Dentist Providers In Evanston, Illinois

Search Dentist NPI records in Evanston, IL

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Evanston, IL. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 141, of which 38 are registered as organizations and 103 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

73% Individuals

27% Organizations

33% Female

40% Male

73% Individual Providers (103)27% Medical Organizations (38)33% Female Providers (47)40% Male Providers (56)

Map of Providers

We have mapped the Dentist providers in Evanston, IL to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Evanston, IL
NPI	Name	Address	Insurance	Medicare	PECOS
1013944438	HALA S KILLIDAR (Individual)	820 DAVIS ST SUITE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National First Commonwealth Insurance Company Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice of Illinois Inc. UnitedHealthcare	Non-Participating Provider	YES
1013967876	ASHLEY YUEN-LING CHAN (Individual)	2805 CENTRAL ST EVANSTON, IL 60201 (224) 420-7022		Non-Participating Provider	YES
1023263241	RICHARD S HOPF D.D.S. P.C. (Organization)	500 DAVIS STREET SUITE 504 EVANSTON, IL 60201 (847) 475-4270		Non-Participating Provider	NO
1023468352	STEPHANIE A NGUYEN (Individual)	2650 RIDGE AVE SUITE 1304 EVANSTON, IL 60201 (847) 570-2369	Aetna CVS Health Guardian Humana Renaissance Dental	Non-Participating Provider	YES
1023596228	ADENIJI BOWDEN (Individual)	2611 BROADWAY AVE EVANSTON, IL 60201 (773) 263-6517	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO
1033103585	ROBERT BRUCE STEPHENS (Individual)	1560 SHERMAN AVENUE SUITE # 807 STEPHENS DENTISTRY EVANSTON, IL 60201 (847) 864-8151		Opted out of Medicare	YES
1033374129	KIRK BENNEWITZ (Individual)	500 DAVIS ST #504 EVANSTON, IL 60201 (847) 491-1011		Non-Participating Provider	NO
1043332208	PETER MONAGHAN (Individual)	1800 SHERMAN AVE STE 517 EVANSTON, IL 60201 (847) 475-6300		Non-Participating Provider	NO
1043384456	JIMMY ROBERT DONG (Individual)	636 CHURCH ST #721 EVANSTON, IL 60201 (847) 475-6606		Non-Participating Provider	NO
1053369363	CARL LEVAN CHEEKS (Individual)	1626 DARROW AVE EVANSTON, IL 60201 (847) 869-9708	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Renaissance Dental	Non-Participating Provider	NO
1124238720	KATHLEEN J. CURRY (Individual)	823 CHICAGO AVE EVANSTON, IL 60202 (847) 491-1200	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1144898578	ALEXANDER CRAIG KARKAZIS (Individual)	1029 HOWARD ST EVANSTON, IL 60202 (847) 491-0600	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Illinois DentaQuest Insurance Company Inc- IL First Commonwealth Insurance Company Guardian Humana UnitedHealthcare	Non-Participating Provider	NO
1154530459	TOWN CENTRE DENTAL GROUP, LTD. (Organization)	636 CHURCH ST SUITE 309 EVANSTON, IL 60201 (847) 328-1180		Non-Participating Provider	NO
1154530590	ROBERT SCOTT KRUEGER (Individual)	636 CHURCH ST SUITE 309 EVANSTON, IL 60201 (847) 328-1180		Non-Participating Provider	YES
1164686457	DAVID RICKI TUROK (Individual)	500 DAVIS ST STE 510 EVANSTON, IL 60201 (847) 864-2243	Guardian	Non-Participating Provider	NO
1174262562	SHRASTA TAYO TAMRAKAR (Individual)	500 DAVIS ST STE 601 EVANSTON, IL 60201 (847) 492-3492	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO
1174505663	RICHARD TYE (Individual)	1800 SHERMAN AVE SUITE 601 EVANSTON, IL 60201 (847) 492-3492		Non-Participating Provider	NO
1174547822	ARNOLD K CHERNOFF (Individual)	636 CHURCH ST 304 EVANSTON, IL 60201 (847) 475-4080		Non-Participating Provider	NO
1174609457	POLLY SUE REESE (Individual)	2500 RIDGE AVE SUITE 102 EVANSTON, IL 60201 (847) 869-1272	Humana	Non-Participating Provider	NO
1174936611	JOSEPH BAJTNER (Individual)	2650 RIDGE AVE EVANSTON, IL 60201 (847) 570-2461	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1174972202	RARES RAIBULET (Individual)	1560 SHERMAN AVE STE 902 EVANSTON, IL 60201 (847) 864-8151	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Renaissance Dental	Non-Participating Provider	NO
1194972893	CARLA F. LAMARR (Individual)	708 CHURCH ST SUITE # 208 EVANSTON, IL 60201 (847) 866-6630	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1205095387	THE CENTER FOR ORAL, MAXILLOFACIAL & IMPLANT SURGERY (Organization)	500 DAVIS ST 509 EVANSTON, IL 60201 (847) 869-9303		Non-Participating Provider	NO
1205904547	PAUL L FISCHL (Individual)	636 CHURCH ST SUITE 200W EVANSTON, IL 60201 (847) 864-0822		Non-Participating Provider	YES
1215302625	PREFERRED DENTISTRY ASSOCIATES, LLC (Organization)	1029 HOWARD STREET EVANSTON, IL 60202 (847) 869-1029	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois	Non-Participating Provider	NO
1215994223	JEAN-CLAUDE SENECAL (Individual)	2555 GROSS POINT RD UNIT 106 EVANSTON, IL 60201 (910) 257-5591		Non-Participating Provider	NO
1225108210	RICHARD C PRENDERGAST (Individual)	636 CHURCH ST SUITE 707 EVANSTON, IL 60201 (847) 491-1880		Non-Participating Provider	NO
1225154438	A TEREAU PEARSON (Individual)	1964 DEMPSTER ST EVANSTON, IL 60202 (847) 332-1406		Non-Participating Provider	NO
1225280225	TERRANCE E FIPPINGER (Individual)	1560 SHERMAN AVE SUITE 610 EVANSTON, IL 60201 (847) 869-5417		Non-Participating Provider	NO
1235204041	KIMBERLY MAYS SMITH (Individual)	2422 MAIN ST EVANSTON, IL 60202 (847) 264-9330	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1245449503	STAMATA BLANAS (Individual)	636 CHURCH ST SUITE 322 EVANSTON, IL 60201 (847) 475-4544		Non-Participating Provider	NO
1245543289	PREFERRED DENTISTRY ASSOCIATES OF WISCONSIN, L.L.C. (Organization)	1029 HOWARD ST SUITE 201 EVANSTON, IL 60202 (847) 491-0660	DentaTrust/DentaSpan	Non-Participating Provider	NO
1245897586	NADA SALEM (Individual)	820 DAVIS ST STE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian Humana Renaissance Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1265411276	JOSEPH E CANZONA (Individual)	2500 RIDGE AVE SUITE 302 EVANSTON, IL 60201 (847) 328-8899		Non-Participating Provider	NO
1265476840	JOANN KOCHIKARAN (Individual)	820 DAVIS ST SUITE 460 EVANSTON, IL 60201 (847) 332-2226	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1265501324	HAE Y YOON (Individual)	1819 CHURCH ST EVANSTON, IL 60201 (847) 866-7430	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1265596696	HERBERT W LEMEE (Individual)	708 CHURCH ST 208 EVANSTON, IL 60201 (847) 866-6630	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1265598312	JULIA ANN WEERTMAN (Individual)	636 CHURCH ST SUITE 504 EVANSTON, IL 60201 (847) 864-6668		Non-Participating Provider	NO
1275661779	BEST ENDODONTICS OF EVANSTON LTD (Organization)	500 DAVIS ST SUITE 814 EVANSTON, IL 60201 (847) 869-2223		Non-Participating Provider	NO
1285762971	CHARLES ANTHONY MCBROOM (Individual)	1029 HOWARD ST STE 203 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Guardian Paramount Paramount Dental	Non-Participating Provider	YES
1285996504	MARCOS ANTONIO MONTOYA (Individual)	1560 SHERMAN AVE STE 902 EVANSTON, IL 60201 (847) 864-8151	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Renaissance Dental	Non-Participating Provider	NO
1306014782	KATHRYN DELFS (Individual)	500 DAVIS ST STE 106 EVANSTON, IL 60201 (847) 328-2336	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas UnitedHealthcare	Non-Participating Provider	NO
1306173299	PREFERRED DENTAL, P.C. (Organization)	1029 HOWARD ST SUITE 201 EVANSTON, IL 60202 (847) 491-0660		Non-Participating Provider	NO
1306469754	PDANPC (Organization)	1029 HOWARD ST STE 201 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois	Non-Participating Provider	NO
1306874029	MARYAM MOGHADAM (Individual)	234 RIDGE AVE #1 EVANSTON, IL 60202 (847) 864-5491	Ambetter from Arizona Complete Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BannerAetna BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Arizona Cigna Healthcare Delta Dental of Arizona EMI Health Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Arizona Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1306889316	NOLAN KIN MING CHUN (Individual)	1560 SHERMAN AVE STE 520 EVANSTON, IL 60201 (847) 864-6951	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1306999719	MICHAEL GEORGE KARAGIANIS (Individual)	1029 HOWARD ST STE 201 EVANSTON, IL 60202 (847) 491-0660		Non-Participating Provider	NO
1316004690	PAUL SHELDON CHAITKIN (Individual)	2700 BRYANT AVE EVANSTON, IL 60201 (847) 869-1166		Non-Participating Provider	NO
1326245705	DENTAL HEALTH CARE LTD (Organization)	2611 BROADWAY AVE EVANSTON, IL 60201 (847) 475-8700		Non-Participating Provider	NO
1326531823	THOMAS KAMINSKI (Individual)	2650 RIDGE AVE STE 1304 EVANSTON, IL 60201 (847) 570-2380	Guardian	Non-Participating Provider	NO
1326661778	PDASPC (Organization)	1029 HOWARD ST STE 201 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois	Non-Participating Provider	NO
1326786401	MALISSA ARROYO (Individual)	1601 SHERMAN AVE STE B EVANSTON, IL 60201 (312) 846-6752	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National First Commonwealth Insurance Company Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1356876635	LAUREN MING (Individual)	800 AUSTIN ST STE 506 EVANSTON, IL 60202 (818) 390-0722	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Illinois Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice of Illinois Inc. UnitedHealthcare	Non-Participating Provider	YES
1396875662	NORTH SHORE DENTISTRY FOR CHILDREN (Organization)	1560 SHERMAN AVE SUITE 610 EVANSTON, IL 60201 (847) 869-5417		Non-Participating Provider	NO
1396887378	DANIEL K MARINIC (Individual)	2611 BROADWAY EVANSTON, IL 60201 (847) 475-8700		Non-Participating Provider	NO
1396957361	PREFERRED DENTAL GROUP, LTD. (Organization)	1029 HOWARD ST STE 203 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois	Non-Participating Provider	NO
1407108251	NORTH SHORE DENTAL ASSOCIATES (Organization)	636 CHURCH ST #322 EVANSTON, IL 60201 (847) 475-4544		Non-Participating Provider	NO
1417128059	DAN J NYKAZA DDS LTD (Organization)	2200 CENTRAL STREET EVANSTON, IL 60201 (847) 869-7710		Non-Participating Provider	NO
1437507381	TANYA RANGINWALA (Individual)	2650 RIDGE AVE SUITE 1304 EVANSTON, IL 60201 (937) 408-1261	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1447248877	ROGER NOUNEH (Individual)	636 CHURCH ST SUITE 722 EVANSTON, IL 60201 (847) 475-7754	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1447584560	T MARIE PC (Organization)	1029 HOWARD ST EVANSTON, IL 60202 (847) 491-0660		Non-Participating Provider	NO
1457405987	GREEN BAY TRAIL DENTISTRY ERIC ESTES (Organization)	2632 GREEN BAY RD EVANSTON, IL 60201 (847) 869-4844		Non-Participating Provider	NO
1477673044	LIEN LE (Individual)	909 DAVIS ST SUITE 120 EVANSTON, IL 60201 (847) 475-6300		Non-Participating Provider	NO
1477998433	JAZMINE B DILLARD (Individual)	1964 DEMPSTER ST EVANSTON, IL 60202 (847) 563-4484	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois DentaQuest Insurance Company Inc- IL Dominion National Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1497169882	WILLIAM EDWARD GORDON (Individual)	635 CHICAGO AVE EVANSTON, IL 60202 (847) 491-0880	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1497740724	LESLIE REEDER (Individual)	636 CHURCH ST STE 722 EVANSTON, IL 60201 (847) 475-7754		Non-Participating Provider	YES
1497931315	BARRY WALVOORD (Individual)	1572 MAPLE AVE SUITE 101 EVANSTON, IL 60201 (847) 328-1700		Non-Participating Provider	NO
1508279456	NICOLE DYME (Individual)	1285 HARTREY AVE EVANSTON, IL 60202 (847) 666-3494	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Delta Dental of Illinois Oscar Health Plan Inc. UnitedHealthcare	Non-Participating Provider	YES
1518042266	JASON SCOTT GLICK (Individual)	2942 CENTRAL ST EVANSTON, IL 60201 (847) 905-0555		Non-Participating Provider	NO
1518117357	EMILY M WILLIAMS (Individual)	1560 SHERMAN AVE STE 610 EVANSTON, IL 60201 (847) 869-5417	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company DentaQuest Insurance Company Inc- IL Dominion National Guardian Humana Paramount Paramount Dental Solstice of Illinois Inc. UnitedHealthcare	Non-Participating Provider	YES
1538150693	JAMES BRIAN STEPHENS (Individual)	1560 SHERMAN AVE EVANSTON, IL 60201 (847) 864-8151		Opted out of Medicare	YES
1548230865	GARY E BORDEN (Individual)	500 DAVIS ST #509 EVANSTON, IL 60201 (847) 869-9303		Opted out of Medicare	YES
1548889496	KTSMILES, INC SMILE SUITE ORTHODONTICS (Organization)	2422 MAIN ST EVANSTON, IL 60202 (847) 264-9330	UnitedHealthcare	Non-Participating Provider	NO
1558080283	M & R DENTAL, PLLC (Organization)	1560 SHERMAN AVE STE 902 EVANSTON, IL 60201 (847) 864-8151		Non-Participating Provider	NO
1578185716	AMINAT YEWANDE OSUJI (Individual)	636 CHURCH ST STE 200W EVANSTON, IL 60201 (847) 448-1684		Non-Participating Provider	NO
1578620670	CRAIG DOUGLAS LEHTMAN (Individual)	708 CHURCH STREET SUITE 209 EVANSTON, IL 60201 (847) 328-0011	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1578907689	M TIMOTHY MURPHY (Individual)	500 DAVIS ST STE 509 EVANSTON, IL 60201 (847) 869-9303		Opted out of Medicare	YES
1578972303	ANDRE AMARANTE (Individual)	2424 MAIN ST EVANSTON, IL 60202 (224) 999-1224	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1588734271	VERENA PHILLIPS (Individual)	1800 SHERMAN AVE STE 601 EVANSTON, IL 60201 (847) 492-3492		Non-Participating Provider	YES
1588736540	SCOTT K BENTKOVER (Individual)	500 DAVIS ST SUITE 814 EVANSTON, IL 60201 (847) 869-2223		Non-Participating Provider	NO
1598985046	BEHLES FAMILY DENTAL CARE, LLC (Organization)	500 DAVIS ST SUITE 106 EVANSTON, IL 60201 (847) 328-8990		Non-Participating Provider	NO
1639149909	PAUL T AKERS (Individual)	500 DAVIS ST #509 EVANSTON, IL 60201 (847) 869-9303		Opted out of Medicare	YES
1639342454	THE RADIANT SMILE, PC (Organization)	1632 MAPLE AVE EVANSTON, IL 60201 (847) 328-3573		Non-Participating Provider	NO
1639960990	DELAYNIE REED FIELD (Individual)	2650 RIDGE AVE STE 1304 EVANSTON, IL 60201 (847) 570-2380		Non-Participating Provider	NO
1649657255	MELVIN AND JAZMINE DILLARD DDS, PC DENTAL ART SPECIALISTS (Organization)	1964 DEMPSTER ST EVANSTON, IL 60202 (312) 600-8119	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois DentaQuest Insurance Company Inc- IL UnitedHealthcare	Non-Participating Provider	NO
1659598704	DAN JOSEPH NYKAZA (Individual)	2200 CENTRAL ST EVANSTON, IL 60201 (847) 869-7710		Non-Participating Provider	NO
1669499505	EVANSTON PERIODONTICS, LLC (Organization)	636 CHURCH ST SUITE # 722 EVANSTON, IL 60201 (847) 475-7754		Non-Participating Provider	NO
1669876983	MEIRA R. BERMAN DMD PC ELEMENTS DENTAL STUDIO (Organization)	1605 BENSON AVE EVANSTON, IL 60201 (847) 906-3120		Non-Participating Provider	NO
1679034540	DANIELLE DUARTE (Individual)	2611 BROADWAY AVE EVANSTON, IL 60201 (847) 532-2688	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Humana Paramount Paramount Dental Renaissance Dental	Opted out of Medicare	NO
1689726465	STACEY B. GALANIS (Individual)	1029 HOWARD ST EVANSTON, IL 60202 (847) 491-0660		Non-Participating Provider	NO
1689728024	SHARON J DURFEE (Individual)	3000 CENTRAL ST EVANSTON, IL 60201 (847) 866-7755	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1700212040	ELLEN E TKACH, D.D.S., P.C. (Organization)	1029 HOWARD ST STE 201 EVANSTON, IL 60202 (847) 431-4416		Non-Participating Provider	NO
1700234663	RICHARD HOPF (Individual)	500 DAVIS ST SUITE 504 EVANSTON, IL 60201 (847) 475-4270		Non-Participating Provider	NO
1720022387	MICHAEL A JOHNSON (Individual)	820 DAVIS ST SUITE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Ambetter from Meridian Ambetter Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National EMI Health First Commonwealth Insurance Company Florida Combined Life Guardian Humana MedMutual Paramount Paramount Dental Renaissance Dental Solstice of Illinois Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1720468721	COLLEEN ELIZABETH MCSHANE (Individual)	2650 RIDGE AVE WALGREEN BLDG., SUITE 2507 EVANSTON, IL 60201 (847) 570-2461	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Illinois Humana Renaissance Dental Solstice of Illinois Inc. UnitedHealthcare	Non-Participating Provider	YES
1730225111	PAUL F BERY (Individual)	636 CHURCH ST STE#517 EVANSTON, IL 60201 (847) 475-0120	Guardian	Non-Participating Provider	YES
1730231796	ELIZABETH MARIA ZWOLINSKA (Individual)	1029 HOWARD ST SUITE 201 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois Dominion National Guardian Paramount Paramount Dental	Non-Participating Provider	YES
1730563743	XHENI BASKO (Individual)	1632 MAPLE AVE EVANSTON, IL 60201 (847) 328-3573	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Renaissance Dental Solstice of Illinois Inc.	Non-Participating Provider	YES
1740408111	MARIUS C. FARKAS (Individual)	1813 DEMPSTER ST STE. #2R EVANSTON, IL 60201 (773) 310-4883	Guardian	Non-Participating Provider	NO
1740432749	MARIA L SIMON (Individual)	1560 SHERMAN AVE SUITE 610 EVANSTON, IL 60201 (847) 869-5417	Guardian	Non-Participating Provider	NO
1740515386	CHRISTIAN NOLTEN D M D LTD (Organization)	1029 HOWARD ST SUITE 201 EVANSTON, IL 60202 (847) 491-0660	DentaQuest Insurance Company Inc- IL	Non-Participating Provider	NO
1750555439	BARBARA TRINIDAD CANLAS (Individual)	2200 CENTRAL ST EVANSTON, IL 60201 (847) 869-7710	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Michigan	Non-Participating Provider	NO
1760786941	HEATHER YOON DDS, PC (Organization)	1819 CHURCH ST EVANSTON, IL 60201 (847) 866-7430		Non-Participating Provider	NO
1770101560	JONKER CASPER JACOBS (Individual)	820 DAVIS ST STE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1770162521	EMELIA M. KARKAZIS (Individual)	1029 HOWARD ST STE 201 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Delta Dental of Illinois	Non-Participating Provider	NO
1770222739	HIU YAN SOONG (Individual)	2650 RIDGE AVE STE 1304 EVANSTON, IL 60201 (847) 570-2380	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas First Commonwealth Insurance Company Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1770522625	PAULINE A YOSEPH (Individual)	820 DAVIS ST SUITE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1780759159	MICHELLE M PELC (Individual)	800 AUSTIN ST SUITE 506 WEST TOWER EVANSTON, IL 60202 (847) 332-2400	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Renaissance Dental	Non-Participating Provider	NO
1780794883	PHILLIP JOHN MARTINI (Individual)	636 CHURCH ST # 501 EVANSTON, IL 60201 (847) 491-0203	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1790042323	ANASTASIA MARIE HAUPT (Individual)	807 DAVIS ST UNIT 2011 EVANSTON, IL 60201 (208) 251-6098	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1790525012	ARSHIA JAFAR NIA (Individual)	2650 RIDGE AVE STE 1304 EVANSTON, IL 60201 (773) 702-1150		Non-Participating Provider	YES
1811154164	JOSEPH B SILBERMAN (Individual)	500 DAVIS ST SUITE 510 EVANSTON, IL 60201 (847) 864-2243		Non-Participating Provider	NO
1821042433	MICHAEL EDWARD GORDON (Individual)	635 CHICAGO AVE EVANSTON, IL 60202 (847) 491-0880	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois DentaQuest Insurance Company Inc- IL Dominion National Humana Paramount Paramount Dental	Non-Participating Provider	YES
1821137647	ROBERT A SWANSON (Individual)	636 CHURCH ST SUITE 319 EVANSTON, IL 60201 (847) 475-4141		Non-Participating Provider	NO
1821152729	BRADLEY ALAN WEISS (Individual)	636 CHURCH ST SUITE 200 W EVANSTON, IL 60201 (847) 864-0082		Opted out of Medicare	YES
1821180696	JOHN KENNETH FAVALE (Individual)	1604 CHICAGO AVE EVANSTON, IL 60201 (847) 866-8844	Aetna CVS Health Humana	Opted out of Medicare	YES
1821558974	MONIKA SINGH (Individual)	2200 CENTRAL ST EVANSTON, IL 60201 (847) 869-7710	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Illinois Guardian	Non-Participating Provider	NO
1831768274	MICHAEL MEYER (Individual)	1601 SHERMAN AVE STE B EVANSTON, IL 60201 (312) 846-6752	Delta Dental of Wisconsin Inc. Guardian Humana	Non-Participating Provider	NO
1841357084	PROCARE DENTAL GROUP, P.C. LAKESIDE DENTISTRY (Organization)	820 DAVIS ST STE 460 EVANSTON, IL 60201 (847) 332-2226	Aetna CVS Health Solstice of Illinois Inc. UnitedHealthcare	Non-Participating Provider	NO
1841997319	EVANSTON DENTAL PLLC (Organization)	500 DAVIS ST STE 510 EVANSTON, IL 60201 (847) 864-2243		Non-Participating Provider	NO
1851125405	WINNING SMILE DENTAL GROUP, LLC WINNING SMILE DENTAL GROUP (Organization)	2500 RIDGE AVE STE 102 EVANSTON, IL 60201 (847) 869-1272		Non-Participating Provider	NO
1861377723	BITES ORTHODONTICS PLLC (Organization)	901 CHURCH ST EVANSTON, IL 60201 (224) 904-1380		Non-Participating Provider	NO
1861666992	DR. DONALD H. SALTZMAN, D.D.S., P.C. (Organization)	1029 HOWARD ST EVANSTON, IL 60202 (847) 492-0660		Non-Participating Provider	NO
1861727232	NANCY A POZNICK, DDS, LLC (Organization)	1029 HOWARD ST SUITE 203 EVANSTON, IL 60202 (847) 491-0660		Non-Participating Provider	NO
1871718452	FISCHL DENTAL ASSOCIATES, P.C. FISCHL AND WEISS DENTAL ASSOCIATES, P.C. (Organization)	636 CHURCH STREET SUITE 200W EVANSTON, IL 60201 (847) 864-0822		Non-Participating Provider	NO
1871856617	MELVIN LAUREL DILLARD (Individual)	1964 DEMPSTER ST EVANSTON, IL 60202 (773) 608-9334	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois DentaQuest Insurance Company Inc- IL Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1881861565	STEPHENS DENTISTRY, INC. (Organization)	1560 SHERMAN AVE SUITE # 807 EVANSTON, IL 60201 (847) 864-8151		Non-Participating Provider	NO
1881869279	ROBERT EVAN LOZOFF (Individual)	515 SHERIDAN RD 302 EVANSTON, IL 60202 (720) 317-8421	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1912052226	AMANPREET SINGH (Individual)	1029 HOWARD ST EVANSTON, IL 60202 (847) 491-0660	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1912128604	DEBORAH S MARMOR (Individual)	2550 CRAWFORD AVE SUITE 4 EVANSTON, IL 60201 (847) 278-8418		Non-Participating Provider	NO
1922096171	FRANK LAMBROS KARKAZIS (Individual)	1029 HOWARD ST SUITE 201 EVANSTON, IL 60202 (847) 491-0660	Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Delta Dental of Illinois DentaQuest Insurance Company Inc- IL Dominion National First Commonwealth Insurance Company Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1942326350	SHERMAN DENTAL ASSOCIATES OF EVANSTON, LTD (Organization)	909 DAVIS ST SUITE 120 EVANSTON, IL 60201 (847) 475-6300		Non-Participating Provider	NO
1942496435	KATHRYN REZEK (Individual)	636 CHURCH ST STE. 718 EVANSTON, IL 60201 (184) 732-8141		Non-Participating Provider	NO
1952315921	WILLIAM NICOL MCGILCHRIST (Individual)	636 CHURCH ST SUITE 520 EVANSTON, IL 60201 (847) 864-0188		Non-Participating Provider	NO
1952648990	DR CARL L CHEEKS DDS PC (Organization)	1626 DARROW AVE EVANSTON, IL 60201 (847) 869-9708		Non-Participating Provider	NO
1952776809	ERIC ESTES (Individual)	2632 GREEN BAY RD EVANSTON, IL 60201 (847) 869-4844		Non-Participating Provider	NO
1952817298	WEBSTER DENTAL CARE EVANSTON, LTD (Organization)	500 DAVIS ST STE 601 EVANSTON, IL 60201 (847) 492-3492	Aetna CVS Health	Non-Participating Provider	NO
1962574210	CHARLES H CHEN (Individual)	1632 MAPLE AVE EVANSTON, IL 60201 (847) 328-3573	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1962653600	PERIODONTICS & IMPLANTS, LTD. (Organization)	636 CHURCH ST SUITE 707 EVANSTON, IL 60201 (847) 491-1880		Non-Participating Provider	NO
1972671113	MARIE BRADLEY FISCHL (Individual)	636 CHURCH ST SUITE 200W EVANSTON, IL 60201 (847) 864-0822		Non-Participating Provider	YES
1992233084	HEATHER MARIE MILLER (Individual)	2805 CENTRAL ST EVANSTON, IL 60201 (847) 328-8500	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Renaissance Dental	Non-Participating Provider	NO

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