

444



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE

445



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


DRIVE


mortho.com/H

ome.aspx

WELLCARE

PAMELA REVEL REVEL DENTAL GENERAL

DENTISTRY

210 BELLAIRE

DRIVE

NICHOLASVILLE KY 40356 859 887 3835 http://reveldent

al.org/

COVENTRY


DENTISTRY

210 BELLAIRE

DRIVE


al.org/

FEE FOR

SERVICE


DENTISTRY

210 BELLAIRE

DRIVE


al.org/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230

NICHOLASVILLE KY 40356 859 881 9398 http://www.do

wlendental.co

m/index.html

COVENTRY

446



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

HUMANA


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

COVENTRY

447



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

HUMANA


DENTISTRY

GENERAL

DENTISTRY

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

WELLCARE

DOWLEN FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

230 NORTH

PLAZA DRIVE

SUITE 230


wlendental.co

m/index.html

FEE FOR

SERVICE

DAVID SMITH DAVID E SMITH

DMD PSC INC

GENERAL

DENTISTRY

938 SOUTH MAIN

STREET



DMD PSC INC

GENERAL

DENTISTRY

938 SOUTH MAIN

STREET


SERVICE


DMD PSC INC

GENERAL

DENTISTRY

938 SOUTH MAIN

STREET


RANDALL BAKER RANDAL L BAKER

DMD

GENERAL

DENTISTRY

131 JESSICA

LANE

OLIVE HILL KY 41164 606 286 5980 COVENTRY


DMD

GENERAL

DENTISTRY

131 JESSICA

LANE

OLIVE HILL KY 41164 606 286 5980 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

131 JESSICA

LANE

OLIVE HILL KY 41164 606 286 5980 WELLCARE

448



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

KEVIN JORDAN KEVIN JORDAN

DMD

GENERAL

DENTISTRY

154 SCOTT

STREET

OLIVE HILL KY 41164 606 286 4121 COVENTRY


DMD

GENERAL

DENTISTRY

154 SCOTT

STREET

OLIVE HILL KY 41164 606 286 4121 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

154 SCOTT

STREET

OLIVE HILL KY 41164 606 286 4121 WELLCARE

ST CLAIRE

REGIONAL

FAMILY

MEDICINE

OLIVE HILL

MEDICAL CLINIC 155 BRICKLAYER

STREET

OLIVE HILL KY 41164 606 286 4152 http://www.st-

claire.org/

FEE FOR

SERVICE

ST CLAIRE

REGIONAL

FAMILY

MEDICINE

OLIVE HILL


STREET


claire.org/

PASSPORT

ST CLAIRE

REGIONAL

FAMILY

MEDICINE

OLIVE HILL


STREET


claire.org/

WELLCARE

JAMES CREWS II PEDIATRIC

DENTISTRY OF

OWENSBORO

GENERAL

DENTISTRY

2200 EAST

PARRISH

AVENUE SUITE

202

OWENSBORO KY 42303 270 683 7447 COVENTRY


DENTISTRY OF

OWENSBORO

GENERAL

DENTISTRY

2200 EAST

PARRISH

AVENUE SUITE

202

OWENSBORO KY 42303 270 683 7447 FEE FOR

SERVICE

449



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY OF

OWENSBORO

GENERAL

DENTISTRY

2200 EAST

PARRISH

AVENUE SUITE

202

OWENSBORO KY 42303 270 683 7447 WELLCARE

SUZANNA ASHBY MILLS COMMUNITY

DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32

OWENSBORO KY 42301 270 691 6205 http://www.ow

ensborodentalc

linic.com/

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

WELLCARE

BRANDON TAYLOR COMMUNITY

DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

COVENTRY


DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

FEE FOR

SERVICE


DENTAL CLINIC

GENERAL

DENTISTRY

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

WELLCARE

450



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

COMMUNITY

DENTAL CLINIC

MULTI

SPECIALTY

GROUP

2315 MAYFAIR

DRIVE SUITE 32


ensborodentalc

linic.com/

FEE FOR

SERVICE

DANIEL REYNOLDS DANIEL

REYNOLDS DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD BLDG 2

OWENSBORO KY 42303 270 926 0548 http://www.da

nielreynoldsd

md.com/

COVENTRY


REYNOLDS DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD BLDG 2


nielreynoldsd

md.com/

FEE FOR

SERVICE


REYNOLDS DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD BLDG 2


nielreynoldsd

md.com/

WELLCARE

CAROL BRAUN CAROL J BRAUN

DDS

PEDIATRIC

DENTIST

2816 VEACH

ROAD SUITE 201



DDS

PEDIATRIC

DENTIST

2816 VEACH

ROAD SUITE 201


SERVICE


DDS

PEDIATRIC

DENTIST

2816 VEACH

ROAD SUITE 201


KATHERINE HIGDON CAROL J BRAUN

DDS

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 201



DDS

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 201


SERVICE


DDS

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 201


451



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ROBERT JACKSON ROBERT A

JACKSON DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 305

OWENSBORO KY 42303 270 683 5344 http://www.rob

ertjacksondmd.

com/

COVENTRY


JACKSON DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 305


ertjacksondmd.

com/

FEE FOR

SERVICE


JACKSON DMD

GENERAL

DENTISTRY

2816 VEACH

ROAD SUITE 305


ertjacksondmd.

com/

WELLCARE

MISTY BREY SANFORD PRICKELL AND

BREY SANFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD



BREY SANFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD


SERVICE


BREY SANFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD


HOLLY PICKRELL PICKRELL AND

BREY SANDFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD



BREY SANDFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD


SERVICE


BREY SANDFORD

GENERAL

DENTISTRY

2817 VEACH

ROAD


JOSEPH HIGGINSON OWENSBORO

DENTAL SLEEP

MEDICINE

ORTHODONTIST 2868 FARRELL

CRESCENT

OWENSBORO KY 42303 270 684 0822 http://www.hig

ginsonorthodo

ntics.com/

COVENTRY

452



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL SLEEP

MEDICINE


CRESCENT


ginsonorthodo

ntics.com/

FEE FOR

SERVICE


DENTAL SLEEP

MEDICINE


CRESCENT


ginsonorthodo

ntics.com/

WELLCARE

VICKI FREY THOMPSON AND

FREY COSMETIC

AND FAMILY

DENTISTRY

GENERAL

DENTISTRY

3164 ALVEY

PARK DRIVE

EAST

OWENSBORO KY 42303 270 683 0620 http://www.tho

mpsonandfrey.

com/

COVENTRY


FREY COSMETIC

AND FAMILY

DENTISTRY

GENERAL

DENTISTRY

3164 ALVEY

PARK DRIVE

EAST


mpsonandfrey.

com/

FEE FOR

SERVICE


FREY COSMETIC

AND FAMILY

DENTISTRY

GENERAL

DENTISTRY

3164 ALVEY

PARK DRIVE

EAST


mpsonandfrey.

com/

WELLCARE

JASON PENDLEY OWENSBORO

FAMILY

DENTISTRY

GENERAL

DENTISTRY

4921 GOETZ

DRIVE


ensborofamily

dentistry.com/

Tech.htm

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4921 GOETZ

DRIVE


ensborofamily

dentistry.com/

Tech.htm

FEE FOR

SERVICE

453



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

4921 GOETZ

DRIVE


ensborofamily

dentistry.com/

Tech.htm

WELLCARE

ROBERT B ADKINS AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE

OWENSBORO KY 42303 271 683 6623 http://youllsmi

le.com/

FEE FOR

SERVICE

ROBERT B ADKINS AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

WELLCARE

AUDRA DORROH AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

COVENTRY


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

FEE FOR

SERVICE


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

WELLCARE

WILLIAM HARRIS AUDBON DENTAL

CENTER OF

OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

COVENTRY

454



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER OF

OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

FEE FOR

SERVICE


CENTER OF

OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

WELLCARE

ROGER MCALPIN AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

COVENTRY


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

FEE FOR

SERVICE


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

WELLCARE

TERI NEWTON AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


TERI NEWTON AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


SERVICE

455



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

TERI NEWTON AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


TERRY TURLEY AUDUBON

DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

COVENTRY


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

FEE FOR

SERVICE


DENTAL CENTER

OF OWENSBORO

GENERAL

DENTISTRY

610 CARLTON

DRIVE


le.com/

WELLCARE

JAMES JOHNSON JOHNSON FAMILY

DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE

OWENSBORO KY 42301 270 685 5242 http://www.dr

mikeandmatt.c

om/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE


mikeandmatt.c

om/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE


mikeandmatt.c

om/

WELLCARE

MATTHEW JOHNSON JOHNSON FAMILY

DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE


mikeandmatt.c

om/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE


mikeandmatt.c

om/

FEE FOR

SERVICE

456



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

722 HARVARD

DRIVE


mikeandmatt.c

om/

WELLCARE

KIN SHAW BLUEGRASS

DENTAL

GENERAL

DENTISTRY

920 FREDRICA

STREET SUITE

301

OWENSBORO KY 42301 270 926 7272 http://www.blu

egrassdental.ne

t/

COVENTRY

KIN SHAW BLUEGRASS

DENTAL

GENERAL

DENTISTRY

920 FREDRICA

STREET SUITE

301


egrassdental.ne

t/

FEE FOR

SERVICE

KIN SHAW BLUEGRASS

DENTAL

GENERAL

DENTISTRY

920 FREDRICA

STREET SUITE

301


egrassdental.ne

t/

PASSPORT

KIN SHAW BLUEGRASS

DENTAL

GENERAL

DENTISTRY

920 FREDRICA

STREET SUITE

301


egrassdental.ne

t/

WELLCARE

BROCK WARD OWEN DENTAL

CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 COVENTRY


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 HUMANA


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 WELLCARE

457



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LEIGH WARD OWEN DENTAL

CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 COVENTRY


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET


SERVICE


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 HUMANA


CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET

OWENTON KY 40359 502 484 0091 WELLCARE

OWEN DENTAL

CENTER

GENERAL

DENTISTRY

330 WEST

SEMINARY

STREET


SERVICE

LARRY HAMLIN LARRY E HAMLIN

DMD

GENERAL

DENTISTRY

135 SUDDITH

STREET

OWINGSVILLE KY 40360 606 674 6305 COVENTRY


DMD

GENERAL

DENTISTRY

135 SUDDITH

STREET

OWINGSVILLE KY 40360 606 674 6305 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

135 SUDDITH

STREET

OWINGSVILLE KY 40360 606 674 6305 WELLCARE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 137 CEDAR

POINT DRIVE

OWINGSVILLE KY 40360 800 929 7733 http://www.ky

ortho.com/

COVENTRY

458



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


POINT DRIVE


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


POINT DRIVE


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 137 OLD 36

HIGHWAY


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


HIGHWAY


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


HIGHWAY


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


HIGHWAY


ortho.com/

COVENTRY

459



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


HIGHWAY


ortho.com/

FEE FOR

SERVICE

CHARLES BOHLE JR BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET

PADUCAH KY 42001 270 442 0256 http://www.bo

hledental.com/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

WELLCARE

BENJAMIN JOHNSON BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

staff.html

FEE FOR

SERVICE

BENJAMIN JOHNSON BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

staff.html

WELLCARE

JONATHAN MAHAN BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

FEE FOR

SERVICE

JONATHAN MAHAN BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

WELLCARE

MICHAEL SPARKS BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

staff.html

FEE FOR

SERVICE

460



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MICHAEL SPARKS BOHLE FAMILY

DENTISTRY

GENERAL

DENTISTRY

1836 BROADWAY

STREET


hledental.com/

staff.html

WELLCARE

BOHLE FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

1836 BROADWAY

STREET


hledental.com/

FEE FOR

SERVICE

JAMES CAUDILL AUDUBON

DENTAL CENTER

OF PADUCAH

GENERAL

DENTISTRY

1927 IRVIN COBB

DRIVE

PADUCAH KY 42003 270 442 6617 FEE FOR

SERVICE

JAMES CAUDILL AUDUBON

DENTAL CENTER

OF PADUCAH

GENERAL

DENTISTRY

1927 IRVIN COBB

DRIVE

PADUCAH KY 42003 270 442 6617 WELLCARE

AUDUBON

DENTAL CENTER

OF PADUCAH

GENERAL

DENTISTRY

1927 IRVIN COBB

DRIVE


SERVICE

JOHN D CRAFT FAMILY DENTAL

CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET

PADUCAH KY 42001 270 442 2310 COVENTRY


CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET


SERVICE


CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET


JOHN K CRAFT FAMILY DENTAL

CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET


461



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET


SERVICE


CLINIC

GENERAL

DENTISTRY

2136 BROADWAY

STREET


JAMES WOODS BLUEGRASS

ORTHODONTICS

ORTHODONTIST 2307 KENTUCKY

AVENUE

PADUCAH KY 42003 270 443 7405 http://www.blu

egrassorthodon

tics.com/

COVENTRY


ORTHODONTICS


AVENUE


egrassorthodon

tics.com/

FEE FOR

SERVICE


ORTHODONTICS


AVENUE


egrassorthodon

tics.com/

WELLCARE

BLUEGRASS

ORTHODONTICS

MULTI

SPECIALTY

GROUP

2307 KENTUCKY

AVENUE


egrassorthodon

tics.com/

FEE FOR

SERVICE

JAMES JOHNSTON PADUCAH

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2850 LONE OAK

ROAD SUITE 1

PADUCAH KY 42003 270 554 3131 http://paducah

pediatricdentis

try.com/index.

htm

COVENTRY


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2850 LONE OAK

ROAD SUITE 1


pediatricdentis

try.com/index.

htm

FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

2850 LONE OAK

ROAD SUITE 1


pediatricdentis

try.com/index.

htm

WELLCARE

462



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

SHAWN RICE RICE

ORTHODONTICS

ORTHODONTIST 2850 LONE OAK

ROAD SUITE 2

PADUCAH KY 42003 270 534 1991 http://www.ric

eortho.com/

COVENTRY

SHAWN RICE RICE

ORTHODONTICS


ROAD SUITE 2


eortho.com/

FEE FOR

SERVICE

SHAWN RICE RICE

ORTHODONTICS


ROAD SUITE 2


eortho.com/

WELLCARE

JEFFREY BOWEN BEVERLY

LARGENT DMD

GENERAL

DENTISTRY

3008 OREGON

STREET



LARGENT DMD

GENERAL

DENTISTRY

3008 OREGON

STREET


SERVICE


LARGENT DMD

GENERAL

DENTISTRY

3008 OREGON

STREET


JOHN COLGAN JR BEVERLY

LARGENT DMD

ORTHODONTIST 3008 OREGON

STREET


SERVICE

JOHN COLGAN JR BEVERLY

LARGENT DMD

ORTHODONTIST 3008 OREGON

STREET


BEVERLY LARGENT BEVERLY

LARGENT DMD

PEDIATRIC

DENTIST

3008 OREGON

STREET



LARGENT DMD

PEDIATRIC

DENTIST

3008 OREGON

STREET


SERVICE

463



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LARGENT DMD

PEDIATRIC

DENTIST

3008 OREGON

STREET


BEVERLY

LARGENT DMD

GENERAL

DENTISTRY

3008 OREGON

STREET


SERVICE

FRANCIS ABELL ABELL GENERAL

DENTISTRY PSC

GENERAL

DENTISTRY

PRACTIONER

4975 ALBEN

BARKLEY DRIVE

SUITE 3

PADUCAH KY 42001 270 554 3031 http://www.ab

elldental.com/

COVENTRY


DENTISTRY PSC

GENERAL

DENTISTRY

PRACTIONER

4975 ALBEN

BARKLEY DRIVE

SUITE 3


elldental.com/

FEE FOR

SERVICE


DENTISTRY PSC

GENERAL

DENTISTRY

PRACTIONER

4975 ALBEN

BARKLEY DRIVE

SUITE 3


elldental.com/

WELLCARE

ABELL GENERAL

DENTISTRY PSC

GENERAL

DENTISTRY

4975 ALBEN

BARKLEY DRIVE

SUITE 3


elldental.com/

FEE FOR

SERVICE

JAMES CASTLE JAMES R CASTLE

DMD

GENERAL

DENTISTRY

140 MAIN

STREET

PAINTSVILLE KY 41240 606 789 6385 COVENTRY


DMD

GENERAL

DENTISTRY

140 MAIN

STREET

PAINTSVILLE KY 41240 606 789 6385 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

140 MAIN

STREET

PAINTSVILLE KY 41240 606 789 6385 WELLCARE


DMD

GENERAL

DENTISTRY

325 BROADWAY

STREET


464



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

325 BROADWAY

STREET


SERVICE


DMD

GENERAL

DENTISTRY

325 BROADWAY

STREET


GARY BROWN GARY D BROWN

DMD

GENERAL

DENTISTRY

455 MAIN

STREET



DMD

GENERAL

DENTISTRY

455 MAIN

STREET


SERVICE


DMD

GENERAL

DENTISTRY

455 MAIN

STREET


GREGORY COLEMAN GREGORY

COLEMAN DMD

PSC

GENERAL

DENTISTRY

816 FM

STAFFORD

AVENUE

PAINTSVILLE KY 41240 606 789 1845 http://gregoryd

colemandmd.c

om/

COVENTRY


COLEMAN DMD

PSC

GENERAL

DENTISTRY

816 FM

STAFFORD

AVENUE


colemandmd.c

om/

FEE FOR

SERVICE


COLEMAN DMD

PSC

GENERAL

DENTISTRY

816 FM

STAFFORD

AVENUE


colemandmd.c

om/

WELLCARE

AMANDA THORNBERRY AMANDA

THORNBERRY

DMD

GENERAL

DENTISTRY

109 NORTH

MIDDLETOWN

ROAD

PARIS KY 40361 859 987 7474 COVENTRY


THORNBERRY

DMD

GENERAL

DENTISTRY

109 NORTH

MIDDLETOWN

ROAD

PARIS KY 40361 859 987 7474 FEE FOR

SERVICE


THORNBERRY

DMD

GENERAL

DENTISTRY

109 NORTH

MIDDLETOWN

ROAD

PARIS KY 40361 859 987 7474 WELLCARE

465



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BARTON MCFARLAND BART

MCFARLAND

DMD

GENERAL

DENTISTRY

2020 ALVERSON

DRIVE

PARIS KY 40361 859 987 4775 http://www.par

issedationdenti

st.com/

COVENTRY


MCFARLAND

DMD

GENERAL

DENTISTRY

2020 ALVERSON

DRIVE


issedationdenti

st.com/

FEE FOR

SERVICE


MCFARLAND

DMD

GENERAL

DENTISTRY

2020 ALVERSON

DRIVE


issedationdenti

st.com/

WELLCARE

JASON MCILVAIN DENTAL HEALTH

ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE



ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE

PARIS KY 40361 859 987 3290 FEE FOR

SERVICE


ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE


JEWELL MEADE DENTAL HEALTH

ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE



ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE

PARIS KY 40361 859 987 3290 FEE FOR

SERVICE

466



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE

PARIS KY 40361 859 987 3290 HUMANA


ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE


RACHEL WILSON DENTAL HEALTH

ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE



ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE

PARIS KY 40361 859 987 3290 FEE FOR

SERVICE


ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE


DENTAL HEALTH

ASSOCIATES PSC

GENERAL

DENTISTRY

2115 ROCKY

DRIVE

PARIS KY 40361 859 987 3290 FEE FOR

SERVICE

ANNA NEWMAN DOWNTOWN

DETNISTRY

GENERAL

DENTISTRY

436 MAIN

STREET

PARIS KY 40361 859 987 5550 http://www.do

wntowndentist

ryparis.com/

COVENTRY

467



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DETNISTRY

GENERAL

DENTISTRY

436 MAIN

STREET


wntowndentist

ryparis.com/

FEE FOR

SERVICE


DETNISTRY

GENERAL

DENTISTRY

436 MAIN

STREET


wntowndentist

ryparis.com/

WELLCARE

TRAVIS RATLIFF SHARP SMILES

DENTISTRY

GENERAL

DENTISTRY

4159 NORTH

MAYO TRAIL

SUITE 200

PIKESVILLE KY 41501 606 432 0101 http://www.sha

rpsmilesdentist

ry.com/

COVENTRY

TRAVIS RATLIFF SHARP SMILES

DENTISTRY

GENERAL

DENTISTRY

4159 NORTH

MAYO TRAIL

SUITE 200

PIKESVILLE KY 41501 606 432 0101 http://www.sha

rpsmilesdentist

ry.com/

FEE FOR

SERVICE

CHONDA HARRIS THE DENTIST

OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101

PIKEVILLE KY 41501 606 433 0033 http://www.the

dentest

office.com/

COVENTRY


OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

FEE FOR

SERVICE


OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

WELLCARE

468



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BEN WHITFIELD THE DENTIST

OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

COVENTRY


OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

FEE FOR

SERVICE


OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

WELLCARE

THE DENTIST

OFFICE PSC

GENERAL

DENTISTRY

1144 SOUTH

MAYO TRAIL

SUITE 101


dentist

office.com/

FEE FOR

SERVICE

ANDY KEATON KEATON

ORTHODONTICS

ORTHODONTIST 118 CAROLINE

AVENUE SUITE 1

PIKEVILLE KY 41501 606 432 8165 http://www.ke

atonorthodonti

cs.com/

COVENTRY

ANDY KEATON KEATON

ORTHODONTICS


AVENUE SUITE 1


atonorthodonti

cs.com/

FEE FOR

SERVICE

ANDY KEATON KEATON

ORTHODONTICS


AVENUE SUITE 1


atonorthodonti

cs.com/

WELLCARE

469



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JILL KEATON KEATON

ORTHODONTICS

GENERAL

DENTISTRY

118 CAROLINE

AVENUE SUITE 1


atonorthodonti

cs.com/

COVENTRY

JILL KEATON KEATON

ORTHODONTICS

GENERAL

DENTISTRY

118 CAROLINE

AVENUE SUITE 1


atonorthodonti

cs.com/

FEE FOR

SERVICE

JILL KEATON KEATON

ORTHODONTICS

GENERAL

DENTISTRY

118 CAROLINE

AVENUE SUITE 1


atonorthodonti

cs.com/

WELLCARE

JOHN PHILLIPS KEATON

ORTHODONTICS


AVENUE SUITE 1


atonorthodonti

cs.com/

FEE FOR

SERVICE

JOHN PHILLIPS KEATON

ORTHODONTICS


AVENUE SUITE 1


atonorthodonti

cs.com/

WELLCARE

KEATON

ORTHODONTICS

118 CAROLINE

AVENUE SUITE 1


atonorthodonti

cs.com/

FEE FOR

SERVICE

WILLIAM COLLINS WILLIAM E

COLLINS INC

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE

PIKEVILLE KY 41501 606 437 9601 COVENTRY


COLLINS INC

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE

PIKEVILLE KY 41501 606 437 9601 FEE FOR

SERVICE

470



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COLLINS INC

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE

PIKEVILLE KY 41501 606 437 9601 WELLCARE

JOHNATHAN HENSLEY J SHANE

HENSLEY DMD

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE



HENSLEY DMD

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE


SERVICE


HENSLEY DMD

GENERAL

DENTISTRY

126 TRIVETTE

DRIVE


CHAD STREET EAST KENTUCKY

ORAL AND

MAXILLOFACIAL

SURGERY

ORAL SURGEON 129 LORAINE

STREET

PIKEVILLE KY 41501 606 432 9639 http://www.ek

yoms.com/inde

x.html

FEE FOR

SERVICE

CHAD STREET EAST KENTUCKY

ORAL AND

MAXILLOFACIAL

SURGERY

ORAL SURGEON 129 LORAINE

STREET

PIKEVILLE KY 41501 606 432 9639 http://www.ek

yoms.com/inde

x.html

WELLCARE

QUENTIN ROBINETTE ROBINETTE AND

HENSLEY FAMILY

DENTISTRY

GENERAL

DENTISTRY

153 HIBBARD

STREET


471



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


HENSLEY FAMILY

DENTISTRY

GENERAL

DENTISTRY

153 HIBBARD

STREET


SERVICE


HENSLEY FAMILY

DENTISTRY

GENERAL

DENTISTRY

153 HIBBARD

STREET


TOM HARTSOCK HARTSOCK

ORTHODONTICS

ORTHODONTIST 161 COLLEGE

STREET

PIKEVILLE KY 41501 606 432 3603 http://www.har

tsockorthodont

ics.com/

COVENTRY


ORTHODONTICS


STREET


tsockorthodont

ics.com/

FEE FOR

SERVICE


ORTHODONTICS


STREET


tsockorthodont

ics.com/

WELLCARE

ALFRED PELPHREY ALFRED L

PELPHREY PSC

PEDIATRIC

DENTIST

300 NORTH

MAYO TRAIL

SUITE 1

PIKEVILLE KY 41501 606 437 1461 http://www.yo

urchildssmile.c

om/

COVENTRY


PELPHREY PSC

PEDIATRIC

DENTIST

300 NORTH

MAYO TRAIL

SUITE 1


urchildssmile.c

om/

FEE FOR

SERVICE


PELPHREY PSC

PEDIATRIC

DENTIST

300 NORTH

MAYO TRAIL

SUITE 1


urchildssmile.c

om/

WELLCARE

472



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

CARL TACKETT CARL E TACKETT

DMD

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 105



DMD

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 105


SERVICE


DMD

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 105


SUSAN ALTMAN ALTMAN AND

TURNER

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 200



TURNER

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 200


SERVICE


TURNER

GENERAL

DENTISTRY

419 TOWN

MOUNTAIN

ROAD SUITE 200


JOSHUA LEONARD JOSHUA

LEONARD DMD

GENERAL

DENTISTRY

8857 META

HIGHWAY SUITE

3

PIKEVILLE KY 41503 606 631 4377 http://www.jos

hleonarddmd.c

om/

COVENTRY


LEONARD DMD

GENERAL

DENTISTRY

8857 META

HIGHWAY SUITE

3


hleonarddmd.c

om/

FEE FOR

SERVICE

473



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LEONARD DMD

GENERAL

DENTISTRY

8857 META

HIGHWAY SUITE

3


hleonarddmd.c

om/

WELLCARE

MANSFIELD DIXON JR WOOLUMS AND

DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE

PINEVILLE KY 40977 606 337 3034 http://www.pin

evilledentist.co

m/

COVENTRY


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

FEE FOR

SERVICE


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

WELLCARE

DANIEL SLUSHER WOOLUMS AND

DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

COVENTRY


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

FEE FOR

SERVICE


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

WELLCARE

KERRY WOOLUM WOOLUMS AND

DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

COVENTRY

474



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

FEE FOR

SERVICE


DIXON FAMILY

DENTISTRY

GENERAL

DENTISTRY

121 VIRGINIA

AVENUE


evilledentist.co

m/

WELLCARE

KATHRYN LEFEVERS KATHRYN D

LEFEVERS DMD

GENERAL

DENTISTRY

850 RIVERVIEW

AVENUE 3RD

FLOOR

PINEVILLE KY 40977 606 337 6297 COVENTRY


LEFEVERS DMD

GENERAL

DENTISTRY

850 RIVERVIEW

AVENUE 3RD

FLOOR

PINEVILLE KY 40977 606 337 6297 FEE FOR

SERVICE


LEFEVERS DMD

GENERAL

DENTISTRY

850 RIVERVIEW

AVENUE 3RD

FLOOR

PINEVILLE KY 40977 606 337 6297 WELLCARE

MINIX MARTIN MINX DENTAL

CENTER

GENERAL

DENTISTRY

253 HAGER

STREET

PRESTONSBURG KY 41216 606 886 0808 COVENTRY


CENTER

GENERAL

DENTISTRY

253 HAGER

STREET

PRESTONSBURG KY 41216 606 886 0808 FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

253 HAGER

STREET

PRESTONSBURG KY 41216 606 886 0808 WELLCARE

475



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ROBERT HERRICK ROBERT B

HERRICK DMD

GENERAL

DENTISTRY

274 SOUTH LAKE

DRIVE



HERRICK DMD

GENERAL

DENTISTRY

274 SOUTH LAKE

DRIVE


SERVICE


HERRICK DMD

GENERAL

DENTISTRY

274 SOUTH LAKE

DRIVE

PRESTONSBURG KY 41653 606 886 1095 HUMANA


HERRICK DMD

GENERAL

DENTISTRY

274 SOUTH LAKE

DRIVE


ALAN HYDEN HYDEN

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

38 GRACE DRIVE PRESTONSBURG KY 41653 606 886 6565 http://www.hy

denpediatricde

ntistry.com/

COVENTRY

ALAN HYDEN HYDEN

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST


denpediatricde

ntistry.com/

FEE FOR

SERVICE

ALAN HYDEN HYDEN

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST


denpediatricde

ntistry.com/

WELLCARE

ROBERT LESLIE ROBERT KEITH

LESLIE DMD

GENERAL

DENTISTRY

400 UNIVERSITY

DRIVE SUITE 110


476



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


LESLIE DMD

GENERAL

DENTISTRY

400 UNIVERSITY

DRIVE SUITE 110


SERVICE


LESLIE DMD

GENERAL

DENTISTRY

400 UNIVERSITY

DRIVE SUITE 110



LESLIE DMD

GENERAL

DENTISTRY

400 UNIVERSITY

DRIVE SUITE 110


EDFORD CLARK EDDY CLARK

DMD

GENERAL

DENTISTRY

415 NORTH LAKE

DRIVE SUITE 201



DMD

GENERAL

DENTISTRY

415 NORTH LAKE

DRIVE SUITE 201


SERVICE


DMD

GENERAL

DENTISTRY

415 NORTH LAKE

DRIVE SUITE 201



DMD

GENERAL

DENTISTRY

415 NORTH LAKE

DRIVE SUITE 201


477



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BILL FRANCIS FRANCIS FRANCIS

AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1



AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


SERVICE


AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1



AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


DEMETRA FRANCIS FRANCIS FRANCIS

AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1



AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


SERVICE


AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


478



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


BRIAN WALLACE FRANCIS FRANCIS

AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1



AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


SERVICE


AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1



AND WALLACE

GENERAL

DENTISTRY

781 SOUTH LAKE

DRIVE SUITE 1


MISTY CLARK HEALTHY SMILES GENERAL

DENTISTRY

83 OAK RIDGE

COURT



DENTISTRY

83 OAK RIDGE

COURT


SERVICE


DENTISTRY

83 OAK RIDGE

COURT


479



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

83 OAK RIDGE

COURT


LORA SITTON LORA SITTON

DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

400 WEST

WASHINGTON

STREET

PRINCETON KY 42445 270 365 6174 COVENTRY


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

400 WEST

WASHINGTON

STREET

PRINCETON KY 42445 270 365 6174 FEE FOR

SERVICE


DMD FAMILY

DENTISTRY

GENERAL

DENTISTRY

400 WEST

WASHINGTON

STREET

PRINCETON KY 42445 270 365 6174 WELLCARE

KWANE WATSON SMILES ON

MEETING STREET

GENERAL

DENTISTRY

10515 MEETING

STREET UNIT 4

PROSPECT KY 40059 502 420 2480 COVENTRY


MEETING STREET

GENERAL

DENTISTRY

10515 MEETING

STREET UNIT 4

PROSPECT KY 40059 502 420 2480 FEE FOR

SERVICE


MEETING STREET

GENERAL

DENTISTRY

10515 MEETING

STREET UNIT 4

PROSPECT KY 40059 502 420 2480 HUMANA


MEETING STREET

GENERAL

DENTISTRY

10515 MEETING

STREET UNIT 4

PROSPECT KY 40059 502 420 2480 PASSPORT

480



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MEETING STREET

GENERAL

DENTISTRY

10515 MEETING

STREET UNIT 4

PROSPECT KY 40059 502 420 2480 WELLCARE

JEFFREY CRENSHAW PEDIATRIC

DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42

PROSPECT KY 40059 502 292 1160 http://www.pe

ddentofprospe

ct.com/

COVENTRY


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/

FEE FOR

SERVICE


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/

HUMANA


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/

PASSPORT

DANIELLE HAMAN SMITH PEDIATRIC

DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/index.h

tml

COVENTRY


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/index.h

tml

FEE FOR

SERVICE


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/index.h

tml

PASSPORT

481



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY OF

PROSPECT

PEDIATRIC

DENTIST

12927 WEST

HIGHWAY 42


ddentofprospe

ct.com/index.h

tml

WELLCARE


ORTHODONTICS


HIGHWAY 42

PROSPECT KY ##### 502 228 2122 http://www.tay

lororthodontics

.com/default.as

p

FEE FOR

SERVICE


ORTHODONTICS


HIGHWAY 42

PROSPECT KY ##### 502 228 2122 http://www.tay

lororthodontics

.com/default.as

p

PASSPORT

SARAH MITCHELL MITCHELL

ORTHODONTICS


HIGHWAY 42

SUITE 103

PROSPECT KY 40059 502 228 9494 http://www.mit

chellortho.com

/

FEE FOR

SERVICE

SARAH MITCHELL MITCHELL

ORTHODONTICS


HIGHWAY 42

SUITE 103

PROSPECT KY 40059 502 228 9494 http://www.mit

chellortho.com

/

PASSPORT

PAIGE WARREN JAMES PHILLIPS

DMD AND PAIGE

WARREN DMD

GENERAL

DENTISTRY

125 EAST MAIN

STREET

PROVIDENCE KY 42450 270 667 7301 COVENTRY

482



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD AND PAIGE

WARREN DMD

GENERAL

DENTISTRY

125 EAST MAIN

STREET

PROVIDENCE KY 42450 270 667 7301 FEE FOR

SERVICE


DMD AND PAIGE

WARREN DMD

GENERAL

DENTISTRY

125 EAST MAIN

STREET

PROVIDENCE KY 42450 270 667 7301 WELLCARE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

169 EAST

LINCOLN TRAIL

BLVD

RADCLIFF KY 40160 270 351 5858 http://www.ge

nerationsfamil

ydentistry.com

/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

169 EAST

LINCOLN TRAIL

BLVD

RADCLIFF KY 40160 270 351 5858 http://www.ge

nerationsfamil

ydentistry.com

/

PASSPORT

ANGELA SHELTON RADCLIFF

FAMILY DENTAL

CARE

GENERAL

DENTISTRY

299 WEST

LINCOLN TRAIL

BLVD SUITE 102

RADCLIFF KY 40160 270 352 5566 http://www.rad

clifffamilydent

alcare.com/

FEE FOR

SERVICE

ANGELA SHELTON RADCLIFF

FAMILY DENTAL

CARE

GENERAL

DENTISTRY

299 WEST

LINCOLN TRAIL

BLVD SUITE 102

RADCLIFF KY 40160 270 352 5566 http://www.rad

clifffamilydent

alcare.com/

PASSPORT

483



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

ERROL DEVEAUX DEVEAUX

DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD

RADCLIFF KY 40160 270 352 4343 http://www.drd

eveaux.com/H

ome.aspx

COVENTRY


DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD


eveaux.com/H

ome.aspx

FEE FOR

SERVICE


DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD


eveaux.com/H

ome.aspx

PASSPORT

BRENT HURST DEVEAUX

DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD


eveaux.com/

FEE FOR

SERVICE

BRENT HURST DEVEAUX

DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD


eveaux.com/

PASSPORT

BRENT HURST DEVEAUX

DENTAL CARE

CENTER

GENERAL

DENTISTRY

309 NORTH

WILSON ROAD


eveaux.com/

WELLCARE

PHILIP CORNETTE III AESTHETIC

DENTAL CENTER

OF KENTUCKY

GENERAL

DENTISTRY

347 WEST

LINCOLN TRAIL

SUITE 1

RADCLIFF KY 40160 270 351 3505 http://drcornett

e.com/index.ht

ml

FEE FOR

SERVICE

484



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

OF KENTUCKY

GENERAL

DENTISTRY

347 WEST

LINCOLN TRAIL

SUITE 1


e.com/index.ht

ml

HUMANA


DENTAL CENTER

OF KENTUCKY

GENERAL

DENTISTRY

347 WEST

LINCOLN TRAIL

SUITE 1


e.com/index.ht

ml

PASSPORT


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE #C

RICHMOND KY 40475 859 626 9620 http://dentistry

forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE #C


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE #C


forchildrenky.c

om/Home.aspx

WELLCARE


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE

485



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CHILDREN

RICHMOND

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

WELLCARE


CHILDREN

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

COVENTRY


CHILDREN

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

FEE FOR

SERVICE


CHILDREN

PEDIATRIC

DENTIST

1012 IVAL JAMES

BLVD SUITE C


forchildrenky.c

om/Home.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS

ORTHODONTIST 1012 IVAL JAMES

BOULEVARD

RICHMOND KY 40475 859 623 0068 http://www.wg

mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

WELLCARE

486



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

FEE FOR

SERVICE


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

HUMANA


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

WELLCARE


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

COVENTRY


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

FEE FOR

SERVICE

487



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND MAGGARD

ORTHODONTICS


BOULEVARD


mortho.com/H

ome.aspx

WELLCARE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 118 MERIDIAN

WAY SUITE 4

RICHMOND KY 40475 800 929 7733 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


WAY SUITE 4


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


WAY SUITE 4


ortho.com/

WELLCARE

JEFFREY BOWEN BLUEGRASS

PEDIATRIC

DENTISTRY

GENERAL

DENTISTRY

120 MERIDIAN

WAY SUITE 2

RICHMOND KY 40475 859 626 1810 http://www.blu

egrasspediatric

dentistry.com/

COVENTRY


PEDIATRIC

DENTISTRY

GENERAL

DENTISTRY

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

FEE FOR

SERVICE

488



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


PEDIATRIC

DENTISTRY

GENERAL

DENTISTRY

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

WELLCARE

JOHN THOBABEN BLUEGRASS

PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

COVENTRY


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

FEE FOR

SERVICE


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

PASSPORT


PEDIATRIC

DENTISTRY

PEDIATRIC

DENTIST

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

WELLCARE

BLUEGRASS

PEDIATRIC

DENTISTRY

MULTI

SPECIALTY

GROUP

120 MERIDIAN

WAY SUITE 2


egrasspediatric

dentistry.com/

FEE FOR

SERVICE

RODNEY COLEMAN DENTISTRY ON

MAIN

GENERAL

DENTISTRY

1208 WEST MAIN

STREET

RICHMOND KY 40475 859 625 5522 http://www.col

emandentistry.

com/

COVENTRY


MAIN

GENERAL

DENTISTRY

1208 WEST MAIN

STREET


emandentistry.

com/

FEE FOR

SERVICE

489



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MAIN

GENERAL

DENTISTRY

1208 WEST MAIN

STREET


emandentistry.

com/

WELLCARE

MARK STEPHENS SMILES 4U

RICHMOND

GENERAL

DENTISTRY

138 NORTH

KEENLAND

DRIVE SUITE C

RICHMOND KY 40475 859 626 0069 COVENTRY


RICHMOND

GENERAL

DENTISTRY

138 NORTH

KEENLAND

DRIVE SUITE C

RICHMOND KY 40475 859 626 0069 FEE FOR

SERVICE


RICHMOND

GENERAL

DENTISTRY

138 NORTH

KEENLAND

DRIVE SUITE C

RICHMOND KY 40475 859 626 0069 WELLCARE

LESLIE BAECHTOLD LESLIE L

BAECHTOLD DDS

PEDIATRIC

DENTIST

2006 MERCHANT

DRIVE



BAECHTOLD DDS

PEDIATRIC

DENTIST

2006 MERCHANT

DRIVE


SERVICE


BAECHTOLD DDS

PEDIATRIC

DENTIST

2006 MERCHANT

DRIVE


JAMES MURPHY JAMES C MURPHY

DMD

GENERAL

DENTISTRY

201 GERI LANE RICHMOND KY 40475 859 623 8622 COVENTRY


DMD

GENERAL

DENTISTRY

201 GERI LANE RICHMOND KY 40475 859 623 8622 FEE FOR

SERVICE

490



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

201 GERI LANE RICHMOND KY 40475 859 623 8622 WELLCARE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 2130 LEXINGTON

ROAD SUITE D


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


ROAD SUITE D


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


ROAD SUITE D


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


ROAD SUITE D


ortho.com/

WELLCARE

JASON GAMBREL MADISON

DENTAL

ASSOCIATES

GENERAL

DENTISTRY

308 HIGHLAND

PARK DRIVE

RICHMOND KY 40475 859 626 9851 http://madison

da.com/index.h

tml

COVENTRY


DENTAL

ASSOCIATES

GENERAL

DENTISTRY

308 HIGHLAND

PARK DRIVE


da.com/index.h

tml

FEE FOR

SERVICE

491



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL

ASSOCIATES

GENERAL

DENTISTRY

308 HIGHLAND

PARK DRIVE


da.com/index.h

tml

WELLCARE

DENNIS CANTER WHITE

HOUSE

CLINIC

RICHMOND

GENERAL

DENTISTRY

401 HIGHLAND

PARK

RICHMOND KY 40475 859 626 7700 http://www.wh

itehouseclinics

.com/index.ht

m

COVENTRY

DENNIS CANTER WHITE

HOUSE

CLINIC

RICHMOND

GENERAL

DENTISTRY

401 HIGHLAND

PARK


itehouseclinics

.com/index.ht

m

FEE FOR

SERVICE

DENNIS CANTER WHITE

HOUSE

CLINIC

RICHMOND

GENERAL

DENTISTRY

401 HIGHLAND

PARK


itehouseclinics

.com/index.ht

m

WELLCARE


CENTER FOR

ORAL SURGERY

ORAL SURGEON 4097 ATWOOD

DRIVE

RICHMOND KY 40475 859 623 7711 http://www.ke

ntuckyoms.co

m/index.html

COVENTRY


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

492



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

JASON FORD KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

DONALD MAX KENTUCKY

CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

COVENTRY

493



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

HUMANA


CENTER FOR

ORAL SURGERY


DRIVE


ntuckyoms.co

m/index.html

WELLCARE

KENTUCKY

CENTER FOR

ORAL SURGERY

MULTI

SPECIALTY

GROUP

4097 ATWOOD

DRIVE


ntuckyoms.co

m/index.html

FEE FOR

SERVICE

RHONDA CORMNEY RHONDA H

CORMNEY DMD

SPECIALIST IN

ORTHODONTICS

ORTHODONTIST 519 HAMPTON

WAY SUITE 8



CORMNEY DMD

SPECIALIST IN

ORTHODONTICS


WAY SUITE 8


SERVICE

494



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CORMNEY DMD

SPECIALIST IN

ORTHODONTICS


WAY SUITE 8


MARSHALL NEY JR RICHMOND

HEADACHE

CLINIC


STREET

RICHMOND KY 40476 859 623 3761 http://lexingto

nheadacheclini

c.com/

COVENTRY


HEADACHE

CLINIC


STREET


nheadacheclini

c.com/

FEE FOR

SERVICE


HEADACHE

CLINIC


STREET


nheadacheclini

c.com/

WELLCARE

STEPHEN MATTINGLY STEPHEN P

MATTINGLY DMD

GENERAL

DENTISTRY

805 EASTERN

BYPASS SUITE 4

RICHMOND KY 40475 859 623 0222 http://www.ste

vemattinglydm

d.com/

COVENTRY


MATTINGLY DMD

GENERAL

DENTISTRY

805 EASTERN

BYPASS SUITE 4


vemattinglydm

d.com/

FEE FOR

SERVICE


MATTINGLY DMD

GENERAL

DENTISTRY

805 EASTERN

BYPASS SUITE 4


vemattinglydm

d.com/

WELLCARE

495



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

LISA DEAN BELLEFONTE

FAMILY DENTAL

CARE

GENERAL

DENTISTRY

1592 DIEDERICH

BLVD

RUSSELL KY 41169 606 836 9962 COVENTRY


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

1592 DIEDERICH

BLVD

RUSSELL KY 41169 606 836 9962 FEE FOR

SERVICE


FAMILY DENTAL

CARE

GENERAL

DENTISTRY

1592 DIEDERICH

BLVD

RUSSELL KY 41169 606 836 9962 WELLCARE

JERRY MAYER JERRY MAYER

DMD

ORAL SURGEON 400 SAINT

CHRISTOPHER

DRIVE

RUSSELL KY 41169 606 833 0303 COVENTRY


DMD


CHRISTOPHER

DRIVE

RUSSELL KY 41169 606 833 0303 FEE FOR

SERVICE


DMD


CHRISTOPHER

DRIVE

RUSSELL KY 41169 606 833 0303 WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5

RUSSELL SPRINGS KY 42642 270 866 8891 http://www.sm

ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE

496



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

PASSPORT


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

COVENTRY

497



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

COVENTRY

498



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

2289 LAKEWAY

DRIVE HIGHWAY

27 SUITE 5


ilesouthky.com

/

WELLCARE

ROBERT GRIPPE GRIPPE FAMILY

DENTISTRY

GENERAL

DENTISTRY

458 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 7222 COVENTRY


DENTISTRY

GENERAL

DENTISTRY

458 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 7222 FEE FOR

SERVICE

499



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

458 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 7222 WELLCARE

HENRY SMITH SMITH AND

SMITH

GENERAL

DENTISTRY

519 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 3560 COVENTRY


SMITH

GENERAL

DENTISTRY

519 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 3560 FEE FOR

SERVICE


SMITH

GENERAL

DENTISTRY

519 MAIN

STREET

RUSSELL SPRINGS KY 42642 270 866 3560 WELLCARE


CENTER OR ORAL

AND IMPLANT

SURGERY


SUMMER

STREET

RUSSELLVILLE KY 42275 270 726 6008 http://www.ed

yeesturgill.co

m/index.html

COVENTRY


CENTER OR ORAL

AND IMPLANT

SURGERY


SUMMER

STREET


yeesturgill.co

m/index.html

FEE FOR

SERVICE


CENTER OR ORAL

AND IMPLANT

SURGERY


SUMMER

STREET


yeesturgill.co

m/index.html

WELLCARE

DALE CLARK DALE W CLARK

FAMILY

DENTISTRY

GENERAL

DENTISTRY

204 EAST 4TH

STREET

RUSSELLVILLE KY 42276 270 726 7511 COVENTRY

500



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY

DENTISTRY

GENERAL

DENTISTRY

204 EAST 4TH

STREET

RUSSELLVILLE KY 42276 270 726 7511 FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

204 EAST 4TH

STREET

RUSSELLVILLE KY 42276 270 726 7511 WELLCARE

PAUL KERR PAUL N KERR

DMD

GENERAL

DENTISTRY

64 SHELTON

LANE

RUSSELLVILLE KY 42276 270 726 9595 http://www.drp

aulkerr.com/

COVENTRY


DMD

GENERAL

DENTISTRY

64 SHELTON

LANE


aulkerr.com/

FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

64 SHELTON

LANE


aulkerr.com/

WELLCARE

BETH RATLIFF RATLIFF AND

RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT

SALYERSVILLE KY 41465 606 349 2812 COVENTRY


RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT

SALYERSVILLE KY 41465 606 349 2812 FEE FOR

SERVICE


RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT

SALYERSVILLE KY 41465 606 349 2812 WELLCARE

JAMES RATLIFF II RATLIFF AND

RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT


501



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT


SERVICE


RATLIFF

GENERAL

DENTISTRY

128 CARDINAL

COURT


RICHARD CONNELLY CONNELLY AND

HIGGINS

GENERAL

DENTISTRY

761 PARKWAY

DRIVE



HIGGINS

GENERAL

DENTISTRY

761 PARKWAY

DRIVE


SERVICE


HIGGINS

GENERAL

DENTISTRY

761 PARKWAY

DRIVE


HOWARD HIGGINS CONNELLY AND

HIGGINS

GENERAL

DENTISTRY

761 PARKWAY

DRIVE


BIG SANDY

HEALTH

CARE HOPE

FAMILY

MEDICAL

CENTER

MEDICAL CLINIC 835 PARKWAY

DRIVE

SALYERSVILLE KY 41653 606 349 5126 http://www.bs

hc.org/

COVENTRY

BIG SANDY

HEALTH

CARE HOPE

FAMILY

MEDICAL

CENTER


DRIVE


hc.org/

FEE FOR

SERVICE

502



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

BIG SANDY

HEALTH

CARE HOPE

FAMILY

MEDICAL

CENTER


DRIVE


hc.org/

WELLCARE

TABATHA ADAMS TABATHA M

ADAMS DMD PSC

GENERAL

DENTISTRY

912 EAST

MOUNTAIN

PARKWAY



ADAMS DMD PSC

GENERAL

DENTISTRY

912 EAST

MOUNTAIN

PARKWAY


SERVICE


ADAMS DMD PSC

GENERAL

DENTISTRY

912 EAST

MOUNTAIN

PARKWAY


KIMBERLY BUCKNER DENTAL CLINIC GENERAL

DENTISTRY

HIGHWAY 7 AND

32

SANDY HOOK KY 41171 606 738 5545 COVENTRY


DENTISTRY

HIGHWAY 7 AND

32

SANDY HOOK KY 41171 606 738 5545 FEE FOR

SERVICE


DENTISTRY

HIGHWAY 7 AND

32

SANDY HOOK KY 41171 606 738 5545 WELLCARE

JAMES HUNTSMAN HUNTSMAN AND

MARSH

GENERAL

DENTISTRY

199 WEST MAIN

STREET

SCOTTSVILLE KY 42164 270 237 3655 COVENTRY

JAMES HUNTSMAN HUNTSMAN AND

MARSH

GENERAL

DENTISTRY

199 WEST MAIN

STREET

SCOTTSVILLE KY 42164 270 237 3655 FEE FOR

SERVICE

ANTHONY BROWNING VICCO DENTAL

CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 COVENTRY

503



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 WELLCARE

SANDRA BROWNING VICCO DENTAL

CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 COVENTRY


CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 FEE FOR

SERVICE


CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 WELLCARE

VICCO DENTAL

CENTER

GENERAL

DENTISTRY

35 LONGFIELD

CIRCLE

SCUDDY KY 41773 606 476 8121 FEE FOR

SERVICE

REBECCA WERNER DR WERNER

DENTAL SPA

GENERAL

DENTISTRY

1038

WASHINGTON

STREET

SHELBYVILLE KY 40065 502 633 9733 http://www.she

lbyvillekydenti

st.com/

COVENTRY


DENTAL SPA

GENERAL

DENTISTRY

1038

WASHINGTON

STREET


lbyvillekydenti

st.com/

FEE FOR

SERVICE


DENTAL SPA

GENERAL

DENTISTRY

1038

WASHINGTON

STREET


lbyvillekydenti

st.com/

HUMANA


DENTAL SPA

GENERAL

DENTISTRY

1038

WASHINGTON

STREET


lbyvillekydenti

st.com/

PASSPORT

504



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JESSICA EUGENIO MORTENSON

FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101

SHELBYVILLE KY 40065 502 633 1584 http://mortenso

ndental.com/D

efault.asp

COVENTRY


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/D

efault.asp

WELLCARE

AMANDA JACKSON MORTENSON

FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/de

fault.asp

FEE FOR

SERVICE

505



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

SHELBYVILLE

GENERAL

DENTISTRY

130 STONECREST

ROAD SUITE 101


ndental.com/de

fault.asp

WELLCARE

KIRBY HOETKER PEDIATRIC

DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD

SHELBYVILLE KY 40065 502 633 4441 http://www.do

ctorkirby.com/

index.html

COVENTRY


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

FEE FOR

SERVICE


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

HUMANA


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

PASSPORT

506



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

WELLCARE

BRIGID WICKSON PEDIATRIC

DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

COVENTRY


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

FEE FOR

SERVICE


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

HUMANA


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

PASSPORT


DENTISTRY OF

SHELBYVILLE

PEDIATRIC

DENTIST

141 STONECREST

ROAD


ctorkirby.com/

index.html

WELLCARE

PEDIATRIC

DENTISTRY OF

SHELBYVILLE

MULTI

SPECIALTY

GROUP

141 STONECREST

ROAD


ctorkirby.com/

index.html

FEE FOR

SERVICE

507



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PEDIATRIC

DENTISTRY OF

SHELBYVILLE

MULTI

SPECIALTY

GROUP

141 STONECREST

ROAD


ctorkirby.com/

index.html

PASSPORT


BRACES

SHELBYVILLE

ORTHODONTIST 1415 MAIN

STREET

SHELBYVILLE KY 40065 502 633 4613 http://bracesbr

acesbraces.co

m/index.php

COVENTRY


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

HUMANA


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

PASSPORT


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

WELLCARE


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

COVENTRY

508



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

FEE FOR

SERVICE


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

HUMANA


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

PASSPORT


BRACES

SHELBYVILLE


STREET


acesbraces.co

m/index.php

WELLCARE

JEREMY FAIRBOURN FAIRBOURN

FAMILY

DENTISTRY

GENERAL

DENTISTRY

207 ALPINE

DRIVE SUITE A

SHELBYVILLE KY 40065 502 633 3900 http://www.fai

rbourndentistr

y.com/

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

207 ALPINE

DRIVE SUITE A


rbourndentistr

y.com/

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

207 ALPINE

DRIVE SUITE A


rbourndentistr

y.com/

PASSPORT


FAMILY DENTAL

SHELBYVILLE

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/D

efault.asp

COVENTRY

509



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

SHELBYVILLE

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

SHELBYVILLE

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

SHELBYVILLE

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

SHELBYVILLE

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/D

efault.asp

WELLCARE


FAMILY DENTAL

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/de

fault.asp

HUMANA

510



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

EAST

GENERAL

DENTISTRY

502 MOUNT

EDEN ROAD


ndental.com/de

fault.asp

WELLCARE


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200

SHELBYVILLE KY 40065 502 633 1819 COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200

SHELBYVILLE KY 40065 502 633 1819 FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200

SHELBYVILLE KY 40065 502 633 1819 HUMANA


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200

SHELBYVILLE KY 40065 502 633 1819 PASSPORT


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200

SHELBYVILLE KY 40065 502 633 1819 WELLCARE


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


511



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


SERVICE


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200



DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


JENNIFER MAPLE BRIGHT SMILE

DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200



DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


SERVICE


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200



DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


512



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

60 STONECREST

COURT SUITE

200


SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

GENERAL

DENTISTRY

PRACTICE

60 STONECREST

COURT SUITE

200


SERVICE

SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

GENERAL

DENTISTRY

PRACTICE

60 STONECREST

COURT SUITE

200


SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

GENERAL

DENTISTRY

PRACTICE

60 STONECREST

COURT SUITE

200


SARA PAIGE

TROMBETTI

BRIGHT SMILE

DENTAL CARE

GENERAL

DENTISTRY

PRACTICE

60 STONECREST

COURT SUITE

200


CHRISTINA WHITSETT MAIN STREET

DENTAL

GENERAL

DENTISTRY

706 MAIN

STREET

SHELBYVILLE KY 40065 502 633 4196 http://www.ma

instreetdmd.co

m/home.html

FEE FOR

SERVICE

CHRISTINA WHITSETT MAIN STREET

DENTAL

GENERAL

DENTISTRY

706 MAIN

STREET

SHELBYVILLE KY 40065 502 633 4196 http://www.ma

instreetdmd.co

m/home.html

HUMANA

513



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JERA REDMAN

OWENS

MORTENSON

FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST

SHEPERDSVILLE KY 40165 502 543 2278 http://mortenso

ndental.com/

COVENTRY

JERA REDMAN

OWENS

MORTENSON

FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

FEE FOR

SERVICE

JERA REDMAN

OWENS

MORTENSON

FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

HUMANA

JERA REDMAN

OWENS

MORTENSON

FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

PASSPORT

JERA REDMAN

OWENS

MORTENSON

FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

WELLCARE


FAMILY DENTAL

SHEPHERDVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/D

efault.asp

COVENTRY

514



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

SHEPHERDVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/D

efault.asp

FEE FOR

SERVICE


FAMILY DENTAL

SHEPHERDVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/D

efault.asp

HUMANA


FAMILY DENTAL

SHEPHERDVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/D

efault.asp

PASSPORT


FAMILY DENTAL

SHEPHERDVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/D

efault.asp

WELLCARE


BRACES

SHEPARDSVILLE

ORTHODONTIST 111 LEES

VALLEY ROAD

SHEPHERDSVILLE KY 40165 502 531 9339 http://bracesbr

acesbraces.co

m/

COVENTRY


BRACES

SHEPARDSVILLE


VALLEY ROAD


acesbraces.co

m/

FEE FOR

SERVICE

515



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BRACES

SHEPARDSVILLE


VALLEY ROAD


acesbraces.co

m/

HUMANA


BRACES

SHEPARDSVILLE


VALLEY ROAD


acesbraces.co

m/

PASSPORT


BRACES

SHEPARDSVILLE


VALLEY ROAD


acesbraces.co

m/

WELLCARE


FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST

SHEPHERDSVILLE KY 40165 502 955 7102 http://mortenso

ndental.com/

COVENTRY


FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

FEE FOR

SERVICE


FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

HUMANA

516



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

PASSPORT


FAMILY DENTAL

SHEPARDSVILLE

GENERAL

DENTISTRY

1746 HIGHWAY

44 EAST


ndental.com/

WELLCARE

JING JING ZHANG NORTH BULLITT

FAMILY DENTAL

GENERAL

DENTISTRY

3564 WILLOW

WAY

SHEPHERDSVILLE KY 40165 502 955 1606 http://northbull

ittfamilydental.

com/staff/

COVENTRY


FAMILY DENTAL

GENERAL

DENTISTRY

3564 WILLOW

WAY


ittfamilydental.

com/staff/

FEE FOR

SERVICE


FAMILY DENTAL

GENERAL

DENTISTRY

3564 WILLOW

WAY


ittfamilydental.

com/staff/

HUMANA


FAMILY DENTAL

GENERAL

DENTISTRY

3564 WILLOW

WAY


ittfamilydental.

com/staff/

PASSPORT


FAMILY DENTAL

GENERAL

DENTISTRY

3564 WILLOW

WAY


ittfamilydental.

com/staff/

WELLCARE

517



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


FAMILY DENTAL

SIMPSONVILLE

GENERAL

DENTISTRY

137 BUCK CREEK

ROAD

SIMPSONVILLE KY 40067 502 496 0002 http://mortenso

ndental.com/de

fault.asp

COVENTRY


FAMILY DENTAL

SIMPSONVILLE

GENERAL

DENTISTRY

137 BUCK CREEK

ROAD


ndental.com/de

fault.asp

FEE FOR

SERVICE


FAMILY DENTAL

SIMPSONVILLE

GENERAL

DENTISTRY

137 BUCK CREEK

ROAD


ndental.com/de

fault.asp

HUMANA


FAMILY DENTAL

SIMPSONVILLE

GENERAL

DENTISTRY

137 BUCK CREEK

ROAD


ndental.com/de

fault.asp

PASSPORT


FAMILY DENTAL

SIMPSONVILLE

GENERAL

DENTISTRY

137 BUCK CREEK

ROAD


ndental.com/de

fault.asp

WELLCARE

HAROLD RALEIGH BLUEGRASS

DENTAL CENTER

GENERAL

DENTISTRY

6912

SHELBYVILLE

ROAD

SIMPSONVILLE KY 40067 502 722 0842 COVENTRY


DENTAL CENTER

GENERAL

DENTISTRY

6912

SHELBYVILLE

ROAD

SIMPSONVILLE KY 40067 502 722 0842 FEE FOR

SERVICE

518



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CENTER

GENERAL

DENTISTRY

6912

SHELBYVILLE

ROAD

SIMPSONVILLE KY 40067 502 722 0842 HUMANA


DENTAL CENTER

GENERAL

DENTISTRY

6912

SHELBYVILLE

ROAD

SIMPSONVILLE KY 40067 502 722 0842 WELLCARE


ORAL HEALTH

CENTER

ORAL SURGEON 141 MAIN

STREET

SMITHS GROVE KY 42171 270 451 0071 http://bgohc.co

m

COVENTRY


ORAL HEALTH

CENTER


STREET


m

FEE FOR

SERVICE


ORAL HEALTH

CENTER


STREET


m

HUMANA


ORAL HEALTH

CENTER


STREET


m

WELLCARE


ORAL HEALTH

CENTER


STREET


m

COVENTRY


ORAL HEALTH

CENTER


STREET


m

FEE FOR

SERVICE

519



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER


STREET


m

HUMANA


ORAL HEALTH

CENTER


STREET


m

WELLCARE


ORAL HEALTH

CENTER


STREET


m

COVENTRY


ORAL HEALTH

CENTER


STREET


m

FEE FOR

SERVICE


ORAL HEALTH

CENTER


STREET


m

HUMANA


ORAL HEALTH

CENTER


STREET


m

WELLCARE


ORAL HEALTH

CENTER

GENERAL

DENTISTRY

141 MAIN

STREET


m

COVENTRY

520



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ORAL HEALTH

CENTER

GENERAL

DENTISTRY

141 MAIN

STREET


m

FEE FOR

SERVICE


ORAL HEALTH

CENTER

GENERAL

DENTISTRY

141 MAIN

STREET


m

HUMANA


ORAL HEALTH

CENTER

GENERAL

DENTISTRY

141 MAIN

STREET


m

WELLCARE

CHARLES BENSON BENSON AND

BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 COVENTRY


BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 FEE FOR

SERVICE


BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 WELLCARE

MARY BENSON BENSON AND

BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 COVENTRY


BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 FEE FOR

SERVICE


BENSON

GENERAL

DENTISTRY

148 VINCENT

STREET

SMITHS GROVE KY 42171 270 563 4819 WELLCARE

521



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

THOMAS TOHILL TOHILL

DENTISTRY

GENERAL

DENTISTRY

101 SARAHS

LANE

SOMERSET KY 42503 606 679 4450 http://www.toh

illdentistry.co

m/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

101 SARAHS

LANE


illdentistry.co

m/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

101 SARAHS

LANE


illdentistry.co

m/

WELLCARE

KATHERINE KING SOMERSET

SMILES

GENERAL

DENTISTRY

110 NORTH

CENTERAL

AVENUE

SOMERSET KY 42502 606 679 1402 http://drkatheri

neking.jimdo.c

om/

COVENTRY

KATHERINE KING SOMERSET

SMILES

GENERAL

DENTISTRY

110 NORTH

CENTERAL

AVENUE

SOMERSET KY 42502 606 679 1402 http://drkatheri

neking.jimdo.c

om/

FEE FOR

SERVICE

CHARLES HIERONYMUS SOMERSET

FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 BARNETT

STREET

SOMERSET KY 42501 606 679 1204 http://www.so

mersetdentistry

.com/index.ht

m

COVENTRY


FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 BARNETT

STREET


mersetdentistry

.com/index.ht

m

FEE FOR

SERVICE


FAMILY

DENTISTRY

GENERAL

DENTISTRY

125 BARNETT

STREET


mersetdentistry

.com/index.ht

m

WELLCARE

SOMERSET

FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

125 BARNETT

STREET


mersetdentistry

.com/index.ht

m

FEE FOR

SERVICE

522



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JAMES MUSE MUSE DENTISTRY GENERAL

DENTISTRY

14 BOGLE

OFFICE PARK

DRIVE

SOMERSET KY 42501 606 678 0579 http://www.drj

immuse.com/

COVENTRY

JAMES MUSE MUSE DENTISTRY GENERAL

DENTISTRY

14 BOGLE

OFFICE PARK

DRIVE

SOMERSET KY 42501 606 678 0579 http://www.drj

immuse.com/

FEE FOR

SERVICE

JEFFREY FISK JEFFREY W FISK

DMD PSC

ORTHODONTIST 221 EAST

SOMERSET

CHURCH ROAD

SOMERSET KY 42503 606 451 1448 COVENTRY

JEFFREY FISK JEFFREY W FISK

DMD PSC

ORTHODONTIST 221 EAST

SOMERSET

CHURCH ROAD

SOMERSET KY 42503 606 451 1448 FEE FOR

SERVICE


NEWCOMB

ORTHODONTICS

ORTHODONTIST 224 LANGDON

STREET

SOMERSET KY 42501 606 451 0771 http://pandnort

ho.com/Home/

tabid/36/Defau

lt.aspx

COVENTRY


NEWCOMB

ORTHODONTICS


STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

FEE FOR

SERVICE


NEWCOMB

ORTHODONTICS


STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

WELLCARE

523



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


NEWCOMB

ORTHODONTICS


STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

COVENTRY


NEWCOMB

ORTHODONTICS


STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

FEE FOR

SERVICE


NEWCOMB

ORTHODONTICS


STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

WELLCARE

PETRY AND

NEWCOMB

ORTHODONTICS

MULTI

SPECIALTY

GROUP

224 LANGDON

STREET


ho.com/Home/

tabid/36/Defau

lt.aspx

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

29 EURY LANE SOMERSET KY 42501 606 678 8881 http://www.sm

ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE

524



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE

525



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY


ilesouthky.com

/

WELLCARE

HENRY COFFEY HENRY D COFFEY

DMD

GENERAL

DENTISTRY

313 LANGDON

STREET



DMD

GENERAL

DENTISTRY

313 LANGDON

STREET


SERVICE


DMD

GENERAL

DENTISTRY

313 LANGDON

STREET

SOMERSET KY 42503 606 679 7419 WELLCARE

DARRELL BARTLEY JR DARRELL

BARTLEY JR PSC

GENERAL

DENTISTRY

341 BOGLE

STREET SUITE D


DARRELL BARTLEY JR DARRELL

BARTLEY JR PSC

GENERAL

DENTISTRY

341 BOGLE

STREET SUITE D


SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27


526



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27


SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27



COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27



COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27


SERVICE


COSMETIC AND

FAMILY DENTAL

PLLC

GENERAL

DENTISTRY

3876 SOUTH

HIGHWAY 27


JOHN STROUD BLUEGRASS

DENTURE

CENTER

GENERAL

DENTISTRY

44 OFFICE PARK

DRIVE SUITE 2



DENTURE

CENTER

GENERAL

DENTISTRY

44 OFFICE PARK

DRIVE SUITE 2


SERVICE

527



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTURE

CENTER

GENERAL

DENTISTRY

44 OFFICE PARK

DRIVE SUITE 2


BRANDI PRATHER BRANDI PRATHER

DMD PSC

PEDIATRIC

DENTIST

47 SARAHS LANE SOMERSET KY 42503 606 679 5437 COVENTRY


DMD PSC

PEDIATRIC

DENTIST

47 SARAHS LANE SOMERSET KY 42503 606 679 5437 FEE FOR

SERVICE


DMD PSC

PEDIATRIC

DENTIST

47 SARAHS LANE SOMERSET KY 42503 606 679 5437 WELLCARE

GINA SAINDON SAINDON AND

SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET

SOMERSET KY 42501 606 679 9289 http://saindonf

amilydentistry.

com/

COVENTRY


SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET


amilydentistry.

com/

FEE FOR

SERVICE


SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET


amilydentistry.

com/

WELLCARE

JAMES SAINDON SAINDON AND

SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET


amilydentistry.

com/

COVENTRY

528



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET


amilydentistry.

com/

FEE FOR

SERVICE


SANDON FAMILY

DENTISTRY

GENERAL

DENTISTRY

501 COLLEGE

STREET


amilydentistry.

com/

WELLCARE

SAINDON AND

SANDON FAMILY

DENTISTRY

MULTI

SPECIALTY

GROUP

501 COLLEGE

STREET


amilydentistry.

com/

FEE FOR

SERVICE

GREGORY BINDER CUMBERLAND

DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE



DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


SERVICE


DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


ROBERT GRIPPE CUMBERLAND

DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE



DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


SERVICE


DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


ANNELEE JAYME CUMBERLAND

DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE



DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


SERVICE


DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


529



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JOHN STROUD CUMBERLAND

DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE



DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


SERVICE


DENTAL

GENERAL

DENTISTRY

54 IMAGING

DRIVE


CUMBERLAND

DENTAL

MULTI

SPECIALTY

GROUP

54 IMAGING

DRIVE


SERVICE

BENNIE ALDERDICE BEN ALDERDICE

DMD

ORAL SURGEON CUMBERLAND

MEDICAL PLAZA

100 HARDIN

LANE SUITE B



DMD


MEDICAL PLAZA

100 HARDIN

LANE SUITE B


SERVICE


DMD


MEDICAL PLAZA

100 HARDIN

LANE SUITE B


530



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

NICK ENGLAND JR NICK A ENGLAND

JR DMD

GENERAL

DENTISTRY

534 CENTRAL

AVENUE

SOUTH

WILLIAMSON

KY 41503 606 237 4750 COVENTRY


JR DMD

GENERAL

DENTISTRY

534 CENTRAL

AVENUE

SOUTH

WILLIAMSON

KY 41503 606 237 4750 FEE FOR

SERVICE


JR DMD

GENERAL

DENTISTRY

534 CENTRAL

AVENUE

SOUTH

WILLIAMSON

KY 41503 606 237 4750 WELLCARE

TIFFINEY DUNCAN TIFFINEY TODD

DUNCAN DMD

GENERAL

DENTISTRY

401 SOUTHSIDE

DRIVE

SOUTH

WILLIAMSON

KY 41503 606 237 0073 FEE FOR

SERVICE

TIFFINEY DUNCAN TIFFINEY TODD

DUNCAN DMD

GENERAL

DENTISTRY

401 SOUTHSIDE

DRIVE

SOUTH

WILLIAMSON

KY 41503 606 237 0073 WELLCARE

DON FLOWERS JR DON K FLOWERS

JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE

SPRINGFIELD KY 40069 859 336 7701 http://www.drd

onflowers.com

/

COVENTRY


JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE


onflowers.com

/

FEE FOR

SERVICE


JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE


onflowers.com

/

HUMANA

531



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE


onflowers.com

/

PASSPORT


JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE


onflowers.com

/

WELLCARE

DON K FLOWERS

JR DMD PSC

GENERAL

DENTISTRY

108

COMMERCIAL

AVENUE


onflowers.com

/

FEE FOR

SERVICE

BENJAMIN SMITH BENJAMIN R

SMITH DMD

GENERAL

DENTISTRY

207 LINCOLN

PARK ROAD

SPRINGFIELD KY 40069 859 336 3330 FEE FOR

SERVICE

BENJAMIN SMITH BENJAMIN R

SMITH DMD

GENERAL

DENTISTRY

207 LINCOLN

PARK ROAD

SPRINGFIELD KY 40069 859 336 3330 HUMANA

JOHN ISAACS ISAACS AND

ISAACS

GENERAL

DENTISTRY

39 BOBOLINK

DRIVE

SPRINGFIELD KY 40069 859 336 7680 COVENTRY


ISAACS

GENERAL

DENTISTRY

40 BOBOLINK

DRIVE

SPRINGFIELD KY 40069 859 336 7680 FEE FOR

SERVICE


ISAACS

GENERAL

DENTISTRY

41 BOBOLINK

DRIVE

SPRINGFIELD KY 40069 859 336 7680 HUMANA

532



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


ISAACS

GENERAL

DENTISTRY

42 BOBOLINK

DRIVE

SPRINGFIELD KY 40069 859 336 7680 WELLCARE

JOHN LAIR JOHN S LAIR DMD GENERAL

DENTISTRY

603

LANDCASTER

STREET

STANFORD KY 40484 606 365 7803 COVENTRY


DENTISTRY

603

LANDCASTER

STREET

STANFORD KY 40484 606 365 7803 FEE FOR

SERVICE


DENTISTRY

603

LANDCASTER

STREET

STANFORD KY 40484 606 365 7803 WELLCARE

GARY THOMPSON GARY M

THOMPSON DMD

GENERAL

DENTISTRY

131 NORTH MAIN

STREET

STANTON KY 40380 606 663 2133 COVENTRY


THOMPSON DMD

GENERAL

DENTISTRY

131 NORTH MAIN

STREET

STANTON KY 40380 606 663 2133 FEE FOR

SERVICE


THOMPSON DMD

GENERAL

DENTISTRY

131 NORTH MAIN

STREET

STANTON KY 40380 606 663 2133 WELLCARE

KEMBER HEINE KEMBER HEINE

DDS

GENERAL

DENTISTRY

1107 NORTH

MAIN STREET

STURGIS KY 42459 270 333 4030 COVENTRY


DDS

GENERAL

DENTISTRY

1107 NORTH

MAIN STREET

STURGIS KY 42459 270 333 4030 FEE FOR

SERVICE


DDS

GENERAL

DENTISTRY

1107 NORTH

MAIN STREET

STURGIS KY 42459 270 333 4030 WELLCARE

533



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC

MEDICAL CLINIC 311 REASOR

AVENUE

TAYLORSVILLE KY 40071 502 774 4401 http://www.pd

chc.org/

COVENTRY

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

FEE FOR

SERVICE

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

HUMANA

PARK

DUVALLE

COMMUNITY

HEALTH

CENTER INC


AVENUE


chc.org/

PASSPORT

CYNTHIA BURROUGHS CYNTHIA B

BURROUGHS DMD

GENERAL

DENTISTRY

101 WEST 4TH

STREET

TOMPKINSVILLE KY 42167 270 487 5545 COVENTRY


BURROUGHS DMD

GENERAL

DENTISTRY

101 WEST 4TH

STREET

TOMPKINSVILLE KY 42167 270 487 5545 FEE FOR

SERVICE

534



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


BURROUGHS DMD

GENERAL

DENTISTRY

101 WEST 4TH

STREET

TOMPKINSVILLE KY 42167 270 487 5545 WELLCARE

GREGORY CRABTREE GREGORY K

CRABTREE DMD

GENERAL

DENTISTRY

103 EAST 2ND

STREET



CRABTREE DMD

GENERAL

DENTISTRY

103 EAST 2ND

STREET


SERVICE


CRABTREE DMD

GENERAL

DENTISTRY

103 EAST 2ND

STREET


GORDON MCALPIN GORDON W

MCALPIN DMD

GENERAL

DENTISTRY

110 NORTH MAIN

STREET



MCALPIN DMD

GENERAL

DENTISTRY

110 NORTH MAIN

STREET


SERVICE


MCALPIN DMD

GENERAL

DENTISTRY

110 NORTH MAIN

STREET


JOHN PAGE JOHN D PAGE

DMD

GENERAL

DENTISTRY

204 WEST PAIGE

STREET



DMD

GENERAL

DENTISTRY

204 WEST PAIGE

STREET


SERVICE


DMD

GENERAL

DENTISTRY

204 WEST PAIGE

STREET


535



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

REBECCA GREER REBECCA GREER

DMD

GENERAL

DENTISTRY

42 EXECUTIVE

DRIVE



DMD

GENERAL

DENTISTRY

42 EXECUTIVE

DRIVE


SERVICE


DMD

GENERAL

DENTISTRY

42 EXECUTIVE

DRIVE


CRYSTAL HAGAN ALL SMILES

DENTAL CARE

GENERAL

DENTISTRY

449 CAPP

HARLAN ROAD

TOMPKINSVILLE KY 42167 270 487 0017 http://www.cry

stalhagan.com/

COVENTRY


DENTAL CARE

GENERAL

DENTISTRY

449 CAPP

HARLAN ROAD


stalhagan.com/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

449 CAPP

HARLAN ROAD


stalhagan.com/

WELLCARE

PRIMARY

PLUS

VANCEBURG

MEDICAL CLINIC 211 KY 59 VANCEBURG KY 41179 606 796 9511 http://www.pri

maryplus.net/s

ervices/dental/

COVENTRY

PRIMARY

PLUS

VANCEBURG


maryplus.net/s

ervices/dental/

FEE FOR

SERVICE

PRIMARY

PLUS

VANCEBURG


maryplus.net/s

ervices/dental/

WELLCARE

536



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

JILL PRICE JILL PRICE DMD GENERAL

DENTISTRY

PRACTIONER

48 ASHBROOK

DRIVE

VANCEBURG KY 41179 606 849 1999 COVENTRY


DENTISTRY

PRACTIONER

48 ASHBROOK

DRIVE

VANCEBURG KY 41179 606 849 1999 FEE FOR

SERVICE


DENTISTRY

PRACTIONER

48 ASHBROOK

DRIVE

VANCEBURG KY 41179 606 849 1999 WELLCARE

JOHN OCULL JOHN D OCULL

DENTISTRY PSC

GENERAL

DENTISTRY

570

CLARKSBURG

ROAD

VANCEBURG KY 41179 606 796 3811 COVENTRY


DENTISTRY PSC

GENERAL

DENTISTRY

570

CLARKSBURG

ROAD


SERVICE


DENTISTRY PSC

GENERAL

DENTISTRY

570

CLARKSBURG

ROAD

VANCEBURG KY 41179 606 796 3811 WELLCARE

JOHN D OCULL

DENTISTRY PSC

GENERAL

DENTISTRY

570

CLARKSBURG

ROAD


SERVICE

RONALD MAYS MAYES AND

MAYES

GENERAL

DENTISTRY

76 2ND STREET VANCEBURG KY 41179 606 796 2328 COVENTRY

537



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


MAYES

GENERAL

DENTISTRY

76 2ND STREET VANCEBURG KY 41179 606 796 2328 FEE FOR

SERVICE


MAYES

GENERAL

DENTISTRY

76 2ND STREET VANCEBURG KY 41179 606 796 2328 WELLCARE

ERIC QUILLEN QUILLEN

ORTHODONTICS

ORTHODONTIST 156 FRANKFORT

STREET

VERSAILLES KY 40383 859 879 5045 http://www.qui

llenorthodontic

s.com/

COVENTRY


ORTHODONTICS


STREET


llenorthodontic

s.com/

FEE FOR

SERVICE


ORTHODONTICS


STREET


llenorthodontic

s.com/

WELLCARE

HARRY WATTS HARRY M WATTS

DMD

GENERAL

DENTISTRY

210 CROSSFIELD

DRIVE

VERSAILLES KY 40383 859 873 7101 COVENTRY


DMD

GENERAL

DENTISTRY

210 CROSSFIELD

DRIVE

VERSAILLES KY 40383 859 873 7101 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

210 CROSSFIELD

DRIVE

VERSAILLES KY 40383 859 873 7101 WELLCARE


DENTAL CARE

GENERAL

DENTISTRY

30 NORTH MAIN

STREET

WALTON KY 41094 859 485 4131 http://www.pre

cisiondentalky.

com/home/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

30 NORTH MAIN

STREET


cisiondentalky.

com/home/

WELLCARE


DENTAL CARE

GENERAL

DENTISTRY

30 NORTH MAIN

STREET


cisiondentalky.

com/home/

COVENTRY

538



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTAL CARE

GENERAL

DENTISTRY

30 NORTH MAIN

STREET


cisiondentalky.

com/home/

FEE FOR

SERVICE


DENTAL CARE

GENERAL

DENTISTRY

30 NORTH MAIN

STREET


cisiondentalky.

com/home/

WELLCARE

WALTER BLEVINS JR BLEVINS DENTAL GENERAL

DENTISTRY

777 BROADWAY

STREET

WEST LIBERTY KY 41472 606 743 1212 http://blevinsd

ental.yolasite.c

om/

COVENTRY


DENTISTRY

777 BROADWAY

STREET


ental.yolasite.c

om/

FEE FOR

SERVICE


DENTISTRY

777 BROADWAY

STREET


ental.yolasite.c

om/

WELLCARE

LEIGH GUNNELL LEIGH GUNNELL

DMD

GENERAL

DENTISTRY

903 MAIN

STREET

WEST LIBERTY KY 41472 606 743 7480 COVENTRY


DMD

GENERAL

DENTISTRY

903 MAIN

STREET

WEST LIBERTY KY 41472 606 743 7480 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

903 MAIN

STREET

WEST LIBERTY KY 41472 606 743 7480 WELLCARE

ROBERT HENDERSON ROBERT L

HENDERSON DMD

GENERAL

DENTISTRY

903 MAIN

STREET

WEST LIBERTY KY 41472 606 743 7480 COVENTRY


HENDERSON DMD

GENERAL

DENTISTRY

903 MAIN

STREET


SERVICE

539



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


HENDERSON DMD

GENERAL

DENTISTRY

903 MAIN

STREET

WEST LIBERTY KY 41472 606 743 7480 WELLCARE

ROBERT L

HENDERSON DMD

MULTI

SPECIALTY

GROUP

903 MAIN

STREET


SERVICE

KEVIN ROARK FAMILY DENTAL

OFFICE

GENERAL

DENTISTRY

172 PARKWAY

PLAZA LOOP

WHITESBURG KY 41858 606 633 4251 COVENTRY


OFFICE

GENERAL

DENTISTRY

172 PARKWAY

PLAZA LOOP

WHITESBURG KY 41858 606 633 4251 FEE FOR

SERVICE


OFFICE

GENERAL

DENTISTRY

172 PARKWAY

PLAZA LOOP

WHITESBURG KY 41858 606 633 4251 WELLCARE

MOUNTAIN

COMPREHEN

SIVE HEALTH

CORPORATIO

N

MEDICAL CLINIC 226 MEDICAL

PLAZA LANE

WHITESBURG KY 41858 606 633 4823 http://www.mo

untaincompreh

ensivehealth.c

om/index.html

COVENTRY

MOUNTAIN

COMPREHEN

SIVE HEALTH

CORPORATIO

N


PLAZA LANE


untaincompreh

ensivehealth.c

om/index.html

FEE FOR

SERVICE

540



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MOUNTAIN

COMPREHEN

SIVE HEALTH

CORPORATIO

N


PLAZA LANE


untaincompreh

ensivehealth.c

om/index.html

PASSPORT

MOUNTAIN

COMPREHEN

SIVE HEALTH

CORPORATIO

N


PLAZA LANE


untaincompreh

ensivehealth.c

om/index.html

WELLCARE

DAVID NARRAMORE DAVID A

NARRAMORE

DMD PSC

GENERAL

DENTISTRY

353 MAIN

STREET

WHITESBURG KY 41858 606 633 4854 COVENTRY


NARRAMORE

DMD PSC

GENERAL

DENTISTRY

353 MAIN

STREET

WHITESBURG KY 41858 606 633 4854 FEE FOR

SERVICE


NARRAMORE

DMD PSC

GENERAL

DENTISTRY

353 MAIN

STREET

WHITESBURG KY 41858 606 633 4854 WELLCARE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE

WHITLEY CITY KY 42653 606 376 5055 http://www.sm

ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE

541



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

COVENTRY

542



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

COVENTRY


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE


DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

WELLCARE

ASSOCIATES IN

DENTISTRY

GENERAL

DENTISTRY

54 MEDICAL

LANE


ilesouthky.com

/

FEE FOR

SERVICE

JOHN MOUNTJOY JOHN MOUNTJOY

DMD

GENERAL

DENTISTRY

212 NORTH 4TH

STREET

WILLIAMSBURG KY 40769 606 549 2344 COVENTRY


DMD

GENERAL

DENTISTRY

212 NORTH 4TH

STREET

WILLIAMSBURG KY 40769 606 549 2344 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

212 NORTH 4TH

STREET

WILLIAMSBURG KY 40769 606 549 2344 WELLCARE

JOHN JEFFRIES JOHN A JEFFRIES

DMD

GENERAL

DENTISTRY

317 MAIN

STREET


543



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DMD

GENERAL

DENTISTRY

317 MAIN

STREET


SERVICE


DMD

GENERAL

DENTISTRY

317 MAIN

STREET


ELBERT L BALLOU ELBERT L

BALLOU DDS

GENERAL

DENTISTRY

432 MAIN

STREET


ELBERT L BALLOU ELBERT L

BALLOU DDS

GENERAL

DENTISTRY

432 MAIN

STREET


SERVICE

CAROLINE BROWN FAMILY

DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST



DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST


SERVICE


DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST


MICHAEL SMITH FAMILY

DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST



DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST


SERVICE


DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST


FAMILY

DENTISTRY

GENERAL

DENTISTRY

821 SOUTH

HIGHWAY 25

WEST


SERVICE

544



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

DAVID ISON OUCHLESS

DENTAL

GENERAL

DENTISTRY

111 HUMES

RIDGE ROAD

WILLIAMSTOWN KY 41097 859 823 1811 COVENTRY

DAVID ISON OUCHLESS

DENTAL

GENERAL

DENTISTRY

111 HUMES

RIDGE ROAD

WILLIAMSTOWN KY 41097 859 823 1811 FEE FOR

SERVICE

DAVID ISON OUCHLESS

DENTAL

GENERAL

DENTISTRY

111 HUMES

RIDGE ROAD

WILLIAMSTOWN KY 41097 859 823 1811 WELLCARE

OUCHLESS

DENTAL

GENERAL

DENTISTRY

111 HUMES

RIDGE ROAD

WILLIAMSTOWN KY 41097 859 823 1811 COVENTRY

OUCHLESS

DENTAL

GENERAL

DENTISTRY

111 HUMES

RIDGE ROAD

WILLIAMSTOWN KY 41097 859 823 1811 FEE FOR

SERVICE

DAVID MURPHY DAVID A MURPHY

DMD

GENERAL

DENTISTRY

113 EAST MAIN

STREET

WILMORE KY 40390 606 858 3335 COVENTRY


DMD

GENERAL

DENTISTRY

113 EAST MAIN

STREET

WILMORE KY 40390 606 858 3335 FEE FOR

SERVICE


DMD

GENERAL

DENTISTRY

113 EAST MAIN

STREET

WILMORE KY 40390 606 858 3335 WELLCARE

TIM CRISP TIM F CRISP DMD GENERAL

DENTISTRY

11 CANARY

LANE

WINCHESTER KY 40391 859 744 7031 COVENTRY


DENTISTRY

11 CANARY

LANE

WINCHESTER KY 40391 859 744 7031 FEE FOR

SERVICE


DENTISTRY

11 CANARY

LANE

WINCHESTER KY 40391 859 744 7031 HUMANA

545



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

11 CANARY

LANE

WINCHESTER KY 40391 859 744 7031 WELLCARE

TIM F CRISP DMD GENERAL

DENTISTRY

11 CANARY

LANE


TIM F CRISP DMD GENERAL

DENTISTRY

11 CANARY

LANE


SERVICE

TAMMY MCCORD TAMMY P

MCCORD DMD

GENERAL

DENTISTRY

122

PROFESSIONAL

AVENUE



MCCORD DMD

GENERAL

DENTISTRY

122

PROFESSIONAL

AVENUE


SERVICE


MCCORD DMD

GENERAL

DENTISTRY

122

PROFESSIONAL

AVENUE



MCCORD DMD

GENERAL

DENTISTRY

122

PROFESSIONAL

AVENUE


JAMES OAKS OAKS DENTAL GENERAL

DENTISTRY

1300 WEST

LEXINGTON

AVENUE

WINCHESTER KY 40391 859 744 7590 http://www.dro

aks.com/NewS

ite/?Welcome

COVENTRY


DENTISTRY

1300 WEST

LEXINGTON

AVENUE


aks.com/NewS

ite/?Welcome

FEE FOR

SERVICE

546



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENTISTRY

1300 WEST

LEXINGTON

AVENUE


aks.com/NewS

ite/?Welcome

WELLCARE

ANITA GRAY ANITA A GRAY

DDS PSC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A



DDS PSC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A


SERVICE


DDS PSC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A



DDS PSC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A


ANITA A GRAY

DDS PSC

MULTI

SPECIALTY

GROUP

1303 WEST

LEXINGTON

AVENUE SUITE A


SERVICE


AND PETERSON


LEXINGTON

AVENUE SUITE A


547



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND PETERSON


LEXINGTON

AVENUE SUITE A


SERVICE


AND PETERSON


LEXINGTON

AVENUE SUITE A



AND PETERSON


LEXINGTON

AVENUE SUITE A



AND PETERSON


LEXINGTON

AVENUE SUITE A


SERVICE


AND PETERSON


LEXINGTON

AVENUE SUITE A



AND PETERSON


LEXINGTON

AVENUE SUITE A



AND PETERSON


LEXINGTON

AVENUE SUITE A


SERVICE

548



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


AND PETERSON


LEXINGTON

AVENUE SUITE A



AND PETERSON


LEXINGTON

AVENUE SUITE A


GAYATRI VARANASI ANITA A GRAY

DDS PLLC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A



DDS PLLC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A


SERVICE


DDS PLLC

GENERAL

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A



DDS PLLC

HIGHLANDS

FAMILY

DENTISTRY

1303 WEST

LEXINGTON

AVENUE SUITE A


GRAY MCLAURIN

AND PETERSON


LEXINGTON

AVENUE SUITE A


SERVICE

MICHAEL PRATT PRATT

ORTHODONTICS

ORTHODONTIST 244 REDWING

DRIVE

WINCHESTER KY 40391 859 338 8232 http://www.pra

ttortho.com/

COVENTRY

549



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME

MICHAEL PRATT PRATT

ORTHODONTICS


DRIVE


ttortho.com/

FEE FOR

SERVICE

MICHAEL PRATT PRATT

ORTHODONTICS


DRIVE


ttortho.com/

HUMANA

MICHAEL PRATT PRATT

ORTHODONTICS


DRIVE


ttortho.com/

WELLCARE

ALISA TOLLE ALISA TOLLE

DMD

GENERAL

DENTISTRY

244 WEST

LEXINGTON

AVENUE



DMD

GENERAL

DENTISTRY

244 WEST

LEXINGTON

AVENUE


SERVICE


DMD

GENERAL

DENTISTRY

244 WEST

LEXINGTON

AVENUE



DMD

GENERAL

DENTISTRY

244 WEST

LEXINGTON

AVENUE


DONNA MEEK PEDIATRIC

DENISTRY OF

WINCHESTER

PEDIATRIC

DENTIST

2560 BYPASS

ROAD SUITE 2

WINCHESTER KY 40391 859 737 1000 http://www.pe

diatricdentistry

ofwinchester.c

om/

COVENTRY


DENISTRY OF

WINCHESTER

PEDIATRIC

DENTIST

2560 BYPASS

ROAD SUITE 2


diatricdentistry

ofwinchester.c

om/

FEE FOR

SERVICE

550



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


DENISTRY OF

WINCHESTER

PEDIATRIC

DENTIST

2560 BYPASS

ROAD SUITE 2


diatricdentistry

ofwinchester.c

om/

HUMANA


DENISTRY OF

WINCHESTER

PEDIATRIC

DENTIST

2560 BYPASS

ROAD SUITE 2


diatricdentistry

ofwinchester.c

om/

WELLCARE


CENTER FOR

ORTHODONTICS

ORTHODONTIST 505 SHOPPERS

DRIVE SUITE 4

WINCHESTER KY 40391 800 929 7733 http://www.ky

ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

COVENTRY

551



PRACTICE NAME

FACILITY

NAME

SPECIALTY STREET

ADDRESS


PLAN NAME


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

WELLCARE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

COVENTRY


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

FEE FOR

SERVICE


CENTER FOR

ORTHODONTICS


DRIVE SUITE 4


ortho.com/

WELLCARE

552

dental provider listing as of september 2013terry r riley dds: general dentistry. 107 twin lakes...

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