Utah Medicaid Dental Services

Transcription

1 A REGISTERED MARK OF DELTA DENTAL PLANS ASSOCIATION Utah Medicaid Dental Services Provider Directory September 03 Delta Dental Insurance Company a subsidiary of Delta Dental of California Utah Medicaid Dental Services Member Services --7- #73 (07/3)

2 Delta Dental Insurance Company Utah Medicaid Dental Services Provider Directory September 03

3 UTAH MEDICAID DENTAL SERVICES Welcome to Utah Medicaid Dental Services! A Primary Care Dentist is an individual Dentist that you pick to provide your dental care. Please use this book to find a Primary Care Dentist who will meet your needs. ou can choose a dentist who is close to where you live or work. If English is not your first language, you can choose one with staff who speaks the same language you do. Helpful Information about this Directory The dentists in this book are contracting dentists for Utah Medicaid Dental Services. The book tells you the names of the dentists who work in each office. This book also shows languages spoken in the office other than English. Dentists join the Utah Medicaid Dental Services program all the time. If you already have a dentist you like, but don t see his/her name in this book, please call us. We can tell you if that dentist has joined the program. Want More Information or Need Help? Be sure to read your Member Handbook. The handbook tells you what services the Utah Medicaid Dental Services program covers. It will tell you how to get a dental appointment. It will tell you what to do in an emergency. It will also tell you what to do if you need dental care on weekends and holidays. It will tell about finding a dentist when you are out of town. It tells you what Utah Medicaid Dental Services members rights and responsibilities are. It also tells you what to do if you have a complaint or want to file an appeal. Please call us if you have any questions. Our toll-free telephone number is ou can call us Monday through Friday, from :00 a.m. to 7:00 p.m. (Mountain Time) excluding state-approved holidays. Our automated system is available Monday to Sunday, hours a day. For TT service, please call 7-- (Relay Utah).

4 T A B L E O F C O N T E N T S DAVIS... Bountiful... Centerville... Clearfield... Layton... Syracuse... SALT LAKE... Herriman... Holladay... Magna... Midvale...3 Murray...3 Riverton...3 Salt Lake City... Sandy...5 Taylorsville... West Jordan... West Valley... UTAH... 7 American Fork... 7 Orem... Pleasant Grove... Provo... Spanish Fork...0 WEBER... 0 Egen...0 Ogden...0 Pleasant View... Roy... South Ogden... Delta Dental

5 Directory of Network Providers Davis Pitt Family Dental Facility #: 500 Bountiful So. Main Dental Care Kids 535 E. Medical Dr. Bountiful, UT 00 (0)- Facility #: 550 Centerville, UT 0 (0)5- Colleen Taylor Pedodontist Jason Pitt Jeremy Pitt Clearfield Monarch Dental Bountiful S 500 W # A Bountiful, UT 00 (0)-0 Facility #: 07 Dental Care Center 53 N. 000 W. Clearfield, UT 05 (0) Facility #: 5 Aaron Wright Andrew Vernon Benjamin Menlove Brian Baird John Day Peter Goupios Reed Jarvis Robert Goupios Clark Hicken Midtown Community Health Center Facility #: Darin Dickerson S. State Street, Ste 007 Diya Chadha Glade Crowther Pedodontist Clearfield, UT 05 (0) Jeffery Roberson Jeremiah Lindgren Kent Dastrup Kim Roberts Mark Endrizzi Nathan Wayment Paul Hanna Phillip Olsen Richard Steele Robert Chidester Endodontist Joe Hopkin Robert Bingham R. Clair Palmer Dds 3 N. Main Clearfield, UT 05 (0)5- Facility #: 75 Robert Johnson Sarah Naisbitt Scott Stringham Sean Mckeown Shane Taylor Periodontist Robert Palmer Thomas Davenport William Fisher Centerville Utah Medicaid Dental Services = Accepting New Patients Page

6 Clinton Dr. Jeremy Godderidge Facility #: 57 Comfort Dental Of Clinton 07 W. 00 N., Ste A Clinton, UT 05 (0)5-33 Facility #: 30 7 W. 700 S. Suite 03 Syracuse, UT 075 (0) Jeremy Godderidge Brent Milne Salt Lake John Roring Herriman Layton Dawson Pediatric Dentistry & Orthodontic Facility #: 5 Dawson Pediatric Dentistry & Orthodontic 35 W. 300 S. #00 Facility #: 3 0 N. Fairfeld Rd Layton, UT 0 (0)5-0 Herriman, UT 0 (0)30-05 Brad Dawson Pedodontist Brad Dawson Pedodontist Holladay Hillfield Pediatric And Family Dentistry Hillfield Rd, Ste Layton, UT 0 (0) Darren Wible Heath Hendrickson Facility #: 5 R. Scott Dickson, Dds, Pc 00 Murray Holladay Rd, #00 Holladay, UT 7 (0)77- R. Dickson Magna Facility #: 70 Jared Weaver Genesis Dental Of Magna Facility #: Wisdom Teeth Only N. Hill Field Rd, Ste 5 Layton, UT 0 (0) Facility #: 7 35 So. 00 We., Ste 50 Magna, UT 0 (0) Raymond Hendrickson Syracuse David Cannon David Stubbs Richard Buck Page = Accepting New Patients Utah Medicaid Dental Services

7 Directory of Network Providers Midvale Riverton Marz Orthodontics Facility #: 53 B. Charles Pugh Dds Facility #: 75 E. Fort Union Blvd So. Redwood Rd Midvale, UT 07 (0)30-3 Riverton, UT 05 (0)5-7 Kenneth Marz B. Charles Pugh Wisdom Teeth Only Facility #: 73 Cornfield Dental Center Facility #: South 00 East, Ste W. 00 S. Midvale, UT 07 (0) Riverton, UT 05 (0)5-555 Raymond Hendrickson Bong Noh Murray Ismile Crossroads Dental Facility #: 557 All Smiles Family Dentistry 5 E. 500 S., Ste 50 Murray, UT 07 (0)-003 Facility #: 30 W. 00 S. #00 Riverton, UT 05 (0)5-55 Joel Howarth Hanhngan Nguyentran Riverton Heights Dental Care Facility #: 553 Russell Smith 33 West 300 South Ismile Murray Family Dental E. 500 S. A Murray, UT 07 (0)- Facility #: 55 Riverton, UT 05 (0)7-3 Brian Borg Gerald Torgeson Quality Family Dental Care Facility #: 50 E. 500 S, C03 Murray, UT 07 (0)3-50 David Julian Utah Medicaid Dental Services = Accepting New Patients Page 3

8 oung Family Dental Facility #: Family Dental Care Facility #: 5 Rhetski Lane 500 S. State Street #0 Riverton, UT 05 Salt Lake City, UT 5 (35)-7 Christopher oung Kimel Fisher Kwang Park Michael Boyack Michael Loeser Michael oung Paige White William Cerny Salt Lake City 3g Family Dentistry 000 S. 300 E. Salt Lake City, UT 05 (0)-3 Facility #: Family Dental Plan N. 50 W., Ste 0 Salt Lake City, UT (0) Angelica Mchugh Dean Troili Deborah Perry Gary Spangler Facility #: Hoangcam Nguyen Kim Michelson Genesis Dental Of Salt Lake City Facility #: 57 Jeffrey Sperry 00 E. 00 S. Ste 05 Steven Sperry Central City Dental Clinic 00 E. Facility #: 70 Salt Lake City, UT 0 (0)355-3 Salt Lake City, UT (0)3-575 Eric Visser Hutchings Family Dentistry Facility #: 55 0 S. 700 E. #305 Alan Aoki Chris Ramsdell Salt Lake City, UT 0 (0)33-3 Daniel Baird Devin Link Dr. Matthew Larson E. 00 S. Salt Lake City, UT 0 (0) Facility #: 50 Brent Hutchings Michael Hutchings Matthew Larson Page = Accepting New Patients Utah Medicaid Dental Services

9 Directory of Network Providers Monarch Dental Taylorsville Facility #: 03 Stephen D Ratcliffe Clinic Facility #: S REDWOOD RD 35 W. 000 N. SALT LAKE CT, UT 3 (0)3-00 Salt Lake City, UT (0)3-575 Diya Chadha Pedodontist Alan Aoki Robert Chidester Chris Ramsdell Richard L. Ellis Ii 5 South 700 East Suite B30 Facility #: Daniel Baird Devin Link Salt Lake City, UT 0 (0) Stephen W Carter 55 E 500 So #E00 Facility #: 5 Salt Lake City, UT 07 (0)-73 Richard Ellis Ii Roger T Russell Dds 73 S. Highland Dr Ste 0 Facility #: 50 Stephen Carter Salt Lake City, UT (0)3-5 William C Vargo Dds 73 S. Highland Dr, # Facility #: 5 Salt Lake City, UT (0)3-00 Roger Russell Ruedi Tillmann, Dds 57 So 00E, #0 Salt Lake City, UT (0)-33 Facility #: William Vargo Sandy 3g Family Dentistry 00 S. Centennial Pkwy, #0 Facility #: 7 Sandy, UT 070 (0)-337 Ruidiger Tillmann Stephen B Liddle Dds Facility #: S. Highland Dr Ste 00 Salt Lake City, UT (0)3- Jeffrey Sperry Stephen Liddle Utah Medicaid Dental Services = Accepting New Patients Page 5

10 Lone Peak Dental Care Facility #: Sanford Hamilton Dmd Pc Facility #: S. 700 E. 3 W. 35 So. Sandy, UT 070 (0)57-30 Taylorsville, UT 3 (0)-07 Kenneth Dibble Sanford Hamilton Taylorsville Shawn Hamilton Monarch Dental Facility #: 0 West Jordan 5 S Redwood Rd Fox Park Dental Care Facility #: 55 Taylorsville, UT 3 (0) Redwood Rd West Jordan, UT 0 (0)5-55 Aaron Wright Andrew Vernon Jeffrey Brown Brian Baird Clark Hicken Daniel Meeks Darin Dickerson Glade Crowther James Skousen Jeffery Roberson Jeremiah Lindgren Kent Dastrup Kim Roberts Jordan Valley Dental 73 S. Jordan Landing Blvd, #0 West Jordan, UT 0 (0)-33 Brigham Colton West Valley Facility #: 755 Mark Endrizzi Mark Mcgowan Phillip Olsen Richard Steele Robert Chidester Robert Johnson Sarah Naisbitt Scott Stringham Marz Orthodontics W S. Ste A West Valley, UT (0)30-3 Facility #: 53 Sean Mckeown Periodontist Kenneth Marz Shane Taylor Thomas Davenport William Fisher William Sunberg Page = Accepting New Patients Utah Medicaid Dental Services

11 Directory of Network Providers Monarch Dental Assoc Facility #: 7 Viet Dentistry Pc Facility #: 5 S 000 W STE B West 3500 South, Ste A West Valley, UT 0 (0)55-00 West Valley, UT (0)7-7, HR, RU, ES Aaron Wright Benjamin Wilson Andrew Vernon Kieu Le Brian Baird Clark Hicken Daniel Meeks Darin Dickerson Glade Crowther Gregory Smith James Skousen American Fork Davies Family Dental Utah N. 300 E. American Fork, UT 003 (0)75-3 Facility #: 00 Jeffery Roberson Jeremiah Lindgren John Reschke Kent Dastrup Kim Roberts Kendell Davies Mark Endrizzi Phillip Olsen Richard Steele Robert Chidester Robert Johnson Sarah Naisbitt Scott Stringham Shane Taylor Thomas Davenport William Fisher William Sunberg Monarch Dental/ West Valley Facility #: 7 5 S 000 W STE B WEST VALLE, UT 0 (0)55-00 Diya Chadha Pedodontist Robert Chidester Utah Medicaid Dental Services = Accepting New Patients Page 7

12 Monarch Dental American Fork Facility #: 0 oung Family Dental Facility #: 0 7 N 00 W Ste A 3 E. 00 S. American Fork, UT 003 (0)75-55 American Fork, UT 003 (0) Aaron Wright Christopher oung Andrew Vernon Kwang Park Brian Baird Michael Boyack Clark Hicken Michael Loeser Cory Price Michael oung Daniel Meeks Paige White Daniel Thunell Periodontist William Cerny Darin Dickerson Orem Diya Chadha Glade Crowther James Skousen Jeffery Roberson Jeremiah Lindgren Kent Dastrup Kim Roberts Pedodontist Dodge Family Dentistry 33 W. 0 N. Orem, UT 057 (0)5-00 Facility #: 3 Mark Endrizzi Phillip Olsen Rdean Clark Richard Steele Robert Chidester Robert Johnson Sarah Naisbitt Scott Stringham Sean Mckeown Shane Taylor Periodontist Keith Dodge Double Take Dental N. 00 W. #A3 Orem, UT 057 (0)5-00 Facility #: 55 Thomas Davenport Michael Atwood William Fisher Gentle Dental Arts Facility #: Murdock & Searle Family Dentistry 35 E. 0 S. American Fork, UT 003 (0)75-55 Facility #: W. Center St. Orem, UT 057 (0)-7 Alexander Larsen Bruce Murdock Bryce Searle Page = Accepting New Patients Utah Medicaid Dental Services

13 Directory of Network Providers Pediatric Smiles Of Orem 7 N. 00 W., Ste A Orem, UT 057 (0)3-537 Adam Shepherd oung Family Dental 3 S. State Orem, UT 07 (0)-0 Christopher oung Kwang Park Michael Boyack Michael Loeser Michael oung Facility #: Pedodontist Facility #: 0 Mountainlands Community Health Center 5 So. State Street Provo, UT 0 (0)-000 Chad Booth Provo Dental Care 355 N. University Ave, Ste 330 Provo, UT 0 (0) Daryn Moody David Iroz Paul Nielsen Tyler Hoelzer Facility #: 75 Facility #: 57 Paige White William Cerny Pleasant Grove G. Trevor Smith Dds 0 East State Road Pleasant Grove, UT 0 (0)75-57 Facility #: Unison Dental 3330 N. University Ave, Ste A Provo, UT 0 (0)375-5 Facility #: 53 Jay Scott Wisdom Teeth Only Facility #: 7 Gavin Smith Provo 30 N. University Pkwy, #A Provo, UT 0 (0) Michael H. Lorscheider Dmd 7 N. University Pkwy, #03 Provo, UT 0 (0) Facility #: 5 Raymond Hendrickson Michael Lorscheider Utah Medicaid Dental Services = Accepting New Patients Page

14 Saratoga Springs Call Family Dental Facility #: 7 oung Family Dental 37 N. Redwood Rd Saratoga Springs, UT 05 (0)7- Facility #: 50 Harrison Blvd, Ste 00 B Ogden, UT 03 (0)3-537 Nathan Call Christopher oung Dr. Todd C. Cummings, Dds Facility #: 53 Kwang Park 50 Harrison Blvd, Ste C Michael Boyack Michael Loeser Ogden, UT 03 (0)-05 Michael oung Paige White William Cerny Spanish Fork Todd Cummings Spanish Fork Dental N. 00 E. # Spanish Fork, UT 0 (0)7-357 Facility #: 5 Family Dental Plan 50 E. 5th St., Ste A Ogden, UT 0 (0) Facility #: 3 Tyler Hoelzer Angelica Mchugh Weber Dean Troili Egen Deborah Perry Iverson And Larsen Dental 7 N. Hwy Egen, UT 30 (0)75-3 Vern Iverson Ogden Bryon J Talbot Dds Pc 50 S. Wasatch Dr, Ste B Facility #: 5 Facility #: 53 Gary Spangler Hoangcam Nguyen Kim Michelson James W Ellis Dds Pc 0 33rd St, #C Ogden, UT 03 (0)3-555 James Ellis Facility #: 5 Ogden, UT 03 (0)7-30 Bryon Talbot Page 0 = Accepting New Patients Utah Medicaid Dental Services

15 Directory of Network Providers Jeffrey R Haslam Facility #: 5 Wade E. Larson, Llc Facility #: 53 E 5350 S #C 707 N. 00 E. Ogden, UT 05 (0)7-700 North Ogden, UT (0)7-05 Jeffrey Haslam Wade Larson Midtown Community Health Center Facility #: 3 Pleasant View 0 Adams Ave. Ogden, UT 0 (0) Lamont E. Hesselgesser Dds Pc 703 N. 00 W. Pleasant View, UT 0 (0) Facility #: 355, FR Joe Hopkin Robert Bingham Lamont Hesselgesser Mount Ogden Dental, Pc 0 33rd St, #D Ogden, UT 03 (0)3-555 Derald Geddes Tribe Dental Facility #: 50 Facility #: 5 Pleasant View Dental Center 5 W. Pleasant View Dr Pleasant View, UT (0) Paul Hopkins Roy Facility #: E. 55 S. # Ogden, UT 03 (0) Michael Tribe Tyler C. Shaw Dds 5 Capitol Street, Ste S Ogden, UT 0 (0)3- Tyler Shaw Facility #: 505 Roy Dental Care 533 So 00 W. Roy, UT 07 (0) Carl Dickerson Russell Seamons, Dmd 0 S. 00 W. # Roy, UT 07 (0)773-3 Facility #: 5 Facility #: 5 Russell Seamons Utah Medicaid Dental Services = Accepting New Patients Page

16 South Ogden Donald W Sorensen Dds 50 E. Skyline Dr., Ste 500 South Ogden, UT 05 (0)33-7 Facility #: 753 Donald Sorensen Experienced Dental 07 Fashion Pointe Dr. South Ogden, UT 03 (0) Facility #: 75 Blake Cameron James Barclay Paul Makley Page = Accepting New Patients Utah Medicaid Dental Services

17 Delta Dental Main Dentist Index Page Page Page American Fork Aaron Wright Andrew Vernon Brian Baird Bruce Murdock Bryce Searle Christopher oung Clark Hicken Cory Price Daniel Meeks Daniel Thunell Darin Dickerson Diya Chadha Glade Crowther James Skousen Jeffery Roberson Jeremiah Lindgren Kendell Davies 7 Kent Dastrup Kim Roberts Kwang Park Mark Endrizzi Michael Boyack Michael Loeser Michael oung Paige White Phillip Olsen Rdean Clark William Cerny Bountiful Aaron Wright Andrew Vernon Benjamin Menlove Brian Baird Clark Hicken Colleen Taylor Darin Dickerson Diya Chadha Glade Crowther Jeffery Roberson Jeremiah Lindgren Kent Dastrup Kim Roberts Mark Endrizzi Nathan Wayment Paul Hanna Phillip Olsen Richard Steele Robert Chidester Robert Johnson Sarah Naisbitt Scott Stringham Sean Mckeown Shane Taylor Thomas Davenport William Fisher Centerville Jason Pitt Jeremy Pitt Clearfield Joe Hopkin John Day Peter Goupios Reed Jarvis Robert Bingham Robert Goupios Robert Palmer Egen Vern Iverson 0 Herriman Brad Dawson Holladay R. Dickson Layton Brad Dawson Darren Wible Heath Hendrickson Jared Weaver Raymond Hendrickson Magna David Cannon David Stubbs Richard Buck Midvale Raymond Hendrickson 3 Murray David Julian 3 Gerald Torgeson 3 Hanhngan Nguyentran 3 Russell Smith 3 Ogden Angelica Mchugh 0 Bryon Talbot 0 Dean Troili 0 Deborah Perry 0 Derald Geddes Gary Spangler 0 Hoangcam Nguyen 0 James Ellis 0 Joe Hopkin Kim Michelson 0 Michael Tribe Nathan Call 0 Robert Bingham Todd Cummings 0 Tyler Shaw Wade Larson Orem Alexander Larsen Christopher oung Keith Dodge Kwang Park Michael Atwood Michael Boyack Michael Loeser Michael oung Paige White William Cerny Pleasant Grove Gavin Smith Pleasant View Lamont Hesselgesser Paul Hopkins Provo Chad Booth Daryn Moody David Iroz Jay Scott Michael Lorscheider Paul Nielsen Raymond Hendrickson Tyler Hoelzer Riverton B. Charles Pugh 3 Bong Noh 3 Brian Borg 3 Christopher oung Joel Howarth 3 Kwang Park Michael Boyack Roy Carl Dickerson Russell Seamons Salt Lake City Alan Aoki Angelica Mchugh Brent Hutchings Chris Ramsdell Daniel Baird Dean Troili Deborah Perry Devin Link Eric Visser Gary Spangler Hoangcam Nguyen Jeffrey Sperry Kim Michelson Kimel Fisher Matthew Larson Michael Hutchings Richard Ellis Ii 5 Roger Russell 5

18 Ruidiger Tillmann 5 Stephen Carter 5 Stephen Liddle 5 Steven Sperry William Vargo 5 Sandy Jeffrey Sperry 5 South Ogden Blake Cameron James Barclay Paul Makley Spanish Fork Tyler Hoelzer 0 Syracuse Jeremy Godderidge Taylorsville Aaron Wright Andrew Vernon Brian Baird Clark Hicken Daniel Meeks Darin Dickerson Glade Crowther James Skousen Jeffery Roberson Jeremiah Lindgren Kent Dastrup Kim Roberts Mark Endrizzi Mark Mcgowan Phillip Olsen Richard Steele Robert Chidester Robert Johnson Sanford Hamilton Sarah Naisbitt Scott Stringham Sean Mckeown Shane Taylor Shawn Hamilton Thomas Davenport William Fisher William Sunberg West Jordan Brigham Colton Jeffrey Brown West Valley Aaron Wright 7 Benjamin Wilson 7 Diya Chadha 7 Kenneth Marz Kieu Le 7 Robert Chidester 7 Page Page Page

19 Specialists Listings Descriptions Endodontist: A dentist that may take care of you when you need a root canal. They help prevent, diagnose and treat other diseases and injuries to a tooth. Oral Surgeon: A dentist that may take care of you when you need to pull a tooth. They diagnose and operate on diseases, injuries and defects in the mouth, jaw and face. Orthodontist: A dentist that may take care of you if you need braces. They treat and help with things that are not normal with your teeth and jaws. Periodontist : A dentist that may treat gums, bone or other tissues that support your teeth. Prosthodontist: A dentist that may replace a missing tooth or other oral structure. They may provide things such as a denture, a fixed bridge or a crown.