Dental Contracts Received from 10/1/2019 to 12/3/2019

[Pages:1]Dentist *Corbin Salthouse, DDS *Michelle Elford, DDS *Alison Johnson, DDS *Joseph Brennan. DDS Timothy Thetford, DDS *David Silverglade, DDS *Ioan Boeriu, DDS *Justin Distelrath, DDS *David G Carter, DMD *Anthony Adamo, DDS *Nivine EL Refei, DDS Michael Maddow, DDS *Michael Mott, DDS *Mark Hanselman, DDS Timothy J Killgrove, DDS *Mark A Mastellotto, DDS *Michael Judy, DDS *Sylvia Kramer, DDS *Patrick A Reineck, DDS *Rimple Grewal, DMD *Steven Lantzy, DDS *Jody E. Freytag, DDS *Matthew D. Freytag, DDS *Cassim Ahmed, DDS *Natalie A Nechvatal, DDS *David F. Krueger DDS Richard Lewandowski, DDS Nadeem Khan, DDS *Faith Hayden, DDS *Jay Mistry, DDS *John C. Bacarella, DDS Harneet Grewal, DDS, BDS *Peter Nessif, DDS *Eleanore Awadalla, DDS *Michael Carpenter, DDS *Jonathan Augustine, DDS *Derrick Silva, DDS Zohra Saleh, DDS *Philip Duell, DDS *George V. Thomas, DDS *Shabbir M. Hashim, DDS *Amanda Bucklin, DDS *Michael E. Martin, DDS Sabrina Salim, DDS *Alyson Amerson, DDS *Keith A. Nowalk, DDS Joseph R Schmidbauer, DDS *Daniel R Connely, DDS *Scott S. Kelly, DDS Kausar Rahman, DDS Khurrum Mirza, DDS Peter G Wofram, DDS *Seth M. Greenfield, DDS Chander Bhatti, DDS Scott R. Smith, DDS Kaushik Shah, DDS *William Doherty, DDS George Hebeka, DDS T. Ryan Phipps, DDS Jeffrey J. Levin, DDS James Phipps, DDS Maria T. McMullin, DDS Randall Niederkor, DDS Samantha Zaciewski, DDS *Bethany Taylor, DDS *Nesreen Aouthmany, DDS Mark A Eby, DDS Jason Cohen, DDS Christina Saffo, DDS Daniel Saffo, DDS Todd W. Hasty, DDS

Dental Contracts Received from 10/1/2019 to 12/3/2019

Office Name

Office location

Corbin Salthouse, DDS

13990 Cedar Rd., Ste B, University Heights, OH

Michelle L. Elford, DDS

18540 Outer Dr., Ste. 3, Dearborn, MI

Dental Health Associates

210 W. Airport Hwy, PO Box 270, Swanton, OH

Dental Health Associates

210 W. Airport Hwy, PO Box 270, Swanton, OH

Dental Health Associates

210 W. Airport Hwy, PO Box 270, Swanton, OH

Kids Dental of Dayton - Joan-Florence Besena Salido DDS, Inc

4257 W 3rd Street, Dayton, OH

Loan Sorin Boeriu

4447 Talmadge Rd., Ste F, Toledo OH

Justin Distelrath, DDS, PC

1050 N Monroe St, Monroe, MI

David G Carter, DMD, LLC

4333 Monro St., Ste A, Toledo, OH

Randall Dental

5237 Warrensville Center Rd., Maple Heights, OH

Nivine EL Refai, BDS, DDS, MSD, Inc.

3985 Medina Rd., Ste 160, Medina, OH

Michael Maddow, DDS

24929 Goddard Rd., Taylor, MI

Michael Mott, DDS Inc

402 East Baldwin Ave., PO Box 359, Paulding, OH

Mark Hanselman, DDS

1303 Packard, #202, Ann Arbor, MI

Dr. Timothy J Killgrove, DDS

14420 Eueka Rd., Southgate, MI

Mark A Mastellotto

760 Riverside Ave., Adrian, MI

Michael E Judy DDS, Inc

5919 Teletowne Dr., Ste. 5, Toledo, OH

Sylvia Kramer, DDS

3569 Ridge Road, Cleveland, OH

Patrick A Reineck, DDS

232 E Second St, Port Clinton, OH

Grewal Dental Care, LLC

26597 N. Dixie Hwy, Ste. 169, Perrysburg, OH

Professional Dental Alliance, LLC

201 Van Gundy Dr., Bldg A., Bryan, OH

Walbridge Dental

3601 Ayers Rd., Millbury, OH

Walbridge Dental

3601 Ayers Rd., Millbury, OH

Professional Dental Alliance, LLC

201 Van Gundy Dr., Bldg A., Bryan, OH

Light Touch Dental Care Inc.

7100 Spring Meadows West Dr., Ste B, Holland, OH

Merkley Professionals - Oak Lane Dental

19 W Market St., Ste A, Tiffin, OH

Laskey Dental

3416 W. Laskey Rd, Toledo, OH

Laskey Dental

3416 W. Laskey Rd, Toledo, OH

Montgomery Family Dentistry & Wellness Center, LLC

9200 Montgomery Rd., Ste. 1A, Cincinnati, OH

Whittaker Dental Care

1330 Scott St, Ste. B, Napoleon, OH

John C. Bacarella, DDS

1050 N Monroe St, Monroe, MI

Kids First Pedatric Dentistry, PC

3778 Dix Hwy, Lincoln Park, MI

Terrance E. Nessif, DDS INC

4646 Nantuckett Dr., Toledo, OH

Eleanore Awadalla, DDS

4303 Talmadge Rd., Ste. 101, Toledo, OH

Dental Excellance of Napoleon

875 Westmoreland Ave., Napoleon, OH

Dental Excellance of Napoleon

875 Westmoreland Ave., Napoleon, OH

Dental Excellance of Napoleon

875 Westmoreland Ave., Napoleon, OH

Dental Excellance of Napoleon

875 Westmoreland Ave., Napoleon, OH

Philip Duell DDS PC

22341 West Road, B, Woodhaven, MI

George V. Thomas & Seth M. Greenfield DDS Inc

9510 Diamond Centre Drive, Mentor, OH

Shabbir M. Hashim, DDS Inc

3349 Exectuvie Parkway, Ste. A, Toledo, OH

Bucklin Family Dentistry PC

32 Division St., Coldwater, MI

Michael E. Martin, DDS

3227 W. Dean Rd., PO Box 66, Lambertville, MI

Sabrina Salim, DDS

24929 Goddard Rd., Taylor, MI

Alyson Amerson, DDS

459 S. Main St., Lima, OH

Keith A. Norwalk, DDS Inc.

103 West Fifth St., Geona, OH

Joseph R Schmidbauer, DDS

2609 Starr Ave., Oregon, OH

Daniel R Connely, DDS

5429 Secor Rd., Toledo, OH

Scott S. Kelly, DDS Inc

116 W. John St., Maumee, OH

Khurrum Mirza, DDS PC dba ProCare Dental of Monroe

7500 N Telegraph Rd., Monroe, MI

Khurrum Mirza, DDS PC dba ProCare Dental of Monroe

7500 N Telegraph Rd., Monroe, MI

Trusted Dentistry Nadeem Khan DDS LLC

5163 S. Main St., Sylvania, OH

George V. Thomas & Seth M. Greenfield DDS Inc

9510 Diamond Centre Drive, Mentor, OH

Chander Bhatti, DDS

24929 Goddard Rd., Taylor, MI

Scott R. Smith, DDS

770 Riverside Ave., #201, Adrian, MI

Kaushik Shah, DDS

5606 Secor Rd., Toledo, OH

William J Doherty, DDS, PC

120 Herrick Park Dr. Tecumseh, MI

Drs. Phipps, Levin, Hebeka & Assoc Ltd

970 W Wooster St., Ste 125, Bowling Green, OH

Drs. Phipps, Levin, Hebeka & Assoc Ltd

970 W Wooster St., Ste 125, Bowling Green, OH

Drs. Phipps, Levin, Hebeka & Assoc Ltd

970 W Wooster St., Ste 125, Bowling Green, OH

Drs. Phipps, Levin, Hebeka & Assoc Ltd

970 W Wooster St., Ste 125, Bowling Green, OH

McMullen Dental Care

116 Cole Rd, Monroe, MI

Tiffin Dental Associates

227 St Lawrence Dr. Ste 109, Tiffin, OH

Tiffin Dental Associates

227 St Lawrence Dr. Ste 109, Tiffin, OH

Dental Excellance of Delta

101 Adrian, Delta, OH

Dental Excellance of Delta

101 Adrian, Delta, OH

Mark A Eby, DDS, PC

123 W. 1st Street, Ste B, Monroe, MI

Cohen Modern Dentistry, PC

14420 Eueka Rd., Southgate, MI

New View Dental

28863 Oregon Rd., Apt G72, Perrysburg, OH

New View Dental

28863 Oregon Rd., Apt G72, Perrysburg, OH

Shadow Valley Dental Group LLC

1574 Henthorne, Ste A, Maumee, OH

*Denitist has completed the credentiling process and is considered an in network dental provider.

Zip 44118 48128 43558 43558 43558 45417 43623 48162 43606 44137 44256 48180 45879 48104 48195 49221 43613 44102 43452 43551 43506 43447 43447 43506 43526 44883 43623 43623 45242 43545 48162 48146 43623 43623 43545 43545 43545 43545 48183 44060 43606 49036 48144 48180 45804 43430 43616 43623 43537 48162 48162 43560 44060 48180 49221 43623 49286 43402 43402 43402 43402 48162 44883 44883 43515 43515 48161 48195 43551 43551 43537

Date Credentialing Complete 10/16/19 10/31/19 10/31/19 10/31/19 10/31/19 10/31/19 11/6/19 10/31/19 11/6/19 10/22/19 10/31/19

10/23/19 11/6/19

11/14/19 10/31/19 10/25/19 10/31/19 10/25/19 10/23/19 11/14/19 11/6/19 11/6/19 11/6/19 11/6/19

11/14/19 11/4/19 11/14/19

11/14/19 11/27/19 11/27/19 11/27/19 11/27/19

11/27/19 11/27/19 11/27/19 11/27/19 11/27/19

11/14/19 11/14/19

11/27/19 11/27/19

11/27/19

11/27/2019 - No Medicare

11/27/19 11/27/19

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