Welcome To Regence BlueCross BlueShield Of Utah . - University Of Utah
Welcome to Regence BlueCross BlueShield of UtahUnderstanding your options is a vital part of good care. That’s why your plan gives you access toproviders—physicians, other health care professionals and facilities—who provide a wide rangeof health care services, from routine and preventive care to the most specialized treatment.Using this Provider DirectoryThis directory lists providers in the Preferred ValueCare Dental Network as of March 1, 2022.The provider information contained in this directory—including credentialing, contracting status,and provider-supplied data—is continually gathered from a variety of sources, and is updated atleast monthly. The information in this directory is accurate to the extent that the sources fromwhich the information is collected are accurate. Credentials are validated through a variety ofnational and state credentialing verification sources.This list of providers is current as of the date listed but may change at any time. You can alwaysfind the most up-to-date list of providers in this network on regence.com using the “Find aDoctor” feature (see “Finding information on Regence.com” below for more information.) Youcan also contact a member service specialist to verify a provider’s status and information beforemaking your appointment.Your choice drives your costWe contract with physicians, dentists, other health care professionals and facilities to formprovider networks essential for delivery of health care and dental services to our members. Allproviders must meet certain requirements before they can participate in our provider networks.(For a full listing of requirements, visit www.regence.com/find-a-doctor or contact CustomerService.) With Regence, you’ll get the best benefit (and pay the lowest out-of-pocket cost) whenyou visit an In-Network provider.Any provider in the Preferred ValueCare Dental Network is considered In-Network. Anyprovider not in the Preferred ValueCare Dental Network is considered Out-of-Network. If youvisit an Out-of-Network provider, your out-of-pocket cost may be significantly higher. You mayalso be “balance billed” for the difference between the dollar amount Regence allows for aspecific service (also called the “allowed amount”) and the amount the provider or facilitycharges.For details about your benefits—including coverage levels, limitations and exclusions—pleasesee your benefits booklet or view your benefit information on regence.com.Regence Preferred ValueCare Dental Network Provider DirectoryUpdated March 1, 2022i
Important note about EPO PlansIf you’re enrolled in an EPO plan, keep in mind that there are no out-of-network benefits. Youmust see an In-Network provider. If you do not, you will receive no benefit and will beresponsible for the entire cost. Please choose your providers carefully if you’re enrolled in thistype of plan.Receiving care away from homeDepending on your plan, you and your covered family members may have access to health careacross the country through the BlueCard Program. BlueCard providers will bill the local BlueCross and/or Blue Shield Plan for you. You can find BlueCard providers by visiting bcbs.com orcalling 1 (800) 810-BLUE.Using your member cardShow your member card each time you see a provider or visit a hospital. This gives providers theinformation they need to bill us and is equally important even if you visit providers who are Outof-Network.Submitting claimsMost of the time, you shouldn’t have to submit a claim. But if the need arises (for example, ifyour plan offers Out-of-Network benefits and you see an Out-of-Network provider), you candownload a Member Reimbursement Claim Form from regence.com and send it to:Regence BlueCross BlueShield of UtahAttn: Claims ServicesP.O. Box 30270Salt Lake City, UT 84130-0270Finding information on regence.comFor the most current provider information you can visit our public website atregence.com. The “Find a Doctor” feature on regence.com will allow you to sort, filter andrefine provider search results based on network, provider rating, location, hours of operation, orother attributes that are important to you.In addition, when you create a member account at regence.com, you will gain access to claimsinformation and programs designed to help you navigate your health care and make the most ofyour wellness.Regence Preferred ValueCare Dental Network Provider DirectoryUpdated March 1, 2022ii
Questions?If you have questions about: Status of a particular provider or facility Discrepancies in this printed directory or in our online “Find a Doctor” directory Your coverage, claims or enrollmentPlease call the telephone number on the back of your member card (TTY: 711) to speak with aRegence Customer Service specialist or send an email to info@regence.com.Regence Preferred ValueCare Dental Network Provider DirectoryUpdated March 1, 2022iii
Table of ContentsRural County Notice . 1Dental Providers . 2Alphabetical Provider Index . 169ivMarch 1, 2022
Notice Regarding Access to Health Care Providers in Rural CountiesBy virtue of Utah state law, you may have special entitlement to coverage for health care services from the following providers if you liveor reside: Within 30 paved road miles of the listed providers, or In closer proximity to the listed providers than to your contracted providers.This list identifies all providers who qualify under the law regarding Utah health care providers in rural counties. Your health insurance plan maycontract with some of them and, if so, the terms of that contract would apply to services you receive from them.Independent HospitalsThe following are the Independent Hospitals that fall under the law:(1) Ashley Regional Medical Center, Vernal, Uintah County, Utah(2) Beaver Valley Hospital, Beaver, Beaver County, Utah(3) Blue Mountain Hospital, Blanding, San Juan County, Utah(4) Castleview Hospital, Price, Carbon County, Utah(5) Central Valley Medical Center, Nephi, Juab County, Utah(6) Gunnison Valley Hospital, Gunnison, Sanpete County, Utah(7) Kane County Hospital, Kanab, Kane County, Utah(8) Milford Valley Memorial Hospital, Milford, Beaver County, Utah(9) Moab Regional Hospital, Moab, Grand County, Utah(10) San Juan Hospital, Monticello, San Juan County, Utah(11) Uintah Basin Medical Center, Roosevelt, Duchesne County, UtahFederally Qualified Health CentersThe following are the Federally Qualified Health Centers that fall under the law:(1) Bear Lake Community Health Center, Garden City, Rich County, Utah(2) Bear River Health Clinic, Tremonton, Box Elder County, Utah(3) Blanding Family Chiropractic, Blanding, San Juan County, Utah(4) Blanding Family Practice Community Health Center, Blanding, San Juan County, Utah(5) Blanding Family Vision Center, Blanding, San Juan County, Utah(6) Box Elder Community Health Center, Brigham City, Box Elder County, Utah(7) Brigham City Community Health Center, Brigham City, Box Elder County, Utah(8) Carbon Medical Service Association – Helper Clinic, Helper, Carbon County, Utah(9) Carbon Medical Services Association, Sunnyside, Carbon County, Utah(10) Cedar Community Health Center, Cedar City, Iron County, Utah(11) Family Healthcare, Cedar City, Iron County, Utah(12) Green River Medical Center, Green River, Emery County, Utah(13) Kanosh Community Health Center, Kanosh, Millard County, Utah(14) Kazen Memorial Clinic, Escalante, Garfield County, Utah(15) Koosharem Community Health Center, Richfield, Sevier County, Utah(16) Montezuma Creek Community Health Center, Montezuma Creek, San Juan County, Utah(17) Mountain Lands Community Health Center, Inc., Vernal, Uintah County, Utah(18) Southwest W C H C Mental Health, Panguitch, Garfield County, Utah(19) Wayne Community Health Center, Hanksville, Wayne County, Utah(20) Wayne Community Health Centers, Bicknell, Wayne County, UtahThis list may change periodically, please check our member website at regence.com or call for verification. Please be advised that if youchoose a non-contracted provider you will be responsible for any charges not covered by your health insurance plan. If you have questionsconcerning your rights to see a provider on this list, you may contact your health insurance plan at the phone number on the back of yourmember card. If the health insurance plan does not resolve your problem, you may contact the Office of Consumer Health Assist ance in theInsurance Department toll free at 1 (800) 439-3805 or in-state (801) 538-3077 or at health.uid@utah.gov.1March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameALPINEAMERICAN FORKDENTISTRYDENTISTRYUTAHANDERSON, JOHN ALAN DDS CRIDDLE, MICHAEL WAYNE DDSB & G MANAGEMENT SERVICESLLCCSW DENTAL198 S 1100 E (801) 756-0360Provider Speaks: SPANISH170 N CENTER ST(801) 756-2341ALPINEDENTISTRYJENSEN, AARON A DDS PONY EXPRESS DENTAL OF ALPINE20 W MAIN STREET CT STE 100(801) 756-3570PONY EXPRESS DENTAL OFALPINEALPINE DENTISTRY20 W MAIN STREET CT STE 100(801) 756-3570 MASTERPIECE DENTAL186 S 1100 E (801) 756-5136CRIDDLE, NATHANIEL MARKDMD BLACKHURST, DAVID REESE DDS CSW DENTAL DAVID R BLACKHURST D D S LLC565 E STATE RD (801) 756-7211Provider Speaks: PORTUGUESEBOTT, RYAN GEORGE DDS PORTER, RYAN J DDSPONY EXPRESS DENTAL OF ALPINE20 W MAIN STREET CT STE 100(801) 756-3570WILLOW CREEK DENTAL CARE183 S 500 E (801) 763-9080STUCKI, RANDALL MCKAY DDS PONY EXPRESS DENTAL OF ALPINE20 W MAIN STREET CT STE 100(801) 756-3570Provider Speaks: SPANISHAMERICAN FORKDENTISTRYA F FAMILY DENTAL INC321 E 300 N (801) 756-0933DENTAL PROS OF UTAH PLLC198 S 1100 E (801) 756-0360DAVID R BLACKHURST D D S LLCMODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522DAVIES, KENDELL TROY DMD BRAITHWAITE, STEVEN R DDS 291 N 300 E BROWN, ASHLEY BROOKE DMD CSW DENTALDAVIDOV, MENAKHEM DMDELITE DENTAL LLC288 N WEST STATE RD (801) 763-7737Provider Speaks: SPANISHELITE DENTAL LLC288 N WEST STATE RD (801) 763-7737Provider Speaks: SPANISHTORNOW, MICHAEL SCOTT DMD75 W MAIN STREET CT STE 200(801) 492-7778198 S 1100 E (801) 756-0360DAVID R BLACKHURST565 E STATE RD BRAITHWAITE, RANDY CHARLES (801) 756-7211STUCKI, GRANT TURNER DDS DDS PONY EXPRESS DENTAL OF ALPINE20 W MAIN STREET CT STE 100(801) 756-3570Provider Speaks: SPANISH MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522CAPUA, JOHN KEITH DMD DR JAY PC576 W PACIFIC DR(801) 756-1009576 W PACIFIC DR(801) 756-1009 DR L CRAIG ROSVALL DDS224 S 1100 E (801) 756-6581ELITE DENTAL LLC288 N WEST STATE RD(801) 763-7737 FAIRBANKS, JONATHAN M DDS CHIDESTER, ROBERT J DDS MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 934-3181Provider Speaks: THAI Provider Gender Female Provider Gender Male(801) 756-2346DR JAY PCMURDOCK & SEARLE FAMILYDENTISTRY356 E 20 S (801) 756-4595 This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access2March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameAMERICAN FORKAMERICAN FORKDENTISTRYDENTISTRYUTAH (cont.)AMERICAN FORK (cont.)DENTISTRY (cont.)JONES, BRIAN RAYMOND DMD PARK, KWANG KYV DDS MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522Provider Speaks: SPANISHLIDDLE, JOSEPH DOYLE DDS N CENTER ST GREEN, MICHAEL BRANDON DDS 120(801) 756-3377 B & G MANAGEMENT SERVICES LLC186 S 1100 E (801) 756-5136GREENWOOD DENTALAMERICAN FORK LLC226 N 1100 E STE D(801) 756-6037 GREENWOOD, BRANDON DALEDDS GREENWOOD DENTAL AMERICANFORK LLC226 N 1100 E STE D (801) 756-6037Provider Speaks: JAPANESEGREENWOOD, BRYAN G DDS GREENWOOD DENTAL AMERICANFORK LLC226 N 1100 E STE D (801) 756-6037GREENWOOD, DALE MAX DDS GREENWOOD DENTAL AMERICANFORK LLC226 N 1100 E STE D (801) 756-6037LLOYD, SAMUEL JAMES DDS YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173LOESER, MICHAEL H DMD YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173Provider Speaks: SPANISHMAUGHAN, CAMERONBRADSHAW DMD MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522MCMILLAN, CARL K DDS TMJ THERAPY INC355 E 50 S (801) 756-0900 366 S 500 E (801) 756-2809(801) 756-4989Provider Speaks: SPANISHMURDOCK, BRUCE THOMPSONHEMMERT, JARED WYNN DDS DMD YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173Provider Speaks: SPANISHPHAM, HUNG QUOE DDS MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522PUNG, IAN KILIONA DDS YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173RICHARDS, BRUCE BATEMANDMD 233 E MAIN ST (801) 756-8686Provider Speaks: SPANISHMURDOCK & SEARLE FAMILYDENTISTRY356 E 20 S (801) 756-4595Provider Speaks: JAPANESE Provider Gender Female Provider Gender MaleDR L CRAIG ROSVALL DDS224 S 1100 E (801) 756-6581SCHOFIELD, NATALICHRISTENSEN DDS MUIR, ERIC B DDS HANSEN, CLAYTON MARION DDS 186 S 1100 E PELTON, RITCHIE S DMD ROSVALL, LYNN CRAIG DDS MODERN DENTAL ASSOCIATES476 N 900 W STE A(801) 756-5522YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173Provider Speaks: KOREAN, SPANISHCSW DENTAL198 S 1100 E (801) 756-0360SEARLE, BRYCE DMD MURDOCK & SEARLE FAMILYDENTISTRY356 E 20 S (801) 756-4595Provider Speaks: SPANISH This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access3March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameAMERICAN FORKBICKNELLDENTISTRYUTAH (cont.)AMERICAN FORK (cont.)DENTISTRY (cont.)TRACY, SCOTT AVERY DDS A F FAMILY DENTAL INC321 E 300 N (801) 756-0933WHITE, DALE DANNY DMD CSW DENTAL198 S 1100 E (801) 756-0360WHITE, PAIGE P DDS YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173WILLOW CREEK DENTAL CARE183 S 500 E (801) 763-9080WORKMAN, RYAN MATTHEWDDS YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173YOUNG DENTAL PRACTICE AMERICAN FORK PLLCYOUNG FAMILY DENTAL-AF483 E 200 S (801) 756-7173YOUNG, CHRISTOPHER WAYNEDDS YOUNG DENTAL PRACTICE AMERICAN FORK PLLC483 E 200 S (801) 756-7173DENTISTRYYOUNGQUIST, JEFFREY ALANDDS DR JAY PC576 W PACIFIC DR (801) 756-1009Provider Speaks: SPANISHENDODONTIAPERIODONTICSATKINS, BRADEN CORDELL DMD MODERN DENTAL ASSOCIATES476 N 900 W STE A (801) 756-5522BEAVERBURR, DANIEL SCOTT DDS 321 E 300 N (801) 772-0492Provider Speaks: SPANISHCHRISTENSEN, JOSEPH DANIELDMD 36 S 1100 E STE B(801) 822-9876 DENTISTRYMYERS, DELMONT G DMD 885 N 50 E (435) 438-5940BICKNELLORAL SURGERYDENTISTRYCRAWFORD, GARY LYLE DDS ANDERSEN, WYNN SCOTT DDS ORAL & MAXILLOFACIAL SURGERY1022 E 220 S (801) 756-0766Provider Speaks: SPANISH374 S 300 E (435) 425-3391COLE, DAREN CHARLES DDS WAYNE COMMUNITY HEALTHMCBEE, WILLIAM LECILE DDS CENTERS INCORAL & MAXILLOFACIAL SURGERY1022 E 220 S (801) 756-0766128 S 300 W (435) 425-3744ORAL & MAXILLOFACIALSURGERY KELLEY, RANDALL JAMES DMDWAYNE COMMUNITY HEALTHCENTERS INC128 S 300 W OSGUTHORPE, JEFFREY AVARON (435) 425-3744Provider Speaks: SPANISHDDS MODERN DENTAL ASSOCIATESKENNEDY, ANDREW DALE DDS476 N 900 W STE A (801) 756-5522WAYNE COMMUNITY HEALTHCENTERS INCPEDIATRIC DENTISTRY128 S 300 W JENSEN, SCOTT ANTHONY DDS (435) 425-374425 N 1100 E (801) 492-1346Provider Speaks: SPANISH1022 E 220 S (801) 756-0766 Provider Gender Female Provider Gender Male This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access4March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameBICKNELLBLUFFDALEDENTISTRYUTAH (cont.)BICKNELL (cont.)DENTISTRY (cont.)SEARS, RYAN T DMD WAYNE COMMUNITY HEALTHCENTERS INC128 S 300 W (435) 425-3744STILSON, WILFORD JAY DMD WAYNE COMMUNITY HEALTHCENTERS INC128 S 300 W (435) 425-3744BLANDINGDENTISTRYBAWDEN, HAL CLELL DDS UTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500PEDIATRIC DENTISTRYJOLLEY, CHRIS MATTHEW DDSUTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500Provider Speaks: SPANISHKOPASZ, CHRISTY LYNN DDS PAUL REDD MACDONALD DDS401 S MAIN ST (435) 678-2815910 S 300 W (435) 678-0500DENTISTRY13825 S REDWOOD RD STE 100(801) 679-3024Provider Speaks: GERMANUTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500Provider Speaks: NAVAJOFAMILIES FIRST PEDIATRICDENTISTRY13825 S REDWOOD RD STE 100(801) 679-3024Provider Speaks: ITALIAN14003 S REDWOOD RD(801) 407-1628 ODION, CHARLES EDWARD DDSOLSEN, BRIAN FREDRICK DDS PAUL REDD MACDONALD DDS401 S MAIN ST (435) 678-2815 STRINGHAM, SCOTT DAVID DDS UTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500910 S 300 W (435) 678-0500212 S 200 E (435) 678-3440Provider Speaks: DANISHBLUFFDALE DENTAL14003 S REDWOOD RD(801) 407-1628NEELEY, JAY CHRISTIAN DDS MACDONALD, PAUL REDD DDS FAMILIES FIRST PEDIATRICGOODWINE, BRIAN JAMES DDSJOHANSEN, BRENT DDS BABCOCK, DAVID M DMD BLUFFDALE DENTALUTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500 DENTISTRYUTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500EINERSON, DICK NATHAN DDS SEKAQUAPTEWA, CRYSTALUTAH NAVAJO HEALTH SYSTEMAMBER WILLIE DDS INCORPORATED910 S 300 W (435) 678-0500BLUFFDALE BLUFFDALE DENTAL14003 S REDWOOD RD (801) 407-1628Provider Speaks: SPANISHPEDIATRIC DENTISTRYFAMILIES FIRST PEDIATRICUTAH NAVAJO HEALTH SYSTEM DENTISTRYINCORPORATED13825 S REDWOOD RD STE 100 (801) 679-3024VREEKEN, JOSEPH D DDSUTAH NAVAJO HEALTH SYSTEMINCORPORATED910 S 300 W (435) 678-0500Provider Speaks: PORTUGUESE Provider Gender Female Provider Gender MaleMCDONALD, BLAKE DAVID DDS FAMILIES FIRST ORTHODONTICS LLC13825 S REDWOOD RD STE 100 (801) 679-3024 This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access5March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameBLUFFDALEBOUNTIFULPEDIATRIC DENTISTRYDENTISTRYBRINKERHOFF, MATTHEWSTEVEN DMD UTAH (cont.)BLUFFDALE (cont.)PEDIATRIC DENTISTRY(cont.)NEELEY, JAY CHRISTIAN DDS FAMILIES FIRST PEDIATRICDENTISTRY13825 S REDWOOD RD STE 100(801) 679-3024Provider Speaks: GERMAN BOUNTIFULDENTISTRYALPENGLOW DENTAL PC1459 N MAIN ST STE 4(801) 397-5220 ASAY, GAYLEN STAHLE DDS G. ASAY ENTERPRISES PC1459 N MAIN ST STE 3 (801) 292-4440BAIRD, ANTHONY JOHN DDS MILLCREEK FAMILY DENTAL PC1455 S 500 W STE D (801) 292-4009BLUME, DENNIS J DDS CANNON FAMILY DENTAL, LLCDENTAL DESIGNS OF BOUNTIFUL319 S MAIN ST (801) 295-7171EGGETT, MICHAEL JOHN DDS STOBBE EGGETT DENTAL625 E 500 S STE 201 (801) 292-0443Provider Speaks: SPANISHCANNON, HYRUM MAUGHAN DDS535 E 500 S STE 2(801) 295-5115 G. ASAY ENTERPRISES PC ODION, CHARLES EDWARD DDSFAMILIES FIRST PEDIATRICDENTISTRY13825 S REDWOOD RD STE 100(801) 679-3024Provider Speaks: ITALIANMATTHEW S BRINKERHOFF PC469 MEDICAL DR STE 108 (801) 298-7728DUKE, DAVID LYMAN DDS CANNON FAMILY DENTAL, LLC535 E 500 S STE 2 (801) 295-51151459 N MAIN ST STE 3(801) 292-4440PAGE FAMILY DENTISTRY535 E 500 S STE 3 (801) 292-7807LEVO DENTAL LLC1480 S ORCHARD DR STE 110(801) 295-9500GARDNER, TIMOTHY ANDREWSCARLISLE, KELLY ROSS DMD DMD CHIDESTER, ROBERT J DDS GERRARD, DEVIN MASON DDS MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606Provider Speaks: THAI1480 S ORCHARD DR STE 102(801) 295-5796CHILTON, MICHAEL J DDS MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606CLARK, WALKER DEAN DDS SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880COURAUD, JUSTIN M DMD ALPENGLOW DENTAL PC1459 N MAIN ST STE 4 (801) 397-5220DEDECKER, DENNIS LLOYD DDS 625 E 500 S STE 204(801) 298-2242 HARTVIGSEN, DARIN RICHARDDDS HARTVIGSEN, JAMES LESTERDDS 1325 N MAIN ST STE 1(801) 292-1221 HEIMER, JORDAN M DMD STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044HOYBJERG, TAYLOR GEORGEDDS STOBBE EGGETT DENTAL625 E 500 S STE 201 DENTAL DESIGNS OF BOUNTIFUL (801) 292-0443Provider Speaks: SPANISH319 S MAIN ST (801) 295-7171BOUNTIFUL RIDGE DENTAL LLC415 MEDICAL DR STE A200 (801) 203-0290STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044 Provider Gender Female Provider Gender Male This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access6March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameBOUNTIFULBOUNTIFULDENTISTRYDENTISTRYLOVELAND, DOUGLAS JAY DDSUTAH (cont.) BOUNTIFUL (cont.)DENTISTRY (cont.)IONGI, HEIDI L DMDMODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606JOHNSON, KIRK H DMD ORAL SURGERY SPECIALTY LLC1459 N MAIN ST STE 3 (801) 397-2727Provider Speaks: SPANISHKENT JEFFORY TOONE DDS460 S 400 E (801) 295-5585KUCHENMEISTER, JOSEPHKRISTOFER DDS STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044Provider Speaks: SPANISHLARSEN, PAUL CHRISTIAN DMD 415 MEDICAL DR STE D201 (801) 295-8881Provider Speaks: SPANISHLEVO DENTAL LLC1480 S ORCHARD DR STE 110(801) 295-9500 STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044Provider Speaks: FRENCHMACKAY DENTAL CARE PC 280 N 200 W STE 100(801) 397-2323MACKAY, MATTHEW HUBBARDDDS MACKAY DENTAL CARE PC280 N 200 W STE 100 (801) 397-2323Provider Speaks: SPANISHMATTHEW S BRINKERHOFF PC469 MEDICAL DR STE 108(801) 298-7728 MATTINSON, CRAIG JAMES DDS 1355 N MAIN ST STE 9(801) 294-3345 MCGOWAN, MARK S DDS BOUNTIFUL RIDGE DENTAL LLC415 MEDICAL DR STE A200 (801) 203-0290OLSEN FAMILY DENTAL INC625 E 500 S STE 202(801) 292-4141 OLSEN, PHILLIP PETER DMD OLSEN FAMILY DENTAL INC625 E 500 S STE 202 (801) 292-4141OMAN, GREGORY G DDS 1480 S ORCHARD DR STE 111(801) 298-9441Provider Speaks: SPANISH PAGE, ROBERT FRANCIS DDS PAGE FAMILY DENTISTRY535 E 500 S STE 3 (801) 292-7807PHILLIPS, SHANE LLOYD DDS STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044SACHDEV, MANU MOHAN DMD MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606SCHMUTZ, PAUL ANDREW DDS 581 W 2600 S (801) 295-4746MILLCREEK FAMILY DENTAL PC STOBBE EGGETT DENTAL1455 S 500 W STE D(801) 292-4009 LITTLE MOUNTAIN DENTAL625 E 500 S STE 201 MILNE, BRENT ALEXANDER DMD (801) 292-0443STOBBE, AARON JONATHAN DMD MODERN DENTAL ASSOCIATESLINDGREN, JEREMIAH MAURICE 24 S 500 W STE D (801) 296-1606DDS MODERN DENTAL ASSOCIATESMODERN DENTAL ASSOCIATES24 S 500 W STE D 24 S 500 W STE D (801) 296-1606(801) 296-1606NYBO, JUSTIN JAY DDS LEVO DENTAL LLC1480 S ORCHARD DR STE 110 (801) 295-9500Provider Speaks: CAMBODIAN Provider Gender Female Provider Gender Male STOBBE EGGETT DENTAL625 E 500 S STE 201 (801) 292-0443STUBBS, DAVID D DDS STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044Provider Speaks: SPANISH This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access7March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameBOUNTIFULBOUNTIFULDENTISTRYPEDIATRIC DENTISTRYUTAH (cont.)BOUNTIFUL (cont.)DENTISTRY (cont.)ORAL AND MAXILLOFACIALORAL SURGERYSURGERYANDERSON, GREGORY EARL DDSBROADBENT, MICHAEL WILLIAM ORAL SURGERY SPECIALTY LLCDMD 1459 N MAIN ST STE 3 ORAL AND MAXILLOFACIALTOONE, KENT JEFFORY DDS SURGEONS OF UTAH65 W 400 N STE 102 (801) 779-0506Provider Speaks: PORTUGUESETOSHNIWAL, NEHA DDS CHANDLER, JASON G DMD KENT JEFFORY TOONE DDS460 S 400 E (801) 295-5585MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606Provider Speaks: SPANISHVANDE MERWE, ADRIAN J DDS ADRIAN J VANDE MERWE DDS533 W 2600 S STE 225 (801) 292-7500WEYHER, MCKINSEEBRODERICK DDS MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606Provider Speaks: SPANISHWILLARDSEN, JAMES A DDS STUBBS DENTAL BOUNTIFUL GROUPLLC3383 S ORCHARD DR (801) 813-0044WYSON, JENNIFER W DMD 460 W 500 S (801) 292-2622ZAFIRATOS, THOMAS EMIL DDS MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606(801) 397-2727Provider Speaks: PORTUGUESE,SPANISHORAL AND MAXILLOFACIALSURGEONS OF UTAH ORAL AND MAXILLOFACIALSURGEONS OF UTAH65 W 400 N STE 102 (801) 779-0506Provider Speaks: SPANISH65 W 400 N STE 102(801) 779-0506DEDECKER, DENNIS LLOYD DDSOSGUTHORPE, JEFFREY AVARONDDS 625 E 500 S STE 204(801) 298-2242 HALL, VANCE PATRICK DMD ORAL AND MAXILLOFACIALSURGEONS OF UTAH65 W 400 N STE 102 (801) 779-0506JOHNSON, KIRK H DMD ORAL SURGERY SPECIALTY LLC1459 N MAIN ST STE 3 (801) 397-2727Provider Speaks: SPANISHMCCORMICK, ADAM PATRICKDDS ORAL AND MAXILLOFACIALSURGEONS OF UTAH65 W 400 N STE 102 (801) 779-0506Provider Speaks: SPANISHORAL SURGERY SPECIALTY LLC1459 N MAIN ST STE 3(801) 397-2727 MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606PEDIATRIC DENTISTRYCLARK, WALKER DEAN DDS SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880HORGESHEIMER, JASON J DDS SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880Provider Speaks: GERMANMCDONALD, BLAKE DAVID DDS SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880ODION, CHARLES EDWARD DDS SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880Provider Speaks: ITALIAN Provider Gender Female Provider Gender Male This provider offers TeleHealth services This provider is not accepting new patients at this time. Board Certified. If you want additional details on certification, please call the telephone number on the back ofyour member card (TTY: 711) to speak with a Member Service specialist. For people with physical disabilities, this location provides accessibility for Lavatory and/or Office access For people with physical disabilities, this location does not provide accessibility for Lavatory and/or Office access8March 1, 2022
Dental ProvidersUTAHUTAHSorted by state, county, city, specialty, then nameBOUNTIFULBRIGHAM CITYPEDIATRIC DENTISTRYUTAH (cont.)BOUNTIFUL (cont.)PEDIATRIC DENTISTRY(cont.)REIMSCHIISSEL, JOHN D DMD SOUTH DAVIS PEDIATRIC DENTISTR59 W PAGES LN STE 110 (801) 294-8880DENTISTRYBAUER, JUSTIN DONALD DMD JENSON, RICHARD HOWARD DDSNORTHWESTERN BAND OF THESHOSHONE241 W FOREST ST (435) 723-6120Provider Speaks: FRENCH, SPANISH 111 E FOREST ST STE F (435) 723-2318Provider Speaks: PORTUGUESE1149 S 450 W STE 106(435) 723-2223BUTLER, BRENT STEVE DDS 117 W FOREST ST (435) 723-8136Provider Speaks: SPANISHJESSE A LOW DENTISTRY PCBENSON, BRADY EMORY DDS ABC PEDIATRIC DENTISTRY305 N MAIN ST(435) 734-2626 LAURITZEN, CHRISTOPHER S DDSCOMMUNITY HEALTH CENTERS INC980 S 500 W STE 1 CAPENER, RANDELL MEARL DMD (435) 723-8276SOUTH DAVIS PEDIATRIC DENTISTRY Provider Speaks: SPANISH59 W PAGES LN STE 110 515 W FOREST ST LINK,DEVIN MCCORMICK DDS(801) 294-8880(435) 723-6211 TAYLOR, COLLEEN POWELLProvider Speaks: SPANISHCOMMUNITY HEALTH CENTERS INCDMD 980 S 500 W STE 1 DAINES, HOWARD RAINEY DDS535 MEDICAL DR (435) 723-8276 (801) 292-2828104 WEST DENTALMACKLEY, MARK D DDS 104 W 200 S PERRY DENTAL PLLCPERIODONTICS(435) 734-23942535 S HIGHWAY 89 STE 1 ATKINS, BRADEN CORDELL DMDProvider Speaks: SPANISH(435) 723-4300SOUTH DAVIS PEDIATRICDENTISTR MODERN DENTAL ASSOCIATES24 S 500 W STE D (801) 296-1606BRIGHAM CITYDENTISTRY104 WEST DENTAL30 E 700 S (435) 734-2248HANKS, JONATHAN MICHAELDDS PERRY DENTAL PLLC2535 S HIGHWAY 89 STE 1(435) 723-4300 HAWS FAMILY DENTISTRY104 W 200 S (435) 734-2394BATEMAN, RYAN VERNAL DMD PERRY DENTAL PLLC2535 S HIGHWAY 89 STE 1(435) 723-4300EAGLE MOUNTAIN DENTAL LLC MCARTHUR, NATHAN J DMD 140
Regence Preferred ValueCare Dental Network Provider Directory Updated March 1, 2022. iii Regence Preferred ValueCare Dental Network Provider Directory Updated March 1, 2022 . Bear Lake Community Health Center, Garden City, Rich County, Utah (2) Bear River Health Clinic, Tremonton, Box Elder County, Utah (3) Blanding Family Chiropractic .
2022 SUMMARY OF BENEFITS January 1, 2022 - December 31, 2022 Medicare Blue Choice . (H3351-011) This is a summary of drug and health services covered by Excellus BlueCross BlueShield. Excellus BlueCross BlueShield contracts with the Federal Government and is an HMO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield .
BlueCross’ drug formulary. The generic immediate- release doxycycline will continue to be available for BlueCross members, saving them substantial out-of-pocket expenses. If a BlueCross member in your care still needs doxycycline, you can notify his or her pharmacy to switc
The BlueCross BlueShield Medicaid Formulary Guide is a list of drugs to help guide physicians and phar-macists to select the medication that provides the appropriate treatment for the best price. IntroductIon BlueCross Blue Shield of Western New York has established an independent committee of practicing physicians
CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare . receives an individual member ID card with the name of the PGD on the card. . covering dentist, or off
BlueShield of Northeastern New York, a division of HealthNow New York Inc., an independent licensee of the BlueCross BlueShield Association Questions: Call 1-800-888-1238 or visit us at www.bsneny.com.
May 04, 2018 · BlueShield of Northeastern New York, a division of HealthNow New York Inc., an independent licensee of the BlueCross BlueShield Association Questions: Call 1-800-888-1238 or visit us at www.bsneny.com . If you aren’t clear about any of the underlined terms used in this form, see the Glossary. You can view the Glossary
Activate, Innova or Engage coverage, you can also see your benefit information on . ST CHARLES HEALTH SYSTEMS INC REDMOND, OR (541)548-8131 PAR PPP DBA ST CHARLES MEDICAL CTR OF REDMOND . 2ND WIND SLEEP MEDICAL EQUIPMENT LLC CORVALLIS, OR (541
2 For referenced ASTM standards, visit the ASTM website, www.astm.org, or contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM Standards volume information, refer to the standard’s Document Summary page on the ASTM website. 1
