Dental Provider Directory - Kaiser Permanente

DENTAL PROVIDER DIRECTORY

PUBLISHED JUNE

2020

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-to-date information, please visit or contact Member Services at 1-800-8132000. 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 1-800-324-8010 (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.

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.

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.

COVID-19 Update: To help ensure the safety of our members, staff, and community, we may need to temporarily close or limited in-person services at some of our medical and dental facilities. You can still get the care you need, including in-person emergency care, e-visits, phone or video visits, and more.

For the most up to date information please visit coronavirus.

19416_06-20

All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest. 500 NE Multnomah St., Suite 100, Portland, OR 97232.

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.

All providers listed in this directory speak English.

Abbreviations of dental professional titles

DDS DMD

Doctor of Dental Surgery 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.

19416_06-20

Dental Providers, Kaiser Permanente, Northwest Region. Providers accepting new members indicated in the Accepting New Members column.

Last updated June 2020. For the most up-to-date information, visit .

Aloha Dental Office 17675 SW Tualatin Valley Highway Beaverton, OR. 97003 1-800-813-2000

Provider Name Credential

Charles G Row, DDS David K Walker, DMD

Gender M M

Accepting New

Members

Y

Y

Jay Wylam, DMD

M

Y

Lindsey Gaulke Popov, DMD

F

Y

Nipoon V. Dave, DDS

M

Y

Patrick Heaphy, DMD

M

Y

Specialty General Dentist General Dentist

Periodontist

General Dentist General Dentist

Endodontist

Board Certification

American Board of Periodontology (ABoP)

Beaverton Dental Office 4855 SW Western Avenue Beaverton, OR. 97005 1-800-813-2000

Provider Name Credential

Curtis B Lemrick, DMD Justin Elson, DMD Omid Zarei, Russel G Leoni, DMD Wendy L Kincaid Smovir, DMD

Gender M M M M F

Accepting New

Members Y Y Y Y Y

Specialty General Dentist General Dentist

Denturist General Dentist General Dentist

Board Certification

Hospital Affiliations Hospital Affiliations

Referral Languages other Required than English

N N N N N N

Referral Languages other Required than English

N N N N N

Page 1

19416_06-20

Cascade Park Dental Office 12711 SE Mill Plain Blvd Vancouver, WA. 98684 1-800-813-2000

Provider Name Credential

Aaron S Johnson, DMD David A Straube, DMD

Elizabeth Takamori, DDS

Elly Kim, DDS Jennifer Egli, DDS, MS Johanna L White, DDS

Linh T Vo-Cheng, DMD

Minah DeAinza, DDS Nikolas E Rawley, DMD Richard Omans, DDS

Gender M M

Accepting New

Members

Y

Y

F

Y

F

Y

F

Y

F

Y

Specialty General Dentist General Dentist

Endodontist

General Dentist Orthodontist

General Dentist

F

Y

Pediatric Dentist

F

Y

General Dentist

M

Y

General Dentist

M

Y

General Dentist

Board Certification

American Board of Endodontics (ABoE)

American Board of Pediatric Dentistry

(ABoPD)

Cedar Hills Dental Office 12450 SW Walker Rd Beaverton, OR. 97005 1-800-813-2000

Provider Name Credential

Aaron Lau, DMD Andrea Fraser, DDS Cyrus Jeh Lee, DMD Daniel J Pihlstrom, DDS Paula Censoni-Needham, DMD

Piper Huber, DDS

Gender M F M M F

Accepting New

Members Y Y Y Y Y

Specialty General Dentist General Dentist General Dentist General Dentist General Dentist

F

Y

Pediatric Dentist

Board Certification

American Board of Pediatric Dentistry

(ABoPD)

Page 2

Hospital Affiliations

Referral Languages other Required than English

N N

N

N N N

Kaiser Interstate ASC

N

N N N

Hospital Affiliations

Referral Languages other Required than English

N N N N N

Kaiser Interstate ASC

N

19416_06-20

Clackamas Dental Office 10209 SE Sunnyside Road Clackamas, OR. 97015 1-800-813-2000

Provider Name Credential

Chao Shen, DMD Daniela Diaz, DMD

Gender M F

Accepting New

Members

Y

Y

Specialty General Dentist General Dentist

Desy Wilson, DDS, MS

F

Y

Orthodontist

Karli Inglis, DDS

F

Mailiki L Patterson, DDS

F

Misty H Trybom (Fujii-Carr), DDS

F

Myron T Peng, DMD

M

Susan Schaumburg Restic (Schaumburg), DMD

F

Yoshiyuki Charlie Muraki, DMD

M

Yun Kyung-Lee, DMD

F

Y

Pediatric Dentist

Y

General Dentist

Y

General Dentist

Y

General Dentist

Y

General Dentist

Y

General Dentist

Y

General Dentist

Board Certification

American Board of Orthodontics (ABoO)

Eastmoreland Dental Office 5025 SE 28th Ave Portland, OR. 97202 1-800-813-2000

Provider Name Credential

Jila Bowman, DDS John Oki, DMD Keith Herkert, DMD Marcus J van Witzenburg, DMD Robert T McCashew, DDS

Gender F M M M M

Accepting New

Members Y Y Y Y Y

Specialty Periodontist General Dentist General Dentist General Dentist General Dentist

Board Certification

Hospital Affiliations Kaiser Interstate ASC

Referral Languages other Required than English

N

N

Spanish

N

N N N N

N

N

N

Spanish

Hospital Affiliations Kaiser Interstate ASC

Referral Languages other Required than English

N

Farsi

N

N

N

N

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