Dental Provider Directory - Kaiser Permanente

DENTAL PROVIDER

DIRECTORY

PUBLISHED

J

uly

2024

THIS DIRECTORY APPLIES TO THE FOLLOWING NETWORKS: CLASSIC, CLASSIC COMPLETE,

CLASSIC + DENTAL CHOICE, ADDED CHOICE + DENTAL CHOICE, DENTAL, DENTAL CHOICE

KAISER PERMANENTE NORTHWEST REGION

Listed providers are affiliated with Permanente Dental Associates. The

information in this directory is updated monthly. For the most up-todate information, please visit or contact Member Services at

1-800-813-2000. The availability of physicians, hospitals, providers, and

services may change. Information about practitioners is provided to us

by the practitioners or is obtained as part of the credentialing process

and is accurate as of the date on the directory.

If you have questions, please call Member Services from 8 a.m. to

6 p.m., Monday through Friday, at 1-800-813-2000. For TTY, call 711.

For language interpretation services, call 1-800-324-8010.

Help in your language

Interpreter services, including American Sign Language (ASL), are

available during business hours at no additional cost to members.

Many of our doctors also speak more than one language. Call 1-800324-8010 (toll free), or 1-800-813-2000 (toll free) or 711 (TTY).

You can also call the Oregon Board of Dentistry at 971-673-3200 or

the Washington State Department of Health at 360-236-4700 for more

information, including malpractice history and disciplinary actions.

19416_07-24

Dental Choice PPO members

If you are on a Dental Choice PPO plan, some of the information in this

directory may not apply to you. Dental choice PPO plans have some

requirements and restrictions that are different from our other dental

plans. Please read your Evidence of Coverage to fully understand how

your plan works. This directory does not include all of the providers for

your plan. For a complete listing visit dental/nw to search our

online directory or call 1-866-498-7912.

The information contained in this directory is accurate as of the

July, 2024 publication date. For the most up to date provider

directory information, please contact Member Services at

1-800-813-2000 or visit facilities.

If you are looking for a gender affirming treatment provider

and can¡¯t find a provider close to you, please call our Member

Services department at 1-800-813-2000 for help finding an innetwork provider.

All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest.

500 NE Multnomah St., Suite 100, Portland, OR 97232.

Accessibility of dental offices in this directory

All Kaiser Permanente facilities are accessible

to members.

To report provider directory inaccuracies,

please call Member Services at 1-800-813-2000

or go to webmanager.

Community Referrals

Affiliated community dentists are not part of

Permanente Dental Associates (PDA). They

are dentists credentialed by PDA for Kaiser

Foundation Health Plan of the Northwest, and

they have a contract with PDA. If your PDA dentist

decides that you require covered services not

available internally from a PDA dentist, he or she

may refer you to an affiliated community dentist.

You must have a written, authorized referral from

PDA in order to receive a covered service from an

affiliated community dentist.

For members enrolled through the Federal

Employees Health Benefits (FEHB) program

It is important to know that when you enroll

in this Plan, services are provided through

the Plan¡¯s delivery system as described in the

Plan¡¯s Evidence of Coverage, but the continued

participation of any one doctor, hospital, or

other provider cannot be guaranteed.

Abbreviations of dental professional titles

DDS

Doctor of Dental Surgery

DMD

Doctor of Medical Dentistry

We have dental professionals practicing in the following specialties:

Denturist

A dental technician who specializes in making and fitting dentures.

Endodontist

A dentist who specializes in root canals and the treatment of diseases or injuries

that affect the pulp of teeth.

Orthodontist

A dentist who specializes in preventing and treating misaligned teeth.

Pediatric dentist

A dentist who specializes in treating children from birth through adolescence.

Periodontist

A specialist who treats the gums and supporting structures of the teeth.

Prosthodontist

A dentist who specializes in restoring teeth and/or replacing missing teeth with

bridges, dentures, crowns, or implants.

All providers listed in this directory speak English.

19416_07-24

Dental Providers, Kaiser Permanente, Northwest Region.

Providers accepting new members indicated in the Accepting New Members column.

Last updated July 2024. For the most up-to-date information, visit .

For questions or more information, you may contact Member Services via .

ii

1-800-813-2000

Gender

Accepting

New

Members

Specialty

Board Certification

James E Rapson, DDS, MS

M

Y

TMD

American Board of

Orofacial Pain (ABOP)

N

Yvonne Yang, DDS

F

Y

TMD

American Board of

Orofacial Pain (ABOP)

N

Gender

Accepting

New

Members

Specialty

Board Certification

Charles G Row, DDS

M

Y

General Dentist

N

David K Walker, DMD

M

Y

General Dentist

N

Lindsey Gaulke Popov, DMD

F

Y

General Dentist

N

Patrick Heaphy, DMD

M

Y

Endodontist

N

Gender

Accepting

New

Members

Specialty

Deepak Devarajan, DMD

M

Y

General Dentist

N

Justin Elson, DMD

M

Y

General Dentist

N

McGarrett Sutherland, DMD

M

Y

General Dentist

N

Min-U Tan,

M

Y

Denturist

N

Thien-Y Hoang, DMD

F

Y

General Dentist

N

Wendy L Kincaid Smovir, DMD

F

Y

General Dentist

N

Provider Name

Credential

Hospital Affiliations

Referral Languages other

Required

than English

Aloha Dental Office

17675 SW Tualatin Valley Highway

Beaverton, OR. 97003

1-800-813-2000

Provider Name

Credential

Hospital Affiliations

Referral Languages other

Required

than English

Beaverton Dental Office

4855 SW Western Avenue

Beaverton, OR. 97005

1-800-813-2000

Provider Name

Credential

Board Certification

Page 1

Hospital Affiliations

Referral Languages other

Required

than English

Vietnamese

19416_07-24

Cascade Park Dental Office

12711 SE Mill Plain Blvd

Vancouver, WA. 98684

1-800-813-2000

Gender

Accepting

New

Members

Specialty

Aaron S Johnson, DMD

M

Y

General Dentist

N

David A Straube, DMD

M

Y

General Dentist

N

Elizabeth Takamori, DDS

F

Y

Endodontist

Elly Kim, DDS

F

Y

General Dentist

N

Emily Passino, DMD

F

Y

General Dentist

N

Jason Ahn, DDS

M

Y

General Dentist

N

Jennifer Egli, DDS, MS

F

Y

Orthodontist

N

Linh T Vo-Cheng, DMD

F

Y

Pediatric Dentist

Nikolas E Rawley, DMD

M

Y

General Dentist

N

Richard Omans, DDS

M

Y

General Dentist

N

Gender

Accepting

New

Members

Specialty

Daniel J Pihlstrom, DDS

M

Y

General Dentist

N

Eric Christensen, DMD

M

Y

General Dentist

N

Paula Censoni-Needham, DMD

F

Y

General Dentist

N

Piper Huber, DDS

F

Y

Pediatric Dentist

Ryan LeClaire, DDS

M

Y

General Dentist

N

Yun Kyung-Lee, DMD

F

Y

General Dentist

N

Provider Name

Credential

Board Certification

Hospital Affiliations

American Board of

Endodontics (ABoE)

American Board of

Pediatric Dentistry (ABoPD)

Referral Languages other

Required

than English

N

Kaiser Interstate ASC

Korean

N

Cedar Hills Dental Office

12450 SW Walker Rd

Beaverton, OR. 97005

1-800-813-2000

Provider Name

Credential

Board Certification

American Board of

Pediatric Dentistry (ABoPD)

Page 2

Hospital Affiliations

Kaiser Interstate ASC

Referral Languages other

Required

than English

N

Spanish

19416_07-24

Clackamas Dental Office

10209 SE Sunnyside Road

Clackamas, OR. 97015

1-800-813-2000

Gender

Accepting

New

Members

Specialty

Anh Le, DMD

F

Y

General Dentist

N

Dean Gretzinger, DDS

M

Y

General Dentist

N

Desy Wilson, DDS, MS

F

Y

Orthodontist

Jean Marie Pacewic, DMD

F

Y

General Dentist

N

Joseph Jamus, DMD

M

Y

General Dentist

N

Karli Inglis, DDS

F

Y

Pediatric Dentist

Mailiki L Patterson, DDS

F

Y

General Dentist

N

Misty H Fujii-Carr, DDS

F

Y

General Dentist

N

Susan Schaumburg Restic

(Schaumburg), DMD

F

Y

General Dentist

N

Yoshiyuki Charlie Muraki, DMD

M

Y

General Dentist

N

Gender

Accepting

New

Members

Specialty

Jila Bowman, DDS

F

Y

Periodontist

N

Jonathan Browning, DDS

M

Y

General Dentist

N

Keith Herkert, DMD

M

Y

General Dentist

Marcus J van Witzenburg, DMD

M

Y

General Dentist

Provider Name

Credential

Board Certification

Hospital Affiliations

American Board of

Orthodontics (ABoO)

Referral Languages other

Required

than English

N

Kaiser Interstate ASC

N

Eastmoreland Dental Office

5025 SE 28th Ave

Portland, OR. 97202

1-800-813-2000

Provider Name

Credential

Board Certification

Hospital Affiliations

Kaiser Interstate ASC

Referral Languages other

Required

than English

Farsi

N

N

Page 3

19416_07-24

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download