select plan1 dentist directory - dominion national · pdf fileryan james 208585 aspen dental...

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Dentists listed are under contract as of 5/1/18 Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County * Dinola Marc 210624 Dr. Marc Dinola 122 BEDFORD ST Cumberland MD 21502 General Provider Allegany Laparle Frank 454 Frank A Laparle DDS Pa 214 Paca St Cumberland MD 21502 General Provider Allegany Snodgrass James 210577 Allegany Orthodontics PC 428 NATIONAL HIGHWAY Lavale MD 21502 Orthodontist Allegany Allen Darcy 208584 Aspen Dental 12317 Winchester Rd SW Lavale MD 21502 General Provider Allegany Khaliq Shahryar 208585 Aspen Dental Specialists 12317 Winchester Rd SW Lavale MD 21502 Endodontist Allegany Ryan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Lavale MD 21502 Oral Surgeon Allegany Blough-Labuda Janice 210948 Dr. Janice I. Blough-Labuda 444 NATIONAL HIGHWAY Lavale MD 21502 General Provider Allegany * Brodell Lynne 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany * Mason Ricky 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany * Pensyl Ryan 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany Bjorklund Megan 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Breggs Patrice 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Fooksman Eric 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Ogundipe Oluwatoyin 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Rajaei Alireza 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 Orthodontist Anne Arundel Scarupa Mark 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Smith Rachel 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Vitagliano Valerie 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Willis Treva 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Asher Kevin 185830 Dental One Associates Annapolis PC Specialists 2623 Housley Rd Annapolis MD 21401 Oral Surgeon Anne Arundel Khleif Ramz 185830 Dental One Associates Annapolis PC Specialists 2623 Housley Rd Annapolis MD 21401 Periodontist Anne Arundel Batrouni Ziad 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Dawood Akbar 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Egolum Nkemakonam 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Habib Rania 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Iyer Malini 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Nathan Glenn 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Robinson Allen 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel * Labbe Stephen 608 Stewart & Labbe DDS Pa 114 Forbes St Annapolis MD 21401 Orthodontist Anne Arundel * Heller Alan 4336 Alan R Heller DDS Ms 2200 Defense Highway Crofton MD 21114 Orthodontist Anne Arundel Bonner Perry 50652 All Smiles Orthodontics 1667 Crofton Cir Crofton MD 21114 Orthodontist Anne Arundel Geballa Marc 189332 Marc G Geballa DDS 1667 Crofton Center Crofton MD 21114 Endodontist Anne Arundel Wycall Brian 189332 Marc G Geballa DDS 1667 Crofton Center Crofton MD 21114 Endodontist Anne Arundel Criscitiello Kevin 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Deroo Charles 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Elrafei Mohamed 221143 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Prosthodontist Anne Arundel Farnoosh Koosha 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Ghajarnia Katayoun 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Ghajarnia M. Reza 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Hamidi Arian 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel John Joshua 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Labauve Jacob 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Masood Arif 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Puccio Gregory 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Romanow Gregory 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Oral Surgeon Anne Arundel Steinberg Wayne 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Tujjar Oqba 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Endodontist Anne Arundel Ulery Scott 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Waranch Danielle 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Weiss Karl 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Bonner Perry 50675 All Smiles Orthodonics 3059 Solomons Island Rd Edgewater MD 21037 Orthodontist Anne Arundel Muko Deep 2216 Gambrills Family Dentistry 959 Annapolis Rd Gambrills MD 21054 General Provider Anne Arundel * Mekouar Hicham 51010 Gambrills Orthodontics 331 Gambrills Rd Gambrills MD 21054 Orthodontist Anne Arundel Batrouni Ziad 155935 Maryland Oral Surgery Associates Of Crofton LLC 2401 Brandermill Blvd Gambrills MD 21054 Oral Surgeon Anne Arundel * Abrahams Heather 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Miller Jeffrey 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Williams David 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Wray Kelly 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel Souri Saman 222306 Glen Burnie Oral Surgery Associates PC 300 Hospital Dr Glen Burnie MD 21061 Oral Surgeon Anne Arundel * Anyadike Anthony 37653 Greenway Orthodontics LLC 30 Greenway St NW Glen Burnie MD 21061 Orthodontist Anne Arundel Exposito Jacques 17299 Jacques P Exposito DDS 1404 Crain Highway South Glen Burnie MD 21061 General Provider Anne Arundel Coley Sandra 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Criscitiello Kevin 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Deroo Charles 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel Elrafei Mohamed 221145 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Prosthodontist Anne Arundel Elrafei Mohamed 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Prosthodontist Anne Arundel SELECT PLAN 1 DENTIST DIRECTORY * Indicates dentist that is accepting current patients only. MD Select Plan Dentists Page 1 1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or facility before seeking treatment to confirm the provider is actively participating in your plan.

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Page 1: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County* Dinola Marc 210624 Dr. Marc Dinola 122 BEDFORD ST Cumberland MD 21502 General Provider Allegany

Laparle Frank 454 Frank A Laparle DDS Pa 214 Paca St Cumberland MD 21502 General Provider Allegany Snodgrass James 210577 Allegany Orthodontics PC 428 NATIONAL HIGHWAY Lavale MD 21502 Orthodontist Allegany Allen Darcy 208584 Aspen Dental 12317 Winchester Rd SW Lavale MD 21502 General Provider Allegany Khaliq Shahryar 208585 Aspen Dental Specialists 12317 Winchester Rd SW Lavale MD 21502 Endodontist Allegany Ryan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Lavale MD 21502 Oral Surgeon Allegany Blough-Labuda Janice 210948 Dr. Janice I. Blough-Labuda 444 NATIONAL HIGHWAY Lavale MD 21502 General Provider Allegany

* Brodell Lynne 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany * Mason Ricky 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany * Pensyl Ryan 216462 Family Dentistry 12600 Winchester Rd Lavale MD 21502 General Provider Allegany

Bjorklund Megan 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Breggs Patrice 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Fooksman Eric 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Ogundipe Oluwatoyin 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Rajaei Alireza 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 Orthodontist Anne Arundel Scarupa Mark 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Smith Rachel 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Vitagliano Valerie 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Willis Treva 1709 Dental One Associates Annapolis PC 2623 Housley Rd Annapolis MD 21401 General Provider Anne Arundel Asher Kevin 185830 Dental One Associates Annapolis PC Specialists 2623 Housley Rd Annapolis MD 21401 Oral Surgeon Anne Arundel Khleif Ramz 185830 Dental One Associates Annapolis PC Specialists 2623 Housley Rd Annapolis MD 21401 Periodontist Anne Arundel Batrouni Ziad 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Dawood Akbar 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Egolum Nkemakonam 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Habib Rania 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Iyer Malini 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Nathan Glenn 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel Robinson Allen 176821 Maryland Oral Surgery Associates Of Annapolis LLC 128 Lubrano Dr Annapolis MD 21401 Oral Surgeon Anne Arundel

* Labbe Stephen 608 Stewart & Labbe DDS Pa 114 Forbes St Annapolis MD 21401 Orthodontist Anne Arundel * Heller Alan 4336 Alan R Heller DDS Ms 2200 Defense Highway Crofton MD 21114 Orthodontist Anne Arundel

Bonner Perry 50652 All Smiles Orthodontics 1667 Crofton Cir Crofton MD 21114 Orthodontist Anne Arundel Geballa Marc 189332 Marc G Geballa DDS 1667 Crofton Center Crofton MD 21114 Endodontist Anne Arundel Wycall Brian 189332 Marc G Geballa DDS 1667 Crofton Center Crofton MD 21114 Endodontist Anne Arundel Criscitiello Kevin 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Deroo Charles 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Elrafei Mohamed 221143 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Prosthodontist Anne Arundel Farnoosh Koosha 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Ghajarnia Katayoun 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Ghajarnia M. Reza 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Hamidi Arian 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel John Joshua 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Labauve Jacob 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Masood Arif 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Puccio Gregory 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Romanow Gregory 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Oral Surgeon Anne Arundel Steinberg Wayne 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Tujjar Oqba 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Endodontist Anne Arundel Ulery Scott 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Waranch Danielle 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 General Provider Anne Arundel Weiss Karl 479 Ulery Dental & Orthodontics 1286 Md Rt 3 S Crofton MD 21114 Orthodontist Anne Arundel Bonner Perry 50675 All Smiles Orthodonics 3059 Solomons Island Rd Edgewater MD 21037 Orthodontist Anne Arundel Muko Deep 2216 Gambrills Family Dentistry 959 Annapolis Rd Gambrills MD 21054 General Provider Anne Arundel

* Mekouar Hicham 51010 Gambrills Orthodontics 331 Gambrills Rd Gambrills MD 21054 Orthodontist Anne Arundel Batrouni Ziad 155935 Maryland Oral Surgery Associates Of Crofton LLC 2401 Brandermill Blvd Gambrills MD 21054 Oral Surgeon Anne Arundel

* Abrahams Heather 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Miller Jeffrey 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Williams David 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel * Wray Kelly 221326 Orthodontic Associates 400 Renfro Dr Glen Burnie MD 21060 Orthodontist Anne Arundel

Souri Saman 222306 Glen Burnie Oral Surgery Associates PC 300 Hospital Dr Glen Burnie MD 21061 Oral Surgeon Anne Arundel * Anyadike Anthony 37653 Greenway Orthodontics LLC 30 Greenway St NW Glen Burnie MD 21061 Orthodontist Anne Arundel

Exposito Jacques 17299 Jacques P Exposito DDS 1404 Crain Highway South Glen Burnie MD 21061 General Provider Anne Arundel Coley Sandra 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Criscitiello Kevin 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Deroo Charles 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel Elrafei Mohamed 221145 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Prosthodontist Anne Arundel Elrafei Mohamed 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Prosthodontist Anne Arundel

SELECT PLAN1 DENTIST DIRECTORY

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 1

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 2: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Farnoosh Koosha 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ghajarnia Katayoun 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ghajarnia M. Reza 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel Hamidi Arian 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel John Joshua 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Labauve Jacob 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Puccio Gregory 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Romanow Gregory 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Oral Surgeon Anne Arundel Steinberg Wayne 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Ulery Scott 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Waranch Danielle 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 General Provider Anne Arundel Weiss Karl 50372 Ulery Dental & Orthodontics 7067 Baltimore Annapolis Blvd Glen Burnie MD 21061 Orthodontist Anne Arundel

* Tehrani Saideh 446 Saideh Tehrani Dmd 3450 Fort Meade Rd Laurel MD 20724 General Provider Anne Arundel Ahmed Mohamed 183258 Family Dentistry 677 Old Mill Rd Millersville MD 21108 General Provider Anne Arundel

* Winnard Robert 50799 Robert G Winnard Dmd 1215 Annapolis Rd. Odenton MD 21113 Orthodontist Anne Arundel * Lee Soo Yun 136750 Victory Orthodontics 8761 A Piney Orchard Pkwy Odenton MD 21113 Orthodontist Anne Arundel

Coley Sandra 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Criscitiello Kevin 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Elrafei Mohamed 221144 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 Prosthodontist Anne Arundel Farnoosh Koosha 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Ghajarnia Katayoun 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Ghajarnia M. Reza 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 Orthodontist Anne Arundel Hamidi Arian 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel John Joshua 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Labauve Jacob 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Puccio Gregory 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Romanow Gregory 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 Oral Surgeon Anne Arundel Steinberg Wayne 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Tujjar Oqba 221144 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 Endodontist Anne Arundel Ulery Scott 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Waranch Danielle 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 General Provider Anne Arundel Weiss Karl 2011 Ulery Dental & Orthodontics 8055 Ritchie Hwy Pasadena MD 21122 Orthodontist Anne Arundel Cofie Zenaida 37567 Zenaida Cofie DDS Ms Pa 2622 C-1 Annapolis Rd. Severn MD 21144 Orthodontist Anne Arundel Bonner Perry 50651 All Smiles Orthodontics 22 Truck House Rd Severna Park MD 21146 Orthodontist Anne Arundel

* Abrahams Heather 221332 Orthodontic Associates 537-F BALTIMORE-ANNAPOLIS BOUL Severna Park MD 21146 Orthodontist Anne Arundel * Miller Jeffrey 221332 Orthodontic Associates 537-F BALTIMORE-ANNAPOLIS BOUL Severna Park MD 21146 Orthodontist Anne Arundel * Williams David 221332 Orthodontic Associates 537-F BALTIMORE-ANNAPOLIS BOUL Severna Park MD 21146 Orthodontist Anne Arundel * Wray Kelly 221332 Orthodontic Associates 537-F BALTIMORE-ANNAPOLIS BOUL Severna Park MD 21146 Orthodontist Anne Arundel

Garden Richard 689 Richard B Garden DDS 555 Benfield Road Severna Park MD 21146 Oral Surgeon Anne Arundel * Dyson, Jr. Joseph 163 Joseph L Dyson Jr DDS 4901 Liberty Heights Ave. Baltimore MD 21207 General Provider Baltimore

Hassan Mohamed 210833 Smiles R Us 6666 SECURITY BLVD Baltimore MD 21207 General Provider Baltimore Radparvar Saman 210833 Smiles R Us 6666 SECURITY BLVD Baltimore MD 21207 General Provider Baltimore

* Gordon James 850 Drs Branoff & Kress Pa 3635 Old Court Rd. Baltimore MD 21208 Orthodontist Baltimore Levy Joseph 151087 Joseph E Levy DDS 19 Walker Ave Baltimore MD 21208 General Provider Baltimore

* Platt Jeffrey 895 Drs Berman & Platt DDS Pa 1390 Martin Blvd. Baltimore MD 21220 General Provider Baltimore Greenberg Ned 11212 Ned S Greenberg DDS Pa 2100 Eastern Boulevard Baltimore MD 21220 General Provider Baltimore Vidziunas Paul 11212 Ned S Greenberg DDS Pa 2100 Eastern Boulevard Baltimore MD 21220 General Provider Baltimore Mazer Millard 78261 Ned S Greenberg DDS Pa Specialist 2100 Eastern Boulevard Baltimore MD 21220 Periodontist Baltimore Akinwande Kolade 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Balla Usha 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Bonasso Alessandra 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Buhay-Ogilvie Monica 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Clarke Roxanne 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Croom Murithi Shani 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Eom Hae 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Fatogun Oluwatoyin 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Gravitz Ronald 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 Pedodontist Baltimore Gunawardena Ruchira 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore John Anett 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Montano Ronald 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Naqib Sonay 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Saucer Naimata 210771 Hero Dental Of Essex PC Ronald B Montao Dba Advent 1346 EASTERN BLVD Baltimore MD 21221 General Provider Baltimore Zia Amir 2690 Lansdowne Family Dental 2717 Hammonds Ferry Rd. Baltimore MD 21227 General Provider Baltimore Garcia-Dizon Grace 51111 Adrian A Sanchez DDS Pa 4660 Wilkens Ave Baltimore MD 21228 General Provider Baltimore In Nam 51111 Adrian A Sanchez DDS Pa 4660 Wilkens Ave Baltimore MD 21228 General Provider Baltimore Sanchez Adrian 51111 Adrian A Sanchez DDS Pa 4660 Wilkens Ave Baltimore MD 21228 General Provider Baltimore

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 2

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 3: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Ramamurthy S 271 Sv Ramamurthy DDS 8713 Harford Rd. Baltimore MD 21234 General Provider Baltimore * Abrahams Heather 3409 Orthodontic Associates 7544 Belair Road Baltimore MD 21236 Orthodontist Baltimore * Miller Jeffrey 3409 Orthodontic Associates 7544 Belair Road Baltimore MD 21236 Orthodontist Baltimore * Williams David 3409 Orthodontic Associates 7544 Belair Road Baltimore MD 21236 Orthodontist Baltimore * Wray Kelly 3409 Orthodontic Associates 7544 Belair Road Baltimore MD 21236 Orthodontist Baltimore

Kodeck Robert 356 Robert Kodeck DDS 7850 Rossville Blvd. Baltimore MD 21236 General Provider Baltimore * Abraham Ampili 7871 A G A Family Dentistry LLC 1008 Ingleside Avenue Catonsville MD 21228 General Provider Baltimore

Yuille Bruce 409 Bruce E Yuille DDS 700 Geipe Road Catonsville MD 21228 General Provider Baltimore Vir Kunwar 195908 Catonsville Endodontics LLC 405 Frederick Rd Catonsville MD 21228 Endodontist Baltimore

* Clark Maxine 50741 Maryland Orthodontic Specialists 2 East Rolling Crossroads Catonsville MD 21228 Orthodontist Baltimore * Abrahams Heather 2327 Orthodontic Associates 606 Frederick Road Catonsville MD 21228 Orthodontist Baltimore * Miller Jeffrey 2327 Orthodontic Associates 606 Frederick Road Catonsville MD 21228 Orthodontist Baltimore * Williams David 2327 Orthodontic Associates 606 Frederick Road Catonsville MD 21228 Orthodontist Baltimore * Wray Kelly 2327 Orthodontic Associates 606 Frederick Road Catonsville MD 21228 Orthodontist Baltimore * Jasthi Dharani 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Kim Hyung 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Nayudu Kiran 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Shin Jai 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Venkat Rao Sumanya 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Xerri Steven 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore * Yoon Thomas 210607 Todays Dental Associates 832 N ROLLING RD Catonsville MD 21228 General Provider Baltimore

Allen Darcy 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Gupta Shekar 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Raparthi Rama 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Sharma Sanjeev 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Spirina Ekaterina 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Webb Michael 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Williams Christopher 262145 Aspen Dental 1401 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Coley Sandra 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Criscitiello Kevin 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Farnoosh Koosha 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Ghajarnia Katayoun 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Ghajarnia M. Reza 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 Orthodontist Baltimore Hamidi Arian 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore John Joshua 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Labauve Jacob 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Puccio Gregory 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Steinberg Wayne 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Ulery Scott 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Waranch Danielle 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 General Provider Baltimore Weiss Karl 168078 Ulery Dental & Orthodontics 1171 Merritt Blvd Dundalk MD 21222 Orthodontist Baltimore Tzomides Thomas 51041 Thomas G Tzomides DDS LLC 30 Middle River Rd Middle River MD 21220 General Provider Baltimore Lyn Trevann 191118 Nottingham Oral Surgery Center 7544 Belair Rd Nottingham MD 21236 Oral Surgeon Baltimore Sharma Sanjeev 244305 Aspen Dental Associates 10010 Reisterstown Rd Owings Mills MD 21117 General Provider Baltimore Johnson Gary 244306 Aspen Dental Specialists 10010 Reisterstown Rd Owings Mills MD 21117 Endodontist Baltimore Khaliq Shahryar 244306 Aspen Dental Specialists 10010 Reisterstown Rd Owings Mills MD 21117 Endodontist Baltimore Ryan James 244306 Aspen Dental Specialists 10010 Reisterstown Rd Owings Mills MD 21117 Oral Surgeon Baltimore Woods Clifton 37554 Clifton J Woods Iii DDS 9351 Lakeside Blvd. Owings Mills MD 21117 General Provider Baltimore

* Miller Cynthia 562 Cynthia F Miller DDS 6 Park Center Court Owings Mills MD 21117 General Provider Baltimore * Mistry Monil 562 Cynthia F Miller DDS 6 Park Center Court Owings Mills MD 21117 General Provider Baltimore * Koval Victor 210835 Dr. Victor Koval 20 Crossroads Dr Owings Mills MD 21117 General Provider Baltimore * Abrahams Heather 2338 Orthodontic Associates 20 Crossroads Dr Owings Mills MD 21117 Orthodontist Baltimore * Miller Jeffrey 2338 Orthodontic Associates 20 Crossroads Dr Owings Mills MD 21117 Orthodontist Baltimore * Williams David 2338 Orthodontic Associates 20 Crossroads Dr Owings Mills MD 21117 Orthodontist Baltimore * Wray Kelly 2338 Orthodontic Associates 20 Crossroads Dr Owings Mills MD 21117 Orthodontist Baltimore

Challagulla Prasad 228998 Valley Endodontics 9199 Reisterstown Rd Owings Mills MD 21117 Endodontist Baltimore O'Sullivan Sean 228998 Valley Endodontics 9199 Reisterstown Rd Owings Mills MD 21117 Endodontist Baltimore

* Body David 1762 Dental One Associates Pikesville PC 25 Hooks Lane Pikesville MD 21208 General Provider Baltimore * Huynh Thuylinh 1762 Dental One Associates Pikesville PC 25 Hooks Lane Pikesville MD 21208 Orthodontist Baltimore * Mceachern, Jr. Jay 1762 Dental One Associates Pikesville PC 25 Hooks Lane Pikesville MD 21208 General Provider Baltimore * Padmanabhan Varsha 1762 Dental One Associates Pikesville PC 25 Hooks Lane Pikesville MD 21208 General Provider Baltimore * Scarupa Mark 1762 Dental One Associates Pikesville PC 25 Hooks Lane Pikesville MD 21208 General Provider Baltimore

Nourmand Payam 221699 Mishpacha Dental 3635 Old Court Rd Pikesville MD 21208 General Provider Baltimore Wilder Larry 97174 Larry I Wilder DDS 9015 Liberty Rd Randallstown MD 21133 General Provider Baltimore

* Daniel David 162827 Steven Markow DDS PC 5310 Old Court Rd Randallstown MD 21133 General Provider Baltimore * Markow Steven 162827 Steven Markow DDS PC 5310 Old Court Rd Randallstown MD 21133 General Provider Baltimore

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 3

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 4: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

* Nayudu Kiran 206728 Todays Dental Associates PC 8626 Liberty Rd Randallstown MD 21133 General Provider Baltimore * Shin Jai 206728 Todays Dental Associates PC 8626 Liberty Rd Randallstown MD 21133 General Provider Baltimore * Venkat Rao Sumanya 206728 Todays Dental Associates PC 8626 Liberty Rd Randallstown MD 21133 General Provider Baltimore * Xerri Steven 206728 Todays Dental Associates PC 8626 Liberty Rd Randallstown MD 21133 General Provider Baltimore * Yoon Thomas 206728 Todays Dental Associates PC 8626 Liberty Rd Randallstown MD 21133 General Provider Baltimore * Fishman Alexsandr 234753 Brilliant Smiles Of Maryland 11710 Reisterstown Rd Reisterstown MD 21136 General Provider Baltimore

Alberts Kerry 51098 Charles P Mccausland Iii DDS 312 W Chesapeake Ave Towson MD 21204 General Provider Baltimore Mccausland Iii Charles 51098 Charles P Mccausland Iii DDS 312 W Chesapeake Ave Towson MD 21204 General Provider Baltimore Rosengarden Ivan 529 Joppa Partners 219 W. Joppa Rd. Towson MD 21204 General Provider Baltimore Sehdev Inderjit 529 Joppa Partners 219 W. Joppa Rd. Towson MD 21204 General Provider Baltimore

* Jo Harrison 179662 Main Street Childrens Dentistry & Ortho Towson LLC 120 Sister Pierre Dr Towson MD 21204 Orthodontist Baltimore * Onwueme Malije 179662 Main Street Childrens Dentistry & Ortho Towson LLC 120 Sister Pierre Dr Towson MD 21204 Pedodontist Baltimore * Jo Harrison 179663 Main Street Childrens Dentistry&Ortho Phoenix LLC 120 Sister Pierre Dr Towson MD 21204 Orthodontist Baltimore

Lucas Peter 1773 Brenda K Richardson DDS 515 E. Joppa Rd. Towson MD 21286 Endodontist Baltimore Richardson Brenda 1773 Brenda K Richardson DDS 515 E. Joppa Rd. Towson MD 21286 Endodontist Baltimore Pattanashetti Suresh 50789 Suresh Pattanashetti Dmd PC 8601 LaSalle Road Towson MD 21286 General Provider Baltimore Cofie Zenaida 37566 Zenaida Cofie DDS Ms Pa 8601 La Salle Rd. Towson MD 21286 Orthodontist Baltimore Jesson Vijayalakshmi 17177 Convenient Dental 1726 North Rolling Road Windsor Mill MD 21244 General Provider Baltimore Nourmand Payam 268702 Ez Smile Dental Inc 5006 Sinclair Lane Baltimore MD 21206 General Provider Baltimore City

* Shapiro Helene 229006 Belvedere Square Dental 6015 York Rd Baltimore MD 21212 General Provider Baltimore City Chavis Delwyne 175953 Delwyne L. Chavis Dmd 5808 York Rd. Baltimore MD 21212 General Provider Baltimore City Goodman Robert 25390 Robert A Goodman DDS 6301 North Charles Street Baltimore MD 21212 General Provider Baltimore City

* Burnett Cassandra 21661 Cassandra Burnett DDS 1318 North Caroline Street Baltimore MD 21213 General Provider Baltimore City Hickey Stephen 69564 Stephen J Hickey Dmd 5010 Harford Rd Baltimore MD 21214 General Provider Baltimore City Aragaw Fana 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Cha-Camp Charmaine 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Kinol Tracy 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 Pedodontist Baltimore City Kondratyuk Julija 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Krasnov Rostislav 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Montgomery Tyrus 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Patrick Yetunde 260721 Mondawmin Mall Dental Llp 2401 Liberty Heights Ave Baltimore MD 21215 General Provider Baltimore City Butler Stewart 37575 Park West Health Systems 3319 W. Belvedere Ave. Baltimore MD 21215 General Provider Baltimore City Dunstan Hyacinth 37575 Park West Health Systems 3319 W. Belvedere Ave. Baltimore MD 21215 General Provider Baltimore City Langermann Rena 1207 Rena K Langermann DDS 6606 Cross Country Blvd. Baltimore MD 21215 General Provider Baltimore City Desbordes Fabian 18764 Fabian F Desbordes DDS 2300 Garrison Boulevard Baltimore MD 21216 General Provider Baltimore City Bell Lawrence 1382 Bell & Associates 3324 3326 Auchentoroly Terr Baltimore MD 21217 General Provider Baltimore City Dyson, Jr. Joseph 164 Joseph L Dyson Jr DDS 1721 Pennsylvania Ave. Baltimore MD 21217 General Provider Baltimore City Shelton Benjamin 210174 Benjamin F Shelton DDS Pa 1501 EAST 33RD STREET Baltimore MD 21218 General Provider Baltimore City Akinwande Kolade 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Balla Usha 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Bonasso Alessandra 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Buhay-Ogilvie Monica 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Croom Murithi Shani 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Eom Hae 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Fatogun Oluwatoyin 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Gunawardena Ruchira 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City John Anett 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Naqib Sonay 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City Saucer Naimata 210756 Ronald B Montano DDS PC 1253 W PRATT ST Baltimore MD 21223 General Provider Baltimore City

* Englander Richard 79081 Wilkens Avenue Dental 1926 Wilkens Avenue Baltimore MD 21223 General Provider Baltimore City Akinwande Kolade 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Balla Usha 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Bonasso Alessandra 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Buhay-Ogilvie Monica 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Croom Murithi Shani 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Eom Hae 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Fatogun Oluwatoyin 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Gunawardena Ruchira 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City John Anett 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Montano Ronald 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Mukkara Mamata 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 Orthodontist Baltimore City Naqib Sonay 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Saucer Naimata 210605 Montano DDS Dental Center PC Dba Adventure Dental 5632 THE ALAMEDA Baltimore MD 21239 General Provider Baltimore City Nourmand Payam 70481 Payam Nourmand DDS PC 1900 E Northern Pkwy Baltimore MD 21239 General Provider Baltimore City

* Dowling Thomas 1105 Thomas F Dowling DDS 310 Merrimac Court Prince Frederick MD 20678 Orthodontist Calvert * Gordon James 37543 Drs Branoff & Kress Pa 1425 Liberty Rd. Eldersburg MD 21784 Orthodontist Carroll

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 4

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 5: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

* Pantos Michael 37628 Michael Pantos Dmd Pa 1643 Liberty Rd. Eldersburg MD 21784 Orthodontist Carroll Shin Jai 203336 Todays Dental Associates 2030 Liberty Rd Eldersburg MD 21784 General Provider Carroll Venkat Rao Sumanya 203336 Todays Dental Associates 2030 Liberty Rd Eldersburg MD 21784 General Provider Carroll Xerri Steven 203336 Todays Dental Associates 2030 Liberty Rd Eldersburg MD 21784 General Provider Carroll Yoon Thomas 203336 Todays Dental Associates 2030 Liberty Rd Eldersburg MD 21784 General Provider Carroll Addicks Earl 68507 Earl M Addicks DDS PC 2025 Suffolk Rd Finksburg MD 21048 General Provider Carroll Scurnick Steven 37757 Steven Scurnick DDS 11225 Dovedale Ct Marriottsville MD 21104 General Provider Carroll

* Bae Jun 224436 Family Dentistry 532 Baltimore Blvd Westminster MD 21157 General Provider Carroll Grillon George 591 George L Grillon Dmd 250 Englar Rd Westminster MD 21157 Oral Surgeon Carroll Chizmar Paul 247644 West Cecil Health Center Inc 49 Rock Springs Rd Conowingo MD 21918 General Provider Cecil Davis Emily 247644 West Cecil Health Center Inc 49 Rock Springs Rd Conowingo MD 21918 General Provider Cecil Indyke Gregory 247644 West Cecil Health Center Inc 49 Rock Springs Rd Conowingo MD 21918 General Provider Cecil Asgari Navid 242152 Alpha Dental Center 300 E Pulaski Hwy Elkton MD 21921 General Provider Cecil

* Gham Deepali 70916 Delmarva Center For Dental Excellence 230 S Bridge St Elkton MD 21921 General Provider Cecil Abbasian Vargha 2757 Vargha Abbasian DDS PC 1653 Elkton Rd. Elkton MD 21921 General Provider Cecil Chizmar Paul 247648 West Cecil Health Center Inc 4863 Pulaski Hwy Perryville MD 21903 General Provider Cecil Davis Emily 247648 West Cecil Health Center Inc 4863 Pulaski Hwy Perryville MD 21903 General Provider Cecil Indyke Gregory 247648 West Cecil Health Center Inc 4863 Pulaski Hwy Perryville MD 21903 General Provider Cecil Noppinger Robert 247648 West Cecil Health Center Inc 4863 Pulaski Hwy Perryville MD 21903 General Provider Cecil Williams George 247648 West Cecil Health Center Inc 4863 Pulaski Hwy Perryville MD 21903 General Provider Cecil

* John Orville 410 Metro Dental Center 6620 Crain Hwy La Plata MD 20646 General Provider Charles * Morgan-Belcher Althea 410 Metro Dental Center 6620 Crain Hwy La Plata MD 20646 General Provider Charles

Shumate Kenneth 262158 Shumate Family And Cosmetic Dentistry LLC 3010 Crain Hwy Waldorf MD 20601 General Provider Charles Hector Ricardo 72092 Aegis Dental Group LLC 12092 Ell Lane Waldorf MD 20602 General Provider Charles Sethi Gurpreet 187343 Affordable & Aesthetic Dental Center 303 Post Office Rd Waldorf MD 20602 General Provider Charles Fitchett, Jr Glander 434 Post Office Lake Dental Associates 603 Post Office Road Waldorf MD 20602 General Provider Charles Hood, Iii James 434 Post Office Lake Dental Associates 603 Post Office Road Waldorf MD 20602 General Provider Charles Wiltshire Cathy 434 Post Office Lake Dental Associates 603 Post Office Road Waldorf MD 20602 Orthodontist Charles Maloney Joseph 2324 Tuan D Pham Dmd & Joseph A Maloney DDS LLC 3450 Old Washington Road Waldorf MD 20602 General Provider Charles

* Ego Osuala Derek 168065 Excelsis Root Canal Specialties 11705 Berry Rd Waldorf MD 20603 Endodontist Charles King Michael 238999 King Oral Surgery Associates LLC 4255 Altamont Pl White Plains MD 20695 Oral Surgeon Charles Cole D'Audra 209546 Frederick KiDDS Pediatric Dentistry 211 Shorebird St Frederick MD 21701 Pedodontist Frederick Romanow Gregory 2269 Goldblatt Sweeney & Wise DDS Ms 915 Toll House Rd Frederick MD 21701 Oral Surgeon Frederick Sweeney Albert 2269 Goldblatt Sweeney & Wise DDS Ms 915 Toll House Rd Frederick MD 21701 Oral Surgeon Frederick Tofigh Saeed 2269 Goldblatt Sweeney & Wise DDS Ms 915 Toll House Rd Frederick MD 21701 Oral Surgeon Frederick Wise John 2269 Goldblatt Sweeney & Wise DDS Ms 915 Toll House Rd Frederick MD 21701 Oral Surgeon Frederick Bhinder Hina 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Golpayegani Nahal 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Hassan Mohamed 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Jacklis Ghassan 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Johnson Gary 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 Endodontist Frederick Knox Dominique 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Mazin Mark 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick Park Sang Hoon 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 Periodontist Frederick Reddy Hima-Bindu 193 Bright Now Dental 68 Thomas Johnson Dr. Frederick MD 21702 General Provider Frederick

* Saini Viney 50487 Clarksburg Orthodontics 182 Thomas Johnson Dr Frederick MD 21702 Orthodontist Frederick Muko Deep 69530 Deep Muko DDS Pa 198 Thomas Johnson Dr Frederick MD 21702 General Provider Frederick Cole D'Audra 37535 Frederick Pediatric Dental Associates 57 A Thomas Johnson Drive Frederick MD 21702 Pedodontist Frederick Lloyd Emily 37535 Frederick Pediatric Dental Associates 57 A Thomas Johnson Drive Frederick MD 21702 Pedodontist Frederick Sivakumar Savithri 37535 Frederick Pediatric Dental Associates 57 A Thomas Johnson Drive Frederick MD 21702 Pedodontist Frederick Sivakumar Thiruvanamalai 37535 Frederick Pediatric Dental Associates 57 A Thomas Johnson Drive Frederick MD 21702 Pedodontist Frederick Nawab Ayesha 30666 Mid Maryland Oral & Maxillofacial Surgery 68 Thomas Johnson Drive Frederick MD 21702 Oral Surgeon Frederick Tan Peter 30666 Mid Maryland Oral & Maxillofacial Surgery 68 Thomas Johnson Drive Frederick MD 21702 Oral Surgeon Frederick Zwack William 30666 Mid Maryland Oral & Maxillofacial Surgery 68 Thomas Johnson Drive Frederick MD 21702 Oral Surgeon Frederick

* Pierce Kurt 2405 Kurt A Pierce DDS Ms 604 Solarex Ct. Frederick MD 21703 Orthodontist Frederick Bhinder Hina 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 General Provider Frederick Golpayegani Nahal 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 General Provider Frederick Hassan Mohamed 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 General Provider Frederick Huynh Thuylinh 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 Orthodontist Frederick Johnson Gary 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 Endodontist Frederick Mazin Mark 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 General Provider Frederick Reddy Hima-Bindu 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 General Provider Frederick Tien Niven 37595 Bright Now Dental 5726 B Buckeystown Pk Frederick MD 21704 Oral Surgeon Frederick Duggan Nancy 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Gupta Shekar 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Raparthi Rama 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 5

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 6: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Ryan James 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 Oral Surgeon Harford Sharma Sanjeev 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Spirina Ekaterina 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Webb Michael 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Williams Christopher 256970 Aspen Dental 3486 Emmorton Road Abingdon MD 21009 General Provider Harford Davis Vida 1934 Vida Davis DDS 2921 Emmorton Rd. Abingdon MD 21009 General Provider Harford

* Miranda Alvin 180117 Alvin C Miranda DDS Pa 200 Thomas St Bel Air MD 21014 General Provider Harford * Rosero Christina 180117 Alvin C Miranda DDS Pa 200 Thomas St Bel Air MD 21014 General Provider Harford

Nourmand Payam 70480 Payam Nourmand DDS PC 724 Rock Spring Dr Bel Air MD 21014 General Provider Harford * Hariri Rahim 245971 Smiles Makers LLC 312 Baltimore Pike Bel Air MD 21014 General Provider Harford

Kubiczek Iwona 2857 Iwona Kubiczek DDS PC 2021-B Emmorton Rd. Bel Air MD 21015 General Provider Harford * Abrahams Heather 24754 Orthodontic Associates 2225 Old Emmorton Road Bel Air MD 21015 Orthodontist Harford * Miller Jeffrey 24754 Orthodontic Associates 2225 Old Emmorton Road Bel Air MD 21015 Orthodontist Harford * Williams David 24754 Orthodontic Associates 2225 Old Emmorton Road Bel Air MD 21015 Orthodontist Harford * Wray Kelly 24754 Orthodontic Associates 2225 Old Emmorton Road Bel Air MD 21015 Orthodontist Harford

Tzomides Thomas 953 Thomas G Tzomides DDS LLC 2404 Pleasantville Road Fallston MD 21047 General Provider Harford Mazer Millard 79077 Thomas G Tzomides DDS LLC Specialists 2404 Pleasantville Rd Fallston MD 21047 Periodontist Harford Tzomides Thomas 79077 Thomas G Tzomides DDS LLC Specialists 2404 Pleasantville Rd Fallston MD 21047 General Provider Harford Robinson Allen 236833 Central Md Oral & Facial Surgery Of Clarksville 12431 Clarksville Pike Clarksville MD 21029 Oral Surgeon Howard Robinson Mary 236833 Central Md Oral & Facial Surgery Of Clarksville 12431 Clarksville Pike Clarksville MD 21029 Oral Surgeon Howard Barrow Nataline 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Chao Li 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Chehab Mazen 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Huynh Thuylinh 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 Orthodontist Howard Mazhari Shabnam 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Pahk Daniel 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Sabah Nesreen 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Wright Michael 1420 Dental One Associates Columbia PC 10630 Little Patuxent Pkwy. Columbia MD 21044 General Provider Howard Asher Kevin 185829 Dental One Associates Columbia PC Specialists 10630 Little Patuxent Pkwy Columbia MD 21044 Oral Surgeon Howard Khleif Ramz 185829 Dental One Associates Columbia PC Specialists 10630 Little Patuxent Pkwy Columbia MD 21044 Periodontist Howard Zand Kaveh 221158 Dental One Associates Columbia PC Specialists 10630 Little Patuxent Pkwy Columbia MD 21044 Endodontist Howard

* Abrahams Heather 51035 Orthodontic Associates 8600 Snowden River Pkwy Columbia MD 21045 Orthodontist Howard * Miller Jeffrey 51035 Orthodontic Associates 8600 Snowden River Pkwy Columbia MD 21045 Orthodontist Howard * Williams David 51035 Orthodontic Associates 8600 Snowden River Pkwy Columbia MD 21045 Orthodontist Howard * Wray Kelly 51035 Orthodontic Associates 8600 Snowden River Pkwy Columbia MD 21045 Orthodontist Howard * Skillman Robert 19200 Robert E Skillman DDS Pa 5921 Old Washington Road Elkridge MD 21075 General Provider Howard

Ajmal Nighat 22440 Ajmal Dental Care 10306 B Baltimore National Pik Ellicott City MD 21042 General Provider Howard Ajmal Riffat 22440 Ajmal Dental Care 10306 B Baltimore National Pik Ellicott City MD 21042 General Provider Howard Sedighian Ali 37537 Ali R Sedighian DDS Pa 9005 Chevrolet Dr. Ellicott City MD 21042 General Provider Howard

* Yoon Jaewon 149253 Brite Smile Dental Group 10176 Baltimore National Pike Ellicott City MD 21042 General Provider Howard Kim Philip 70463 Family Dentistry 9005 Chevrolet Dr Ellicott City MD 21042 General Provider Howard

* Clark Maxine 50678 Maryland Orthodontic Specialists 5094 Dorsey Hall Dr Ellicott City MD 21042 Orthodontist Howard * Pantos Michael 37627 Michael Pantos Dmd Pa 10282 Baltimore National Pike Ellicott City MD 21042 Orthodontist Howard * Pak Frances 140283 Pak Dental Associates PC 10326 A Baltimore National Pik Ellicott City MD 21042 General Provider Howard * Winnard Robert 50800 Robert G Winnard Dmd 10030 Baltimore National Pike Ellicott City MD 21042 Orthodontist Howard

Kang Sinha 69942 Sinha Kang Dmd 5034 Dorsey Hall Dr Ellicott City MD 21042 General Provider Howard Murtaza Ghulam 210097 Brian T Wycall DDS PC 6021 University Blvd Ellicott City MD 21043 Endodontist Howard Wycall Brian 210097 Brian T Wycall DDS PC 6021 University Blvd Ellicott City MD 21043 Endodontist Howard Fein Richard 204266 Advanced Root Canal Specialists LLC 9889 Brewers Ct Laurel MD 20723 Endodontist Howard Jureidni Badri 204266 Advanced Root Canal Specialists LLC 9889 Brewers Ct Laurel MD 20723 Endodontist Howard Okehie Valerie 204266 Advanced Root Canal Specialists LLC 9889 Brewers Ct Laurel MD 20723 Endodontist Howard Orgel Adam 204266 Advanced Root Canal Specialists LLC 9889 Brewers Ct Laurel MD 20723 Endodontist Howard Taylor Ronald 204266 Advanced Root Canal Specialists LLC 9889 Brewers Ct Laurel MD 20723 Endodontist Howard Gradishar Robert 206729 Cherry Tree Family Dentistry 11200 Scaggsville Rd Laurel MD 20723 General Provider Howard

* Abrahams Heather 235367 Orthodontic Associates 9889 Brewers Ct Laurel MD 20723 Orthodontist Howard * Miller Jeffrey 235367 Orthodontic Associates 9889 Brewers Ct Laurel MD 20723 Orthodontist Howard * Williams David 235367 Orthodontic Associates 9889 Brewers Ct Laurel MD 20723 Orthodontist Howard * Wray Kelly 235367 Orthodontic Associates 9889 Brewers Ct Laurel MD 20723 Orthodontist Howard * Heller Alan 2481 Alan R Heller DDS Ms 4350 East West Hwy Bethesda MD 20814 Orthodontist Montgomery * Khanna Srotalina 244317 Bethesda Family Smiles 10401 Old Georgetown Rd Bethesda MD 20814 General Provider Montgomery

Demizio Peter 50850 Demizio Dental Center 4400 East West Hwy Bethesda MD 20814 General Provider Montgomery Iyer Malini 61397 Maryland Oral Surgery Associates Of Bethesda LLC 10401 Old Georgetown Rd Bethesda MD 20814 Oral Surgeon Montgomery Kishter Steven 61397 Maryland Oral Surgery Associates Of Bethesda LLC 10401 Old Georgetown Rd Bethesda MD 20814 Oral Surgeon Montgomery

* Cole Reginald 460 Reginald W Cole DDS 4400 East-West Hwy Bethesda MD 20814 General Provider Montgomery Sethi Shalini 79794 Roanne Wiczer Dmd 8311 Wisconsin Ave Bethesda MD 20814 Periodontist Montgomery Wiczer Roanne 1405 Roanne Wiczer Dmd 8311 Wisconsin Ave Bethesda MD 20814 General Provider Montgomery

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 6

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 7: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Willis Treva 170391 Smile Design Studio Of Bethesda 8201 Wisconsin Ave Bethesda MD 20814 General Provider Montgomery Wright Maria 170391 Smile Design Studio Of Bethesda 8201 Wisconsin Ave Bethesda MD 20814 General Provider Montgomery

* Chang Susan 196549 Wildwood Bethesda Cosmetic & Family Dental Care 10401 Old Georgetown Rd Bethesda MD 20814 General Provider Montgomery Grillon George 610 George L Grillon Dmd PC 10215 Fernwood Rd Bethesda MD 20817 Oral Surgeon Montgomery Shroff Amisha 202791 Super Smile Center Of Bethesda 10320 Westlake Dr Bethesda MD 20817 General Provider Montgomery Elkhateeb Mohammad 223758 Image Dental Care LLC 4009 Sandy Spring Rd Burtonsville MD 20866 General Provider Montgomery

* Sheik Mon 37698 Mon F Sheik Dmd 15324 Spencerville Ct Burtonsville MD 20866 General Provider Montgomery * John Anett 262836 Anett John DDS LLC 5530 Wisonson Ave NW Chevy Chase MD 20815 General Provider Montgomery

Manesh Behnam 50910 Bethesda Chevy Chase Dental Care 6831 Wisconsin Ave Chevy Chase MD 20815 General Provider Montgomery Chang Susan 162168 Good Neighbor Dental Corporation 12051 Chestnut Branch Way Clarksburg MD 20871 General Provider Montgomery Lee Kyu 162168 Good Neighbor Dental Corporation 12051 Chestnut Branch Way Clarksburg MD 20871 General Provider Montgomery

* Heller Alan 32681 Alan R Heller DDS 12116 Darnestown Road Darnestown MD 20878 Orthodontist Montgomery Malhmood Arnold 4589 Arnold I Malhmood DDS 474 North Frederick Avenue Gaithersburg MD 20877 General Provider Montgomery Chung Jay 50592 Chestnut Street Cosmetic Dentistry 101 Chestnut Street Gaithersburg MD 20877 General Provider Montgomery Alimorad Lida 202785 Community Clinic Inc 200 Girard St Gaithersburg MD 20877 General Provider Montgomery Farnoosh Koosha 202785 Community Clinic Inc 200 Girard St Gaithersburg MD 20877 General Provider Montgomery Khan Fatima 202785 Community Clinic Inc 200 Girard St Gaithersburg MD 20877 General Provider Montgomery Santhirasegaram Niruja 202785 Community Clinic Inc 200 Girard St Gaithersburg MD 20877 General Provider Montgomery Logmanni Mandana 50501 Gaithersburg Dental Associates 8 Russell Ave Gaithersburg MD 20877 General Provider Montgomery Dubin Gerry 2432 Gerry Dubin Dmd PC 9069 Shady Grove Ct. Gaithersburg MD 20877 General Provider Montgomery Le Chinh 2854 U Smile Dental LLC 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Nguyen Helen 2854 U Smile Dental LLC 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Santhirasegaram Niruja 2854 U Smile Dental LLC 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Santos Barton 2854 U Smile Dental LLC 18220 Contour Rd. Gaithersburg MD 20877 General Provider Montgomery Lavine David 210108 Maryland Advanced Orthodontics 12113 Darnestown Rd Gaithersburg MD 20878 Orthodontist Montgomery Jesson Vijayalakshmi 33884 Angamuthu & Associates DDS Pa 4 Professional Dr. Gaithersburg MD 20879 General Provider Montgomery Winnick Mark 223772 Behnaz Yalda Dmd PC 803 Russell Ave Gaithersburg MD 20879 Periodontist Montgomery Yalda Behnaz 223772 Behnaz Yalda Dmd PC 803 Russell Ave Gaithersburg MD 20879 Periodontist Montgomery

* Tsintolas Chris 544 Chris E Tsintolas DDS Ms 903 Russell Ave. Gaithersburg MD 20879 Orthodontist Montgomery Romanow Gregory 557 Doctors Sweeny, Wise & Romanow DDS, Dmd, Pa 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Sweeney Albert 557 Doctors Sweeny, Wise & Romanow DDS, Dmd, Pa 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Tofigh Saeed 557 Doctors Sweeny, Wise & Romanow DDS, Dmd, Pa 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Wise John 557 Doctors Sweeny, Wise & Romanow DDS, Dmd, Pa 985 Russel Ave. Gaithersburg MD 20879 Oral Surgeon Montgomery Winnick Mark 536 Mark B Winnick DDS Pa 803 Russell Ave Gaithersburg MD 20879 Periodontist Montgomery Ghahreman Habib 463 The Dental Suite 18218 Flower Hill Way Gaithersburg MD 20879 General Provider Montgomery Mirdamadi Behzad 463 The Dental Suite 18218 Flower Hill Way Gaithersburg MD 20879 General Provider Montgomery Demizio Peter 37733 Demizio Dental Center 22 Executive Park Ct Germantown MD 20874 General Provider Montgomery

* Pierce Kurt 605 Kurt A Pierce DDS Ms 19507 Doctors Dr Germantown MD 20874 Orthodontist Montgomery * Tomona Natalia 37656 Natalia Tomona DDS PC 19735 Germantown Rd. Germantown MD 20874 Orthodontist Montgomery

Azad Ali 137482 Oasis Dental Clinic LLC 19533 Doctors Drive Germantown MD 20874 General Provider Montgomery * Patel Hema 172193 Wisteria Dental Care 19729 Executive Park Cir Germantown MD 20874 General Provider Montgomery * Barnett Robert 14880 Robert Barnett DDS 3720 Farragut Avenue Kensington MD 20895 General Provider Montgomery * Scott Stuart 36558 Scott Orthodonics 12132 Central Ave Mitchellville MD 20721 Orthodontist Montgomery

Abrahamian Teny 240443 Teny Abrahamian DDS 6257 Executive Blvd North Bethesda MD 20852 General Provider Montgomery Carson Kweli 50796 Davis Endodontics 11906 Darnestown Rd North Potomac MD 20878 Endodontist Montgomery Davis Gail 50796 Davis Endodontics 11906 Darnestown Rd North Potomac MD 20878 Endodontist Montgomery

* Dowling Thomas 785 Thomas F Dowling DDS 3403 Olandwood Court Olney MD 20832 Orthodontist Montgomery Tamami Farzam 50494 Potomac Dentistry 10006 Falls Rd Potomac MD 20854 General Provider Montgomery Desta David 234736 Dlight Dental 15200 Shady Grove Rd Rockville MD 20850 General Provider Montgomery Li Jingchao 232770 Dlight Dental Specialists 15200 Shady Gove Rd Rockville MD 20850 Periodontist Montgomery

* Egolum Nkemakonam 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Iyer Malini 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Kishter Steven 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Nathan Glenn 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Robinson Brian 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Stark Mitchell 566 Maryland Oral Surgery Associates 14955 Shady Grove Rd. Rockville MD 20850 Oral Surgeon Montgomery * Chang Richard 545 Richard Chang Dmd 14955 Shady Grove Rd Rockville MD 20850 Orthodontist Montgomery

Mahajan Dipty 97861 Rockville Smile Design 9850 Keywest Ave Rockville MD 20850 General Provider Montgomery * Ghazai Lili 153449 Smile Dental Studio LLC 15825 Shady Grove Rd Rockville MD 20850 General Provider Montgomery

Chiu James 181536 Supreme Dental 401 E Jefferson St Rockville MD 20850 General Provider Montgomery * Parikh Chetan 2745 Chetan H Parikh Dmd Pa 5808 Hubbard Dr. Rockville MD 20852 General Provider Montgomery * Kim Hyosik 1041 Hysosik Kim DDS 785-A Rockville Pike Rockville MD 20852 General Provider Montgomery

Hassani Eftekhar 151112 Metropolitan Family Dental 4701 Randolph Rd Rockville MD 20852 General Provider Montgomery * Shefaat Mohammad 247657 Montgomery Dental Group LLC 6000 Executive Blvd Rockville MD 20852 General Provider Montgomery

Shin Debra 172810 Shin Orthodontics LLC 4701 Randolph Rd Rockville MD 20852 Orthodontist Montgomery Shin Richard 172810 Shin Orthodontics LLC 4701 Randolph Rd Rockville MD 20852 Orthodontist Montgomery

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 7

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 8: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

* Esfandiari Sheila 2278 Tenley Orthodontics-Sheila Esfandiari DDS PC 50 West Edmonston Drive Rockville MD 20852 Orthodontist Montgomery Atashbar Hedyeh 1753 Hedyeh Atashbar DDS 11213 Lockwood Drive Silver Spring MD 20901 General Provider Montgomery Sinha Pallavi 234727 I 2 M Dental 10020 Colesville Rd Silver Spring MD 20901 General Provider Montgomery Gayton Craig 208595 Silver Spring Periodontics 10801 Lockwood Dr Silver Spring MD 20901 Periodontist Montgomery Alimorad Lida 245979 Community Clinic 1398 Lamberton Drive Silver Spring MD 20902 General Provider Montgomery Farnoosh Koosha 245979 Community Clinic 1398 Lamberton Drive Silver Spring MD 20902 General Provider Montgomery Khan Fatima 245979 Community Clinic 1398 Lamberton Drive Silver Spring MD 20902 General Provider Montgomery Santhirasegaram Niruja 245979 Community Clinic 1398 Lamberton Drive Silver Spring MD 20902 General Provider Montgomery Romanow Gregory 598 Goldblatt Sweeney & Wise DDS Ps 10313 Georgia Ave Silver Spring MD 20902 Oral Surgeon Montgomery Sweeney Albert 598 Goldblatt Sweeney & Wise DDS Ps 10313 Georgia Ave Silver Spring MD 20902 Oral Surgeon Montgomery Tofigh Saeed 598 Goldblatt Sweeney & Wise DDS Ps 10313 Georgia Ave Silver Spring MD 20902 Oral Surgeon Montgomery Wise John 598 Goldblatt Sweeney & Wise DDS Ps 10313 Georgia Ave Silver Spring MD 20902 Oral Surgeon Montgomery Anderson Peychi 185836 Smileland Pediatric Dentistry 2730 University Blvd W Silver Spring MD 20902 Pedodontist Montgomery Beheshti Reza 185836 Smileland Pediatric Dentistry 2730 University Blvd W Silver Spring MD 20902 Pedodontist Montgomery Nuh Asma 51014 Asma Nuh DDS Pa 1016 Merrimac Dr Silver Spring MD 20903 General Provider Montgomery

* De Marco Lisa 826 Drs Demarco & Tilkin Pa 11120 New Hampshire Ave. Silver Spring MD 20904 Orthodontist Montgomery * Tilkin Nancy 826 Drs Demarco & Tilkin Pa 11120 New Hampshire Ave. Silver Spring MD 20904 Orthodontist Montgomery * Okun Martin 546 Orthodontic Center Of Maryland-Virginia 12520 Prosperity Dr Silver Spring MD 20904 Orthodontist Montgomery

Haghighiyan Majid 51079 Silver Spring Dental Care LLC 13321 New Hampshire Ave Silver Spring MD 20904 General Provider Montgomery * Wiltshire Cathy 72079 Straighten Up Orthodontics 2415 Musgrove Rd Silver Spring MD 20904 Orthodontist Montgomery

Hector Ricardo 37792 Aegis Dental Group LLC 14440 Layhill Rd Silver Spring MD 20906 General Provider Montgomery Dompkowski Douglas 50890 Aspen Hill Dental Specialists 13975 Connecticut Ave Silver Spring MD 20906 Periodontist Montgomery Mihaychuk Nina 221153 Aspen Hill Dental Specialists 13975 Connecticut Ave Silver Spring MD 20906 Endodontist Montgomery Goorah Soorita 8779 Aspen Hill General & Cosmetic Dentistry 13975 Connecticut Avenue Silver Spring MD 20906 General Provider Montgomery Lee Richard 8779 Aspen Hill General & Cosmetic Dentistry 13975 Connecticut Avenue Silver Spring MD 20906 Orthodontist Montgomery Mclaughlin Kaye 8779 Aspen Hill General & Cosmetic Dentistry 13975 Connecticut Avenue Silver Spring MD 20906 General Provider Montgomery

* Allafi Cyrus 149269 Dental Center Of Aspen Hill 13975 Connecticut Ave Silver Spring MD 20906 General Provider Montgomery * Saba Sara 149269 Dental Center Of Aspen Hill 13975 Connecticut Ave Silver Spring MD 20906 General Provider Montgomery

Eghtesadi Ali 200638 Maryland Dental Specialty Group 13975 Connecticut Ave Silver Spring MD 20906 Endodontist Montgomery Gichana Roselyne 200638 Maryland Dental Specialty Group 13975 Connecticut Ave Silver Spring MD 20906 Pedodontist Montgomery Mccall Jana 200638 Maryland Dental Specialty Group 13975 Connecticut Ave Silver Spring MD 20906 Periodontist Montgomery Mihaychuk Nina 221156 Maryland Dental Specialty Group 13975 Connecticut Ave Silver Spring MD 20906 Endodontist Montgomery Mollov Nikolay 200638 Maryland Dental Specialty Group 13975 Connecticut Ave Silver Spring MD 20906 Orthodontist Montgomery Elkhateeb Mohammad 50327 Tlc Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Le Chinh 50327 Tlc Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Nguyen Helen 50327 Tlc Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Santhirasegaram Niruja 50327 Tlc Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Tran Quang 50327 Tlc Modern Dentistry LLC 13623 H-I Georgia Ave Silver Spring MD 20906 General Provider Montgomery Alimorad Lida 242154 Community Clinic Inc 8630 Fenton St Silver Spring MD 20910 General Provider Montgomery Farnoosh Koosha 242154 Community Clinic Inc 8630 Fenton St Silver Spring MD 20910 General Provider Montgomery Khan Fatima 242154 Community Clinic Inc 8630 Fenton St Silver Spring MD 20910 General Provider Montgomery Santhirasegaram Niruja 242154 Community Clinic Inc 8630 Fenton St Silver Spring MD 20910 General Provider Montgomery Moazami Negin 844 Negin A Moazami DDS 8630 Fenton Street Silver Spring MD 20910 General Provider Montgomery

* Scott Stuart 38016 Scott Orthodontics 804 Pershing Dr Silver Spring MD 20910 Orthodontist Montgomery Gilliam Qasiym 238988 Confident Smiles 7511 New Hampshire Ave Takoma Park MD 20912 General Provider Montgomery Warner Oswald 282 Warner Family Dental Center 7000 Carroll Ave. Takoma Park MD 20912 General Provider Montgomery

* Winkelman Peter 192 Sterling Dental Centers 12114 Georgia Avenue Wheaton MD 20902 General Provider Montgomery Aragaw Fana 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 General Provider Montgomery Cha-Camp Charmaine 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 General Provider Montgomery Kinol Tracy 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 Pedodontist Montgomery Kondratyuk Julija 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 General Provider Montgomery Krasnov Rostislav 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 General Provider Montgomery Patrick Yetunde 185838 Wheaton Mall Dental Llp 11160 Veirs Mill Rd Wheaton MD 20902 General Provider Montgomery Gesker Richard 149229 Mary'S Center 8908 Riggs Rd Adelphi MD 20783 General Provider Prince Georges Kim Sandra 149229 Mary'S Center 8908 Riggs Rd Adelphi MD 20783 General Provider Prince Georges Mistry Divesh 149229 Mary'S Center 8908 Riggs Rd Adelphi MD 20783 General Provider Prince Georges Petit Thamar 149229 Mary'S Center 8908 Riggs Rd Adelphi MD 20783 General Provider Prince Georges Rizk Joseph 149229 Mary'S Center 8908 Riggs Rd Adelphi MD 20783 General Provider Prince Georges Menendez Leonardo 4374 Center For Oral & Maxillofacial Surgery 3233 Superior Lane Bowie MD 20715 Oral Surgeon Prince Georges Brutus Jean-Daniel 68505 Kemmerton Family Dentistry 6000 Laurel-Bowie Rd Bowie MD 20715 General Provider Prince Georges Geballa Marc 554 Marc G Geballa DDS 6911 Laurel-Bowie Rd. Bowie MD 20715 Endodontist Prince Georges Reece Brynne 554 Marc G Geballa DDS 6911 Laurel-Bowie Rd. Bowie MD 20715 Endodontist Prince Georges Wycall Brian 554 Marc G Geballa DDS 6911 Laurel-Bowie Rd. Bowie MD 20715 Endodontist Prince Georges Davis Tanzania 14419 Tanzania Davis DDS 3231 Superior Lane Bowie MD 20715 General Provider Prince Georges Gayton Craig 208596 Craig M Gayton DDS PC 3060 Mitchellville Rd Bowie MD 20716 Periodontist Prince Georges Everett Dwayne 21563 Dwayne E Everett DDS 4000 Mitchellville Road Bowie MD 20716 Oral Surgeon Prince Georges

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 8

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 9: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

* Davidson, Jr. Alphonzo 1414 Gateway Dental Alphonzo Davidson Jr DDS 4175 N Hanson Ct Bowie MD 20716 General Provider Prince Georges Hornbeak Daquant 168062 Maryland Center Of Aesthetic Dentistry 4000 Mitchellville Rd Bowie MD 20716 General Provider Prince Georges Allafi Cyrus 332 Neville Mcken DDS 3060 Mitchellville Rd Bowie MD 20716 General Provider Prince Georges Le Tuan 332 Neville Mcken DDS 3060 Mitchellville Rd Bowie MD 20716 General Provider Prince Georges Zhou Yiya 332 Neville Mcken DDS 3060 Mitchellville Rd Bowie MD 20716 General Provider Prince Georges

* Abrahams Heather 2336 Orthodontic Associates 16461 Excalibur Rd Bowie MD 20716 Orthodontist Prince Georges * Miller Jeffrey 2336 Orthodontic Associates 16461 Excalibur Rd Bowie MD 20716 Orthodontist Prince Georges * Williams David 2336 Orthodontic Associates 16461 Excalibur Rd Bowie MD 20716 Orthodontist Prince Georges * Wray Kelly 2336 Orthodontic Associates 16461 Excalibur Rd Bowie MD 20716 Orthodontist Prince Georges * Labbe Stephen 609 Stewart & Labbe DDS Pa 4000 Mitcheville Road Bowie MD 20716 Orthodontist Prince Georges

King Michael 72078 King Oral Surgery Group At Camp Springs 5801 Allentown Rd Camp Springs MD 20746 Oral Surgeon Prince Georges Okoro Chinyere 1764 Dental One Associates Steeplechase PC 9141 Alaking Ct Capitol Heights MD 20743 General Provider Prince Georges Wilson John 1764 Dental One Associates Steeplechase PC 9141 Alaking Ct Capitol Heights MD 20743 General Provider Prince Georges Asher Kevin 185831 Dental One Associates Steeplechase PC Specialists 9141 Alaking Ct Capitol Heights MD 20743 Oral Surgeon Prince Georges Leybovich Martin 185831 Dental One Associates Steeplechase PC Specialists 9141 Alaking Ct Capitol Heights MD 20743 Periodontist Prince Georges Lin Thomas 185831 Dental One Associates Steeplechase PC Specialists 9141 Alaking Ct Capitol Heights MD 20743 Periodontist Prince Georges Allafi Cyrus 333 Neville Mcken DDS 9171 Central Ave. Capitol Heights MD 20743 General Provider Prince Georges Le Tuan 333 Neville Mcken DDS 9171 Central Ave. Capitol Heights MD 20743 General Provider Prince Georges Zhou Yiya 333 Neville Mcken DDS 9171 Central Ave. Capitol Heights MD 20743 General Provider Prince Georges

* Williams Alvin 37717 Alvin B Williams DDS 9135 Piscataway Rd Clinton MD 20735 General Provider Prince Georges Pantano Tamatha 183262 Audubon Dental Center Of Clinton 8918 Woodyard Road Clinton MD 20735 General Provider Prince Georges

* Ego Osuala Derek 68508 Excelsis Root Canal Specialties 7700 Old Branch Ave Clinton MD 20735 Endodontist Prince Georges * Okehie Valerie 68508 Excelsis Root Canal Specialties 7700 Old Branch Ave Clinton MD 20735 Endodontist Prince Georges

Breggs Patrice 189319 Floss Family Dentistry LLC 7700 Old Branch Ave Clinton MD 20735 General Provider Prince Georges * Maloney Joseph 735 Joseph A Maloney DDS 9131 Piscataway Rd. Clinton MD 20735 General Provider Prince Georges

Clark Darrell 198245 Maryland Orthodontics 8839 Branch Ave Clinton MD 20735 Orthodontist Prince Georges Adeniji Bosede 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Brager Stanley 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Eghtesadi Ali 221142 College Park Dental 7305 Baltimore Ave College Park MD 20740 Endodontist Prince Georges Eghtesadi Ali 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 Endodontist Prince Georges Haghighiyan Majid 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Hoang-Nguyen Jacquelyn 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Liu Chiun-Lin 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 Periodontist Prince Georges Su Esther 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Tiwary Romila 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Zadeh Hugh 37542 College Park Dental 7305 Baltimore Ave. College Park MD 20740 Oral Surgeon Prince Georges Lane Daniel 346 Daniel J Lane DDS 7307 Baltimore Ave. College Park MD 20740 General Provider Prince Georges Cohen Lisa 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Dawood Akbar 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Egolum Nkemakonam 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Frey Bradley 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Habib Rania 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Iyer Malini 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Nathan Glenn 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Robinson Allen 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Robinson Brian 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Robinson Mary 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges Stark Mitchell 565 Maryland Oral Surgery Associates 6201 Greenbelt Rd. College Park MD 20740 Oral Surgeon Prince Georges

* Batrouni Ziad 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Cohen Lisa 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Egolum Nkemakonam 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Iyer Malini 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Kishter Steven 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Robinson Brian 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Robinson Mary 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges * Stark Mitchell 239623 Maryland Oral Surgery Associates Of Greenbelt LLC 6201 Greenbelt Rd College Park MD 20740 Oral Surgeon Prince Georges

Larosiliere Patrick 50978 Essence Dental Care 5805 Silver Hill Rd District Heights MD 20747 Orthodontist Prince Georges Syeda Fatima 50978 Essence Dental Care 5805 Silver Hill Rd District Heights MD 20747 General Provider Prince Georges Wilson Adrian 50978 Essence Dental Care 5805 Silver Hill Rd District Heights MD 20747 Pedodontist Prince Georges Dicks Shana 72091 Warner Dental Care LLC 7610 Pennsylvania Ave Forestville MD 20747 General Provider Prince Georges Robinson-Warner Gillian 72091 Warner Dental Care LLC 7610 Pennsylvania Ave Forestville MD 20747 General Provider Prince Georges Warner Gary 72091 Warner Dental Care LLC 7610 Pennsylvania Ave Forestville MD 20747 General Provider Prince Georges

* Watson Zandra 37623 Z Family Dentist 3701 Donnel Dr. Forestville MD 20747 General Provider Prince Georges Hymes Pamela 330 Pamela V Hymes DDS Pa 10905 Fort Washington Rd. Fort Washington MD 20744 General Provider Prince Georges Bryant Larry 738 Larry W Bryant DDS Pa 12200 Annapolis Rd Glenn Dale MD 20769 Oral Surgeon Prince Georges Alimorad Lida 202784 Community Clinic Inc 9220 Springhill Dr Greenbelt MD 20770 General Provider Prince Georges

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 9

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 10: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Farnoosh Koosha 202784 Community Clinic Inc 9220 Springhill Dr Greenbelt MD 20770 General Provider Prince Georges Khan Fatima 202784 Community Clinic Inc 9220 Springhill Dr Greenbelt MD 20770 General Provider Prince Georges Santhirasegaram Niruja 202784 Community Clinic Inc 9220 Springhill Dr Greenbelt MD 20770 General Provider Prince Georges Larose Nanette 261687 Five Star Dental LLC 7525 Greenway Center Dr Greenbelt MD 20770 General Provider Prince Georges

* Wilson Adly 1187 Greenbelt Dental Care PC 7525 Greenway Center Dr. Greenbelt MD 20770 General Provider Prince Georges Elyassi Ali 200672 Greenbelt Oral & Facial Surgery 7525 Greenway Center Dr Greenbelt MD 20770 Oral Surgeon Prince Georges Dalu Paulos 178980 Skp Family Dental LLC 7525 Greenway Center Dr Greenbelt MD 20770 General Provider Prince Georges

* Labbe Stephen 607 Stewart & Labbe Orthodontics 7525 Greenway Ctr Dr Greenbelt MD 20770 Orthodontist Prince Georges Bronstein Arden 155942 Arden Bronstein DDS 6525 Belcrest Rd Hyattsville MD 20782 General Provider Prince Georges Daniels-Parks Gwendolyn 179639 Dr Gwendolyn Daniels Parks & Associates 2201 Queens Chapel Rd Hyattsville MD 20782 General Provider Prince Georges Sinha Pallavi 171400 I 2 M Dental 5402 Queens Chapel Rd Hyattsville MD 20782 General Provider Prince Georges Aragaw Fana 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Cha-Camp Charmaine 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Kinol Tracy 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 Pedodontist Prince Georges Kondratyuk Julija 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Krasnov Rostislav 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Montgomery Tyrus 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Patrick Yetunde 185834 Pg Plaza Dental Llp 3500 East West Hwy Hyattsville MD 20782 General Provider Prince Georges Salmon Trevor 61398 Trevor L Salmon DDS 6505 Bell Crest Rd Hyattsville MD 20782 General Provider Prince Georges Hall, Iii Bert 2370 Hall & Associates 7221 East Ridge Drive Landover MD 20785 General Provider Prince Georges Akinwande Kolade 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Balla Usha 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Bonasso Alessandra 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Buhay-Ogilvie Monica 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Eom Hae 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Fatogun Oluwatoyin 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Gunawardena Ruchira 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges John Anett 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Montano Ronald 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Naqib Sonay 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges Saucer Naimata 210552 Hero Dental Of Landover Hills PC Ronald B Montao D 6725 ANNAPOLIS RD Landover Hills MD 20784 General Provider Prince Georges

* Winkelman Peter 191 Sterling Dental Centers 7503 A Annapolis Road Landover Hills MD 20784 General Provider Prince Georges Ahmed Zia 230494 Aspen Hill Implant & Family Dentistry PC 1300 Mercantile Ln Largo MD 20774 General Provider Prince Georges Woods Clifton 81810 Clifton J Woods Iii DDS 932 Largo Center Dr Largo MD 20774 General Provider Prince Georges Woods Jr William 227434 William M Woods Jr 932 Largo Center Dr Largo MD 20774 General Provider Prince Georges

* Larosiliere Patrick 50979 Woodview Dental Specialists 1401 Mercantile Ln Largo MD 20774 Orthodontist Prince Georges Sanusi Jemi 1270 Yardee Dental-Dr Jemi Sanusi 1400 Mercantile Ln Largo MD 20774 General Provider Prince Georges Eghtesadi Ali 70473 Ali Eghtesadi DDS 8363 Cherry Ln Laurel MD 20707 Endodontist Prince Georges Walters George 221720 Dr George J Walters DDS 8363 Cherry Ln Laurel MD 20707 Oral Surgeon Prince Georges Batz Richard 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Brain Jeffrey 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 Periodontist Prince Georges Bruney -Judd Keisha 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Danesh Fariba 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Dukes Jonathan 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Kafle Sumana 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Karimullah Irfan 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Kavandi Shoreh 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Kim Sung 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Manoochehri Bobak 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Shah Ali 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Wai Wai Sint 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges Weiner Mitchell 1053 Drs Batz & Weiner Lake Dental 8363 Cherry Lane Laurel MD 20707 General Provider Prince Georges

* Kim John 1199 John N Kim DDS Pa 8301 Cherry Ln. Laurel MD 20707 General Provider Prince Georges Jones Ronnie 61295 Ronnie K Jones DDS 8363 Cherry Ln Laurel MD 20707 Periodontist Prince Georges Vazirnezami Delband 172208 Smile Design 13940 Baltimore Ave Laurel MD 20707 General Provider Prince Georges

* Heller Alan 2482 Alan R Heller DDS Ms 9811 Mallard Drive Laurel MD 20708 Orthodontist Prince Georges Abdullah Aslim 581 Aslim Abdullah DDS 14333 Laurel-Bowie Rd Laurel MD 20708 Endodontist Prince Georges

* Defoe Jocelyn 172188 Maryland Advanced Orthodontics 14333 Laurel-Bowie Rd Laurel MD 20708 Orthodontist Prince Georges * Lavine David 172188 Maryland Advanced Orthodontics 14333 Laurel-Bowie Rd Laurel MD 20708 Orthodontist Prince Georges

Cohen Lisa 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Dawood Akbar 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Egolum Nkemakonam 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Frey Bradley 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Habib Rania 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Iyer Malini 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Robinson Allen 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 10

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 11: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Robinson Mary 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges Stark Mitchell 567 Maryland Oral Surgery Associates 14333 Laurel Bowie Rd. Laurel MD 20708 Oral Surgeon Prince Georges

* Frey Bradley 242145 Maryland Oral Surgery Associates Of Laurel Pa 14333 Laurel Bowie Rd Laurel MD 20708 Oral Surgeon Prince Georges * Robinson Mary 242145 Maryland Oral Surgery Associates Of Laurel Pa 14333 Laurel Bowie Rd Laurel MD 20708 Oral Surgeon Prince Georges

Chang Brian 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Oral Surgeon Prince Georges Coley Sandra 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Criscitiello Kevin 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Elrafei Mohamed 221141 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Prosthodontist Prince Georges Farnoosh Koosha 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Ghajarnia Katayoun 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Ghajarnia M. Reza 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Orthodontist Prince Georges Hamidi Arian 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges John Joshua 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Labauve Jacob 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Puccio Gregory 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Romanow Gregory 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Oral Surgeon Prince Georges Steinberg Wayne 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Ulery Scott 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Waranch Danielle 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 General Provider Prince Georges Weiss Karl 2118 Ulery Dental & Orthodontics 12793 Laurel Bowie Road Laurel MD 20708 Orthodontist Prince Georges

* Harmon David 61300 David E Harmon Jr DDS Msd Pa 10264 Lake Arbor Way Mitchellville MD 20721 Orthodontist Prince Georges Griffith Miari-Ann 153451 The Oral Surgery Center Of Mitchellville 12164 Central Ave Mitchellville MD 20721 Oral Surgeon Prince Georges Bhullar Rajinder 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 General Provider Prince Georges Enjati Mohan 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 General Provider Prince Georges Gant Stephen 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 General Provider Prince Georges Rajaei Alireza 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 Orthodontist Prince Georges Suresh Mithun 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 General Provider Prince Georges Warner Gary 2176 Dental One Associates Oxon Hill PC 6196 Oxon Hill Rd. Oxon Hill MD 20745 General Provider Prince Georges Clark Fredrick 258910 Fredrick D Clark 6188 Oxon Hill Rd Oxon Hill MD 20745 General Provider Prince Georges Bishara Nabil 258909 Rivertowne Dental 6188 Oxon Hill Rd Oxon Hill MD 20745 General Provider Prince Georges Brown FrankenberryAnishka 258909 Rivertowne Dental 6188 Oxon Hill Rd Oxon Hill MD 20745 Orthodontist Prince Georges O'Neal David 258909 Rivertowne Dental 6188 Oxon Hill Rd Oxon Hill MD 20745 General Provider Prince Georges Ruderman Carl 555 Carl Ruderman DDS Pa 6309 Baltimore Ave. Riverdale MD 20737 Oral Surgeon Prince Georges Robertson Alicia 232077 Maranatha Robertson Dental 5711 Sarvis Ave Riverdale MD 20737 General Provider Prince Georges

* Bullock Jr Nathaniel 210 The Dental Group 6200 Baltimore Ave. Riverdale MD 20737 General Provider Prince Georges * Figueroa Kashia 210 The Dental Group 6200 Baltimore Ave. Riverdale MD 20737 General Provider Prince Georges * Sease, Jr. Tillman 210 The Dental Group 6200 Baltimore Ave. Riverdale MD 20737 General Provider Prince Georges

Cho Gyusik 2850 The Dental Group Specialists 6200 Baltimore Avenue Riverdale MD 20737 Periodontist Prince Georges Darden Jennifer 2850 The Dental Group Specialists 6200 Baltimore Avenue Riverdale MD 20737 Pedodontist Prince Georges Hagan Brandon 2850 The Dental Group Specialists 6200 Baltimore Avenue Riverdale MD 20737 Orthodontist Prince Georges Patel Pratik 2850 The Dental Group Specialists 6200 Baltimore Avenue Riverdale MD 20737 Endodontist Prince Georges Reece Brynne 2850 The Dental Group Specialists 6200 Baltimore Avenue Riverdale MD 20737 Endodontist Prince Georges Smith Dezrie 16470 Suitland Dental Center 4814 Silver Hill Road Suitland MD 20746 General Provider Prince Georges Allen Darcy 243379 Dimensions Healthcare Associates 5001 Silver Hill Rd Suitland MD 20748 General Provider Prince Georges Rodriguez Lorraine 243379 Dimensions Healthcare Associates 5001 Silver Hill Rd Suitland MD 20748 General Provider Prince Georges Pilgrim Karl 137478 Christian Dental Care 3611 Branch Ave. Temple Hills MD 20748 General Provider Prince Georges Ntuk Michael 51099 Michael Ntuk DDS Mpa PC 3611 Branch Ave Temple Hills MD 20748 General Provider Prince Georges Lapeyrolerie Kimberly 221711 Largo Bright Smiles LLC 10484 Campus Way S Upper Marlboro MD 20774 General Provider Prince Georges Salob Howard 221711 Largo Bright Smiles LLC 10484 Campus Way S Upper Marlboro MD 20774 General Provider Prince Georges Taylor, Iv Vannie 221711 Largo Bright Smiles LLC 10484 Campus Way S Upper Marlboro MD 20774 General Provider Prince Georges Wolfe Iii William 172207 William F Wolfe Iii DDS 2009 Main St Chester MD 21619 General Provider Queen Annes Hlousek Lubor 1441 Walzer Sullivan & Hlousek Pa 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes Jones Kurt 1441 Walzer Sullivan & Hlousek Pa 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes Sullivan Cornelius 1441 Walzer Sullivan & Hlousek Pa 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes Walzer Clifford 1441 Walzer Sullivan & Hlousek Pa 102 Saint Claire Place Stevensville MD 21666 Oral Surgeon Queen Annes Lee Richard 198255 Patuxent Orthodontics 32378 Three Notch Rd California MD 20619 Orthodontist Saint Marys Chase Kenneth 162156 Chase Dentistry 23808 Hollywood Rd Leonardtown MD 20650 General Provider Saint Marys Chase Jamila 162159 Chase Dentistry Specialists 23808 Hollywood Rd Leonardtown MD 20650 Pedodontist Saint Marys Raval Chaitanya 200648 Delaware Maryland Dental Of Easton 8695 Commerce Dr Easton MD 21601 General Provider Talbot Wilson Shawn 200648 Delaware Maryland Dental Of Easton 8695 Commerce Dr Easton MD 21601 General Provider Talbot Raparthi Rama 147935 Aspen Dental 1730 Massey Blvd Hagerstown MD 21740 General Provider Washington Sharma Sanjeev 147935 Aspen Dental 1730 Massey Blvd Hagerstown MD 21740 General Provider Washington Spirina Ekaterina 147935 Aspen Dental 1730 Massey Blvd Hagerstown MD 21740 General Provider Washington Williams Christopher 147935 Aspen Dental 1730 Massey Blvd Hagerstown MD 21740 General Provider Washington Johnson Gary 205695 Aspen Dental Specialists 1730 Massey Blvd Hagerstown MD 21740 Endodontist Washington Khaliq Shahryar 205695 Aspen Dental Specialists 1730 Massey Blvd Hagerstown MD 21740 Endodontist Washington

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 11

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.

Page 12: SELECT PLAN1 DENTIST DIRECTORY - Dominion National · PDF fileRyan James 208585 Aspen Dental Specialists 12317 Winchester Rd SW Ste 100 Lavale MD 21502 Oral Surgeon Allegany * Blough-Labuda

Dentists listed are under contract as of 5/1/18

Last Name First Name Fac ID Dental Office Name Office Address City ST ZIP Discipline County

SELECT PLAN1 DENTIST DIRECTORY

Ryan James 205695 Aspen Dental Specialists 1730 Massey Blvd Hagerstown MD 21740 Oral Surgeon Washington Sharma Sanjeev 239553 Aspen Dental 2412 N Salisbury Blvd Salisbury MD 21801 General Provider Wicomico Spirina Ekaterina 239553 Aspen Dental 2412 N Salisbury Blvd Salisbury MD 21801 General Provider Wicomico Webb Michael 239553 Aspen Dental 2412 N Salisbury Blvd Salisbury MD 21801 General Provider Wicomico Williams Christopher 239553 Aspen Dental 2412 N Salisbury Blvd Salisbury MD 21801 General Provider Wicomico Johnson Gary 239611 Aspen Dental Specialists 2412 N Salisbury Blvd Salisbury MD 21801 Endodontist Wicomico Khaliq Shahryar 239611 Aspen Dental Specialists 2412 N Salisbury Blvd Salisbury MD 21801 Endodontist Wicomico Ryan James 239611 Aspen Dental Specialists 2412 N Salisbury Blvd Salisbury MD 21801 Oral Surgeon Wicomico Forno Donald 37588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico Lee Young 37588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico Quillin Bartley 37588 Eastern Shore Endodontics 1411 Wesley Dr. Salisbury MD 21801 Endodontist Wicomico

* Viertl George 2319 George C Viertl DDS PC 560 Riverside Dr. Salisbury MD 21801 General Provider Wicomico Raval Chaitanya 2767 Delaware Maryland Dental 123 West College Ave. Salisbury MD 21804 General Provider Wicomico Wilson Shawn 2767 Delaware Maryland Dental 123 West College Ave. Salisbury MD 21804 General Provider Wicomico

* Steinberg Robert 33847 Robert D Steinberg DDS 11204 Racetrack Rd Ocean Pines MD 21811 General Provider Worcester

* Indicates dentist that is accepting current patients only.MD Select Plan Dentists Page 12

1 Same as a DHMO with fixed member copayments, no annual maximum dollar limits, no waiting periods, no deductibles, no pre-authorization paperwork or pre-treatment estimates and no claim forms or proof of loss (except in the case of out-of-area emergencies). Member must enroll with a General Dentist. Fac ID is used to indicate which facility a member chooses. Please contact the provider or

facility before seeking treatment to confirm the provider is actively participating in your plan.