DENTAL PROVIDER DIRECTORY
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1 DETAL PROVIDER DIRECTORY PUBLISHED October 2018 THIS DIRECTORY APPLIES TO THE FOLLOWIG ETWORKS: CLASSIC, CLASSIC COMPLETE, CLASSIC + DETAL CHOICE, ADDED CHOICE + DETAL CHOICE, DETAL, DETAL CHOICE KAISER PERMAETE ORTHWEST REGIO 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 kp.org or contact Member Services at 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. For TTY, call 711. For language interpretation services, call 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 (toll free), or (toll free) or 711 (TTY). You can also call the Oregon Board of Dentistry at or the Washington State Department of Health at 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 kp.org/dental/nw to search our online directory or call 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 or go to kp.org/webmanager. Community s Affiliated community dentists are not part of Permanente Dental Associates (PDA). They are dentists credentialed by PDA for Kaiser Foundation Health Plan of the orthwest, 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. All providers listed in this directory speak English _10-18 All plans offered and underwritten by Kaiser Foundation Health Plan of the orthwest. 500 E Multnomah St., Suite 100, Portland, OR
2 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 _10-18 Dental Providers, Kaiser Permanente, orthwest Region. Providers accepting new members indicated in the Members column. Last updated October For the most up-to-date information, visit kp.org.
3 Aloha Dental Office SW Tualatin Valley Highway Beaverton, OR Charles G Row, DDS M Y General Dentist one David K Walker, DMD M Y General Dentist one Jay Wylam, DMD M Y Periodontist Periodontology (ABoP) Lindsey Gaulke Popov, DMD F Y General Dentist one ipoon V. Dave, DDS M Y General Dentist one Patrick Heaphy, DMD M Y Endodontist one one Beaverton Dental Office 4855 SW Western Avenue Beaverton, OR Curtis B Lemrick, DMD M Y General Dentist one Daniel E French, DMD M Y General Dentist one Justin Elson, DMD M Y General Dentist one Russel G Leoni, DMD M Y General Dentist one Wendy L Kincaid Smovir, DMD F Y General Dentist one Page _10-18
4 Cascade Park Dental Office SE Mill Plain Blvd Vancouver, WA Aaron S Johnson, DMD M Y General Dentist one David A Straube, DMD M Y General Dentist one Elly Kim, DDS F Y General Dentist one Jennifer Egli, DDS, MS F Y Orthodontist one Johanna L White, DDS F Y General Dentist one Linh T Vo-Cheng, DMD F Y Pediatric Dentist Pediatric Dentistry (ABoPD) Kaiser Interstate ASC Minah DeAinza, DDS F Y General Dentist one ikolas E Rawley, DMD M Y General Dentist one Richard Omans, DDS M Y General Dentist one Shawn M Fettig M Y Denturist one Y Cedar Hills Dental Office SW Walker Rd Beaverton, OR Aaron Lau, DMD M Y General Dentist one Andrea Fraser, DDS F Y General Dentist one Cyrus Jeh Lee, DMD M Y General Dentist one Daniel J Pihlstrom, DDS M Y General Dentist one Paula Censoni, DMD F Y General Dentist one Piper Huber, DDS F Y Pediatric Dentist Pediatric Dentistry (ABoPD) one Page _10-18
5 Clackamas Dental Office SE Sunnyside Road Clackamas, OR Chao Shen, DMD M Y General Dentist one Daniela Diaz, DMD F Y General Dentist one Dean Geist, DMD M Y General Dentist one Dennis Cain M Y Denturist one Y Desy Wilson, DDS, MS F Y Orthodontist Orthodontics (ABoO) Mailiki L Patterson, DDS F Y General Dentist one Misty H Trybom (Fujii-Carr), DDS F Y General Dentist one Myron T Peng, DMD M Y General Dentist one Susan Schaumburg Restic (Schaumburg), DMD one F Y General Dentist one Yoshiyuki Charlie Muraki, DMD M Y General Dentist one Yun Kyung-Lee, DMD F Y General Dentist one Eastmoreland Dental Office 5025 SE 28th Ave Portland, OR John Oki, DMD M Y General Dentist one Keith Herkert, DMD M Y General Dentist Kaiser Interstate ASC Marcus J van Witzenburg, DMD M Y General Dentist one Mark Villanueva, DDS M Y General Dentist one Matthew Jervis, DMD M Y General Dentist one Robert T McCashew, DDS M Y General Dentist one Page _10-18
6 Glisan Dental Office E Glisan St Portland, OR Carrie L Casper, DMD F Y General Dentist Kaiser Interstate ASC;Kaiser Sunnyside Medical Center Clay L Scarzella, DMD M Y General Dentist one David M Teeter, DMD M Y Orthodontist one Elizabeth Takamori, DDS F Y Endodontist one Farooq asserziayee, DMD M Y General Dentist one Jessica Adams, DDS, MSD F Y Periodontist Periodontology (ABoP) Jimmy J Yoo, DDS M Y General Dentist one John W Pak, DDS M Y General Dentist one Joseph Sease, DMD M Y Pediatric Dentist Pediatric Dentistry (ABoPD) Julia Chang (Dewey), DDS F Y General Dentist one Rebecca Guild, DMD F Y General Dentist one Sarah Heward, DMD F Y Endodontist one Tetsuji Z Watari, DDS M Y Periodontist Periodontology (ABoP) one one one Page _10-18
7 Grand Avenue Dental Office 1314 E Grand Ave Portland, OR Eric Burgin, DDS M Y Orthodontist one Heather Fife-Griffin, DMD F Y General Dentist one Jason R Whitt, DMD M Y General Dentist one Jeffrey J Wolfe, DDS M Y General Dentist one Jennifer A Gilbert, DMD F Y General Dentist one John Worthington, DDS M Y General Dentist one Lisa J Guerrero, DDS F Y General Dentist one Megan Erickson (Coker), DDS F Y General Dentist one Samer Hakimeh, DDS, MS M Y Pediatric Dentist Pediatric Dentistry (ABoPD) Kaiser Interstate ASC Todd Carris, DMD M Y General Dentist one Gresham Dental Office 360 W Burnside Rd Gresham, OR Elijah Volvovic, DMD M Y General Dentist one Lloyd S Chang, DDS M Y General Dentist one hu-ha Tran, DMD F Y General Dentist one icholas Smith, DMD M Y General Dentist one Page _10-18
8 Kaiser Permanente 3 to PhD Wellness Center 2930 E Dekum St Portland, OR Jodeen F Callaghan, DMD F Y General Dentist one Kaiser Permanente Building 500 E Multnomah Suite 100 Portland, OR Felix W Lee, DMD M Y General Dentist one James Alan Smith, DMD M Y General Dentist one Kaiser Permanente Dental at Johnson Creek 9300 SE 91st Ave. Ste 310 Happy Valley, OR Alexis Kleinman, DMD F Y Oral Surgeon Kaiser Interstate ASC;Kaiser Sunnybrook ASC;Kaiser Sunnyside Medical Center;Kaiser Westside Medical Center Jasmine Ju Hyun Cha, DDS F Y General Dentist one Jennifer Teng, DDS F Y General Dentist one John A Hill, DDS M Y General Dentist one Page _10-18
9 John A Holland, DDS M Y Oral Surgeon Kelly Dezura, DMD F Y Oral Surgeon Oral & Maxillofacial Surgery (ABOMS) Kaiser Interstate ASC;Kaiser Skyline Ambulatory Surgery Center;Kaiser Sunnybrook ASC;Kaiser Sunnyside Medical Center Kaiser Interstate ASC;Kaiser Sunnybrook ASC;Kaiser Sunnyside Medical Center;Kaiser Westside Medical Center Michael Chang, DDS M Y General Dentist one Michael Plunkett, DDS M Y General Dentist one Longview Dental Office th Ave Longview, WA adia adereh Ghanee, DMD F Y General Dentist one Dylan Sorber, DMD M Y General Dentist one Ethan S Kaufman, DDS M Y General Dentist one Justin Tan, DDS M Y General Dentist one Paul Lytle, DMD M Y General Dentist one Page _10-18
10 orth Interstate Dental Office Interstate Ave Portland, OR Allison C Broyles, DMD, MS F Y Prosthodontist one Benjamin Lively, DDS M Y General Dentist one Deepak Devarajan, DMD M Y General Dentist one Krista Lowen, DDS, MSD F Y Periodontist one Monica Peterson, DMD F Y General Dentist one Teresa J Waite F Y Denturist one Y orth Lancaster Dental Office 2300 Lancaster Dr., E Salem, OR Aziz Karam, DMD M Y General Dentist one Daniel R Santee, DMD M Y General Dentist one Ira D Povey, DDS M Y General Dentist one Jila Bowman, DDS F Y Periodontist one Kregg L DeLange, DMD M Y General Dentist one Oswaldo Gonzalez Cantarero M Y Denturist one Y Patrick Hagerty, DMD M Y General Dentist one Ronald J Leinassar, DMD M Y General Dentist one Ryan Randol, DDS Y General Dentist one Page _10-18
11 Oregon City Dental Office 1900 SE McLoughlin Blvd Suite 68 Oregon City, OR Douglas K Edwards, DMD M Y General Dentist one Jean Marie Pacewic, DMD F Y General Dentist one John Allen, DMD M Y General Dentist one John Warner, DMD M Y Pediatric Dentist one Molly M Francis, DMD F Y General Dentist Kaiser Sunnyside Medical Center Rachel White, DDS F Y General Dentist one Richard Bohnstedt, DMD M Y General Dentist one Shelby B Setter (Hiles), DDS F Y Pediatric Dentist Kaiser Interstate ASC Rockwood Dental Office 822 E 181st Ave Portland, OR Corey Malensek, DMD M Y General Dentist one Emad Eldin Ghaly M Y Denturist one Y Jonathan Browning, DDS M Y General Dentist one Peter guyen, DMD M Y General Dentist one Steven Justice, DDS M Y General Dentist one Page _10-18
12 Salmon Creek Dental Office E 20th Ave Vancouver, WA Angela A Manalili, DMD F Y General Dentist one Angie Rawley, DMD F Y General Dentist one Brandt G Monfort, DDS M Y General Dentist one Emily Jones, DMD F Y General Dentist one Glenn Ashworth, DDS M Y General Dentist one John Sung Kim, DMD M Y General Dentist one Marcy J Watson, DDS F Y Periodontist Periodontology (ABoP) Matthew Chung, DDS M Y General Dentist one Randy H Reese, DDS M Y Endodontist one William J Creed, DMD M Y General Dentist one one Skyline Dental Office 5135 Skyline Road South Salem, OR Daniel J Chung, DDS M Y General Dentist one Eric Peters, DMD M Y General Dentist Kaiser Interstate ASC;Kaiser Skyline Ambulatory Surgery Center James R Southworth, DMD M Y General Dentist one Jeffrey Pace, DMD M Y Orthodontist one Jennifer M Harms, DDS F Y General Dentist one Joseph Peck, DMD M Y Endodontist one Page _10-18
13 Katherine Lane, DMD, MSD F Y Pediatric Dentist Pediatric Dentistry (ABoPD) Kaiser Interstate ASC;Kaiser Skyline Ambulatory Surgery Center Linda H Le, DDS F Y General Dentist one Robert B White, DDS M Y General Dentist one Tony guyen, DMD M Y General Dentist one Tristan Wong, DMD M Y General Dentist one Tanasbourne Dental Office W Tanasbourne Dr. Suite 300 Hillsboro, OR Brett L Stringer, DMD M Y General Dentist one Gregory S Balekjian, DDS M Y General Dentist one Harold Y Y Young, DMD M Y General Dentist one Juanita V Boettcher, DMD F Y General Dentist Kaiser Interstate ASC;Kaiser Skyline Ambulatory Surgery Center;Kaiser Sunnyside Medical Center;Kaiser Westside Medical Center Kelley Stewart Wilson, DMD F Y General Dentist one Larson Larson Floor, DMD M Y General Dentist one Lauryn Marks, DMD F Y General Dentist one Lester C Laraway, DDS M Y Pediatric Dentist Pediatric Dentistry (ABoPD) Kaiser Interstate ASC Matthew G Antony, DDS M Y General Dentist one May S Kao, DDS F Y General Dentist one Michael Isaac, DDS M Y Oral Surgeon Oral & Maxillofacial Surgery (ABOMS) Kaiser Interstate ASC Phuong Teresa Doan, DMD F Y General Dentist one Page _10-18
14 Sheriann Shimogaki, DDS, MS F Y Orthodontist one Thomas L Ratliff, DDS M Y Orthodontist Orthodontics (ABoO) one Tigard Dental Office 7105 SW Hampton St Tigard, OR Danny H White, DDS M Y General Dentist one Greg G Bowers, DMD M Y General Dentist one Gregory J Reams, DMD M Y Endodontist one Matthew L Shih, DDS M Y General Dentist one Morgan Towle, DDS F Y General Dentist one Rie Kimura-Opperman, DMD F Y General Dentist one Ryan LeClaire, DDS M Y General Dentist one Vanessa K Olson, DDS F Y General Dentist one Valley River Dental 1011 Valley River Way Suite 116B Eugene, OR Tara G Paluska (Khalil), DDS F Y General Dentist one Page _10-18
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16 Kaiser Foundation Health Plan of the orthwest 500 E Multnomah St., Suite 100 Portland, OR KAISER PERMAETE ORTHWEST REGIO 19416_ Kaiser Foundation Health Plan of the orthwest
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