Dental Directory NORTH DAKOTA

Transcription

1 Dental Directory NORTH DAKOTA

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3 Table of Contents CONNECTION DENTAL NETWORK Burke County...3 Burleigh County...3 Cass County...3 Grand Forks County...4 McLean County...4 Pembina County...5 Richland County...5 Rolette County...5 Sheridan County...6 Walsh County...6 Ward County...6 Williams County...7 NOMINATION FORM...10 Please note: All providers listed are directly contracted with the Connection Dental Network but not at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is considered a Connection Dental provider at the location services are rendered (or performed). 1 Updated August 7, 2018

4 Please note: All providers listed are directly contracted with the Connection Dental Network but not at all locations in which they practice. Before receiving services, it is the member s responsibility to verify that the provider is considered a Connection Dental provider at the location services are rendered (or performed). Connection Dental is an Open Panel Dental PPO Network. Dentists are welcome to join the network if they meet our credentialing criteria, agree to participation terms and are approved.

5 Burke County North Dakota Participating Dentists Cass County Burke County 18 Main St SW Bowbells, ND (701) Burleigh County 914 S 12th St Ste 101 Bismarck, ND (701) Martinson, James W University of Minnesota-School of Dentis, W Interstate Ave Ste 132 Bismarck, ND (701) Mon: 8-6 Tues: 8-5 Fri: 8-12 Midstokke, Steven J N 19th St Ste 2 Bismarck, ND (701) Wangler, Ashley D University Of Minnesota, Greensboro Dr Ste 101 Bismarck, ND (701) Fri: 8-12 Wangler, Nicholas P University Of Minnesota-School Of Dentis, Hennepin County Med Center, Greensboro Dr Ste 101 Bismarck, ND (701) Fri: 8-12 Cass County Oral Maxillofacial Surgery Noffze, Michael J Indiana University School of Dentistry, Mayo Clinic College of Medicine - Roches, 1996, Essentia Health Hospital 300 Main Ave Ste 201 Fargo, ND (701) omsassociatesltd@hotmail.com Day, Joshua B University of Minnesota-School of Dentis, th Ave S Ste 10 Fargo, ND (701) Mon: 8-5 Tues: 10-7 Sat: 8-4 Eaton, Matthew J University of Minnesota-School of Dentis, Gateway Dr S Ste 4 Fargo, ND (701) Please note: All providers listed are directly contracted with the Connection Dental Network but not at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is considered a Connection Dental provider at the location services are rendered (or performed). Handicap Accessible Updated August 7,

6 Cass County North Dakota Participating Dentists McLean County Quamme, Brian J University of Minnesota, th Ave S Ste 10 Fargo, ND (701) Mon: 8-5 Tues: 10-7 Sat: 8-4 Rai, Danny M University of Minnesota, th Ave S Ste 10 Fargo, ND (701) Mon: 8-5 Tues: 10-7 Sat: 8-4 Languages spoken: Arabic, German Sampson, Svetlana K rd Ave S Ste 1200 Fargo, ND (701) office@aboutsmilesdentalfm.com Mon: 9-7 Tues: 9-7 Wed: 9-6 Sat: 9-5 Languages spoken: Russian Smith, Meghan M University of Minnesota-School of Dentis, Gateway Dr S Ste 4 Fargo, ND (701) Grand Forks County Austriaco, Jerome B Aspen Dental Management Inc nd Ave S Ste 101 Grand Forks, ND (701) Mon: 9-6 Tues: 11-8 Wed: 9-6 Thurs: 9-6 Beltran, Katalina Temple University, 2017 Aspen Dental Management Inc nd Ave S Ste 103 Grand Forks, ND (701) Mon: Tues: Wed: Thurs: 10-8 Fri: 8-1 Manke, Lauren R S Washington St Grand Forks, ND (701) info@mankedental.com Manke, Rory B S Washington St Grand Forks, ND (701) Mon: Tues: Wed: Thurs: Fri: S Washington St Ste B Grand Forks, ND (701) Mon: Tues: Wed: Thurs: Schefter, Daniel J nd Ave S Ste B Grand Forks, ND (701) McLean County Endodontics Zerr, Marvin A Univ of Nebraska College of Dentistry, Univ of Iowa College of Dentistry, Main St (701) Handicap Accessible Updated August 7, Some providers may not participate in our network at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is a participating provider at the location the member receives services. This list is subject to change.

7 McLean County North Dakota Participating Dentists Rolette County Bruins, Whitney V 416 Kundert St (701) Sat: 9-3 Burbach, Nathan J Kundert St (701) Faure, Nicholas B Oregon Health & Science University, Kundert St (701) Greer, Murray E Kundert St (701) Kundert St (701) Zerr, Marvin A Univ of Nebraska College of Dentistry, Univ of Iowa College of Dentistry, Kundert St (704) Pembina County Schefter, Daniel J th St Walhalla, ND (701) Richland County Devsi, Manmohan S Dakota Ave Wahpeton, ND (701) Rolette County Endodontics Zerr, Marvin A Univ of Nebraska College of Dentistry, Univ of Iowa College of Dentistry, nd Ave Rolette, ND (701) Burbach, Nathan J nd Ave Rolette, ND (701) Faure, Nicholas B Oregon Health & Science University, nd Ave Rolette, ND (701) Greer, Murray E nd Ave Rolette, ND (701) Mon: Tues: 8-5 Some providers may not participate in our network at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is a participating provider at the location the member receives services. This list is subject to change. Handicap Accessible Updated August 7,

8 Rolette County North Dakota Participating Dentists Ward County 114 3rd St NE Rolla, ND (701) nd Ave Rolette, ND (701) Sheridan County 122 E 2nd St Mcclusky, ND (701) Walsh County Beneda, Nicholas D Park St E Park River, ND (701) Brewer, Boone T University of Minnesota-School of Dentis, E 7th St Grafton, ND (701) Languages spoken: Korean, Spanish Larson, Brian J University of Minnesota-School of Dentis, Park St E Park River, ND (701) Ward County Bruins, Whitney V 15 2nd Ave SW Ste 110 (701) Burbach, Nathan J nd Ave SW Ste 110 (701) Faure, Nicholas B Oregon Health & Science University, nd Ave SW Ste 110 (701) asmith@northlandchc.org Greer, Murray E nd Ave SW Ste 110 (701) nd Ave SW Ste 110 (701) nd Ave SW Ste 19 (701) Handicap Accessible Updated August 7, Some providers may not participate in our network at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is a participating provider at the location the member receives services. This list is subject to change.

9 Ward County North Dakota Participating Dentists Williams County Zerr, Marvin A Univ of Nebraska College of Dentistry, Univ of Iowa College of Dentistry, nd Ave SW Ste 110 (701) Williams County Faure, Nicholas B Oregon Health & Science University, Railroad Ave Ste 16 Ray, ND (701) Railroad Ave Ste 16 Ray, ND (701) Some providers may not participate in our network at all locations in which they practice. Before receiving services, it is the member's responsibility to verify that the provider is a participating provider at the location the member receives services. This list is subject to change. Handicap Accessible Updated August 7,

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11 Alphabetical Index of Participating Dentists A Austriaco, Jerome B... 4 B Beltran, Katalina... 4 Beneda, Nicholas D... 6 Brewer, Boone T... 6 Bruins, Whitney V... 5, 6 Burbach, Nathan J... 5, 6 D Day, Joshua B... 3 Devsi, Manmohan S... 5 E Eaton, Matthew J... 3 F Faure, Nicholas B... 5, 6, 7 M Manke, Lauren R... 4 Manke, Rory B... 4 Martinson, James W... 3 Midstokke, Steven J... 3 N Noffze, Michael J... 3 Q Quamme, Brian J... 4 R Rai, Danny M... 4 S Sampson, Svetlana K... 4 Schefter, Daniel J... 4, 5 Smith, Meghan M... 4 G Greer, Murray E... 5, 6 K... 3, 5, 6, 7 W Wangler, Ashley D... 3 Wangler, Nicholas P... 3 Z Zerr, Marvin A... 4, 5, 7 L Larson, Brian J

12 Dentist Nomination Form If the dentist of your choice is not listed in this directory, you may complete this form to nominate the dentist to participate in the Connection Dental Network. An Application packet will be sent to the eligible providers. The normal time frame for credentialing of dentists takes approximately 90 days after application has been received. Dentist Information Name: Address: Phone: Fax: Member Information Name: Address: Phone: Fax: Member Identification Number: Employer Group Name: Group Number: Please Mail the form to the following address: PPO USA, Inc. P.O. Box 7010 Lee s Summit, MO Attn: Operations Fax to Operations at Call cs.ppousa@geha.com Thank you for your interest in the Connection Dental Network.