Dentist Providers In Bronx, New York

Search Dentist NPI records in Bronx, NY

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Bronx, NY. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 1028, of which 198 are registered as organizations and 830 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.

81% Individuals

19% Organizations

36% Female

44% Male

81% Individual Providers (830)19% Medical Organizations (198)36% Female Providers (375)44% Male Providers (455)

Map of Providers

We have mapped the Dentist providers in Bronx, NY 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 Bronx, NY
NPI	Name	Address	Insurance	Medicare	PECOS
1003088659	DC DENTAL OFFICE, P.C. (Organization)	2925 GRAND CONCOURSE SUITE 1A BRONX, NY 10468 (718) 329-4111		Non-Participating Provider	NO
1003168295	SMILE SAVERS ORTHODO (Organization)	2100 BARTOW AVE 218 BRONX, NY 10475 (718) 708-6323		Non-Participating Provider	NO
1003400805	COOP CITYDENTAL ASSOCIATES PLLC (Organization)	2063B BARTOW AVE BRONX, NY 10475 (718) 379-4734		Non-Participating Provider	NO
1003506478	TIERNEY MAGILL BEHLES (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1003812447	VICTOIRE BOGUI (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110		Non-Participating Provider	NO
1013019629	AMIT PUNJ (Individual)	3450 WAYNE AVE APT 13 H BRONX, NY 10467 (918) 850-1030	Anthem Blue Cross and Blue Shield Humana	Non-Participating Provider	NO
1013079920	HADLEY S BACH (Individual)	1966 NEWBOLD AVE SUITE 107 BRONX, NY 10472 (718) 863-9733	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1013228287	KHRYSTYNA LESKIV (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 992-7669	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1013276799	KLENISE PARANHOS (Individual)	2386 JEROME AVE BRONX, NY 10546 (718) 220-1771	Humana	Non-Participating Provider	NO
1013315944	DAVID TASHMAN (Individual)	4601 HENRY HUDSON PKWY W A-11 BRONX, NY 10471 (718) 519-0500		Opted out of Medicare	YES
1013367663	CLAIRE LAUREN LEEWING (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	Humana	Non-Participating Provider	NO
1013396746	MARY SAYEGH (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life Renaissance Dental	Non-Participating Provider	NO
1013474907	PIN LAI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1013907070	SURENDRA R. PATEL (Individual)	48 E KINGSBRIDGE RD BRONX, NY 10468 (718) 933-9603	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
1023105293	KIRTIDA J SHAH (Individual)	3455 BOSTON RD BRONX, NY 10469 (718) 798-2236		Non-Participating Provider	NO
1023139672	PAUL SHAPIRO (Individual)	1530 UNIONPORT RD BRONX, NY 10462 (718) 892-2200	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1023144110	ROBERT SHANOCK (Individual)	100 ALCOTT PL BRONX, NY 10475 (718) 671-9329		Non-Participating Provider	NO
1023198710	SUDHA JITENDRA SANGANEE (Individual)	165 E 179TH ST SUITE: LOBBY- L BRONX, NY 10453 (718) 731-2645		Non-Participating Provider	NO
1023213337	MONTEFIORE DENTAL DEPARTMENT JARRETT DENTAL PEDIATRICS (Organization)	1516 JARRET PL BRONX, NY 10461 (888) 700-6623		Non-Participating Provider	NO
1023237708	KOOK-JIN CHANG (Individual)	234 E. 149TH ST. BRONX, NY 10451 (718) 579-5396	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
1023284338	RAINA C. LEE (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	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 UnitedHealthcare	Non-Participating Provider	NO
1023684115	ENRIKA JOHNSON (Individual)	2432 GRAND CONCOURSE BRONX, NY 10458 (718) 901-8410	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 Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1033115506	PAUL GATES (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	Renaissance Dental	Non-Participating Provider	NO
1033202510	DAVID ABRAHAM MANDEL (Individual)	130 WEST KINGSBRIDGE ROAD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1033306626	TAE CHUL HO (Individual)	3744 3RD AVE BRONX, NY 10456 (718) 590-5090	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 Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1033324660	ROY WINSTON STREETE (Individual)	739 E 230TH ST BRONX, NY 10466 (718) 652-3978		Non-Participating Provider	YES
1033329719	MICHAEL GAYLE (Individual)	1205 E 233RD ST BRONX, NY 10466 (914) 294-5451	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1033381215	PRADHAN AND PRADHAN (Organization)	3950 WHITE PLAINS RD BRONX, NY 10466 (718) 652-6622		Non-Participating Provider	NO
1033381256	RIGHT FAMILY DENTAL P.C. (Organization)	2665 GRAND CONCOURSE BRONX, NY 10468 (718) 365-8660		Non-Participating Provider	NO
1033392303	TEODORA ALBU (Individual)	2960 GRAND CONCOURSE APT 2J BRONX, NY 10458 (718) 563-3305		Non-Participating Provider	NO
1033453873	MARBLE HILL DENTAL OFFICE, PC (Organization)	112 W 228TH ST BRONX, NY 10463 (718) 584-9890		Non-Participating Provider	NO
1033633466	BAY PLAZA MALL DENTAL PLLC (Organization)	200 BAYCHESTER AVE STE 311C BRONX, NY 10475 (347) 625-6438	UnitedHealthcare	Non-Participating Provider	NO
1033658497	KEVIN MEJIAS-AGOSTO (Individual)	1894 WALTON AVE BRONX, NY 10453 (718) 583-2700	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	YES
1033659776	ROBERT W. FRANKEL, D.M.D., P.C. (Organization)	3317 BAINBRIDGE AVE BRONX, NY 10467 (718) 547-2833		Non-Participating Provider	NO
1043293863	DELFINA ELIZABETH COLON-LIZ (Individual)	3467 DEKALB AVE APT 1G BRONX, NY 10467 (718) 994-0005	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
1043324114	JEFFREY LEE GOLDEN (Individual)	2505 WILLIAMSBRIDGE ROAD BRONX, NY 10469 (718) 654-2320	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1043335870	DAVID M GELMAN (Individual)	1500 WATERS PL BRONX, NY 10461 (718) 931-0600		Non-Participating Provider	NO
1043396930	LAWRENCE STEVEN HOLTZMAN (Individual)	1250 WATERS PL STE 503 BRONX, NY 10461 (718) 824-4200		Opted out of Medicare	NO
1043418346	YANGSOOK HAN (Individual)	930 E TREMONT AVE BRONX, NY 10460 (718) 764-1633	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1043505522	PINNACLE DENTAL CARE P.C. (Organization)	2336 GRAND CONCOURSE BRONX, NY 10458 (718) 220-0439		Non-Participating Provider	NO
1043557614	KATHRYN RAY (Individual)	234 E 149TH STREET DENTAL DEPARTMENT 2A8 BRONX, NY 10451 (718) 579-5692	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1043579840	NORA OZU DDS P.C (Organization)	446 EAST 149 STREET BRONX, NY 10455 (646) 401-7878		Non-Participating Provider	NO
1043634660	573 FORDHAM DENTAL PC (Organization)	573 E FORDHAM RD BRONX, NY 10458 (917) 962-9990		Non-Participating Provider	NO
1043635071	TASHORN GOMEZ (Individual)	1775 GRAND CONCOURSE 6TH FLOOR BRONX, NY 10453 (718) 901-8110	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1043833080	FARAJOLLAH SOLEIMANZADEH (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 993-7909	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1053383109	LAURENCE CHARLES ROTH (Individual)	2917 BRUCKNER BLVD BRONX, NY 10461 (718) 597-7888		Non-Participating Provider	NO
1053427377	DAMARIS ALTAGRACIA CORDERO (Individual)	2925 GRAND CONCOURSE SUITE 1A BRONX, NY 10468 (718) 329-4111	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 Paramount Paramount Dental	Non-Participating Provider	NO
1053431379	WILLIAM NGUYEN (Individual)	505 CLAREMONT PARKWAY BRONX, NY 10457 (718) 299-3600	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 Humana	Non-Participating Provider	NO
1053473207	KENNETH M SCHWEITZER (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2381	Humana	Non-Participating Provider	NO
1053501288	WALTER E BIMSTON (Individual)	3130 GRAND CONCOURSE 1F BRONX, NY 10458 (718) 295-3232		Non-Participating Provider	NO
1053574061	REEM HEMANTHARAJU (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1053812073	JOSEPH MAKRAM YOUSSEF (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1053815282	FAWAZ OMAR SHIHADEH (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	Anthem Blue Cross and Blue Shield 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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	YES
1053937466	ANNIE HERMAN PEREL (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 405-8057	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1063420131	LYUBOV FEYGIN (Individual)	2580 E TREMONT AVE BRONX, NY 10461 (718) 824-4597	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
1063527117	SHARI B. KLEIN (Individual)	2600 NETHERLAND AVE SUITE 117 BRONX, NY 10463 (718) 549-3910	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 UnitedHealthcare	Non-Participating Provider	NO
1063544856	VINOD K SHARMA (Individual)	1715 UNIVERSITY AVE. BRONX, NY 10453 (718) 294-0700		Non-Participating Provider	NO
1063553469	KATHLEEN ELIZABETH SZANTO (Individual)	2809 MIDDLETOWN RD BRONX, NY 10461 (718) 597-8800	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 Florida Combined Life Humana	Non-Participating Provider	NO
1063557197	B&B DENTAL,PC (Organization)	910 GRAND CONCOURSE BRONX, NY 10451 (718) 538-2410	UnitedHealthcare	Non-Participating Provider	NO
1063581171	KENNETH S KURTZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2381	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 Humana	Maybe Accepts Medicare	YES
1063608826	EDUART SHKURTI (Individual)	3400 FORT INDEPENDENCE ST APT DF BRONX, NY 10463 (213) 210-4543	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1063685394	PUGSLEY DENTAL P.C. (Organization)	1211B PUGSLEY AVE BRONX, NY 10472 (718) 794-0384	UnitedHealthcare	Non-Participating Provider	NO
1063769156	LESLIE WILFRED SELDIN (Individual)	918 PELHAM PKWY S BRONX, NY 10462 (917) 834-4258		Non-Participating Provider	NO
1063835759	GILA ROSENBAUM (Individual)	3333 HENRY HUDSON PKWY APT 5R BRONX, NY 10463 (917) 846-1312	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1063839744	INHYE CHOI (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-6628	Anthem Blue Cross and Blue Shield UnitedHealthcare	Non-Participating Provider	NO
1063909950	MICHAEL HELLER (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-6628	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 Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1073053880	LAURA WYSOCKI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Humana	Non-Participating Provider	YES
1073502217	ALEJANDRO LEONEL WILLIAMS (Individual)	1624 UNIVERSITY BLVD BRONX, NY 10453 (718) 294-3725	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	Non-Participating Provider	YES
1073636080	ERIC KEVIN CHU (Individual)	857 MORRIS PARK AVE BRONX, NY 10462 (718) 597-3360		Non-Participating Provider	NO
1073661666	IOANA POPOVICI (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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
1073871810	HAROLD G EDWARDS D.D.S. ,P.C. (Organization)	555 E FORDHAM RD BRONX, NY 10458 (718) 365-5050		Non-Participating Provider	NO
1083092464	ESTHER SONNENBLICK (Individual)	2600 NETHERLAND AVE SUITE 117 BRONX, NY 10463 (718) 549-3910	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 UnitedHealthcare	Non-Participating Provider	NO
1083603153	SAILESH SURYAKANT PATEL (Individual)	1417 WYTHE PL BRONX, NY 10452 (718) 590-4678	Anthem Blue Cross and Blue Shield Renaissance Dental	Non-Participating Provider	NO
1083815476	MIHAIL COTZAS (Individual)	468 EAST FORDHAM RD. BRONX, NY 10458 (718) 365-7070		Non-Participating Provider	NO
1083935381	SIMONAS ZMUIDZINAS (Individual)	1957 MAYFLOWER AVE BRONX, NY 10461 (917) 392-5113		Non-Participating Provider	NO
1083956452	ARIEL LEVY (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-6628	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 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 Michigan Mutual Insurance Company Delta Dental of Michigan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1093309585	IYA GABRE (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	BEST Life Florida Combined Life Humana	Non-Participating Provider	NO
1093342651	SUPRIYA KAZI (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2826	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 UnitedHealthcare	Non-Participating Provider	NO
1093371700	JAMES DAMASCUS (Individual)	111 E 210TH ST BRONX, NY 10467 (248) 252-6623	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 Paramount Paramount Dental	Non-Participating Provider	YES
1093390924	LEI YEH (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1093395444	ANI COADERAJ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5731	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1093517138	ANDREW CHANG, DDS (Organization)	815 HUTCHINSON RIVER PKWY STE 845 BRONX, NY 10465 (718) 509-9152		Non-Participating Provider	NO
1093703258	HOWARD ROTH (Individual)	2580 E TREMONT AVE BRONX, NY 10461 (718) 824-4597	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1093728768	JULIE S WEE (Individual)	3201 GRAND CONCOURSE SUITE #1E BRONX, NY 10468 (718) 367-7645	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
1093742223	LYDIA SALAMA (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419	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 Humana Renaissance Dental	Non-Participating Provider	YES
1093939365	ALEXANDER MUSHEYEV (Individual)	237 WILLIS AVE BRONX, NY 10454 (718) 292-6311	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1093941163	FRANCISCA CERON (Individual)	1400 PELHAM PKWY S DEPT. OF DENTISTRY BRONX, NY 10461 (718) 918-3419	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 North Carolina Humana	Non-Participating Provider	NO
1093966517	CAROLINE KIM (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Blue Cross Blue Shield of Michigan Mutual Insurance Company Delta Dental of Michigan Dominion National Guardian Humana Paramount Paramount Dental	Non-Participating Provider	YES
1093985624	CITYWIDE DENTAL FAMILY PRACTICE, PLLC (Organization)	384 E 149TH ST SUITE 216 BRONX, NY 10455 (718) 993-7788		Non-Participating Provider	NO
1104132638	STEVEN ALVARADO (Individual)	1400 PELHAM PKWY S BLDG 1; #3N22 BRONX, NY 10461 (718) 918-6147	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	YES
1104225309	JULIA NIYAZOVA (Individual)	910 E 172ND ST BRONX, NY 10460 (347) 767-2200	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 Humana Paramount Paramount Dental	Non-Participating Provider	YES
1104286558	VIOLET JANG (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1104487529	NAFIZ HASAN (Individual)	1400 PELHAM PKWY S RM 6S10 BRONX, NY 10461 (718) 918-3232		Non-Participating Provider	NO
1104815406	HECTOR BOLIVAR BERNABE (Individual)	1916 GRAND CONCOURSE BRONX, NY 10457 (718) 716-1400	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1104895218	SAMUEL SCHAFFER (Individual)	2110 WALLACE AVE 1A BRONX, NY 10462 (718) 829-5060	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	Non-Participating Provider	YES
1104908904	JAYATI C BHATTACHARYYA (Individual)	1516 JARRET PL SUITE 100 BRONX, NY 10461 (718) 405-8194	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 UnitedHealthcare	Non-Participating Provider	NO
1104914142	FORDHAM PLAZA DENTAL ASSOCIATES CITIDENT DENTAL CENTER (Organization)	466 EAST FORDHAM ROAD BRONX, NY 10458 (718) 365-4300	UnitedHealthcare	Non-Participating Provider	NO
1104924422	OLIVER SULLIVAN (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1114063930	MAIRAJ AHMED (Individual)	918 PELHAM PKWY S #3 BRONX, NY 10462 (718) 684-3131	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1114180650	GHYSLAIN LESSARD-BOIVIN (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1114183365	STEVEN W CARNEY (Individual)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347		Opted out of Medicare	YES
1114219946	JACQUELINE HEEJUNG YOON (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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	Non-Participating Provider	NO
1114318862	NARESSA K SINGH (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 618-8011		Non-Participating Provider	YES
1114418571	JEEMIN CHANG (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (413) 736-0027	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1114447588	ELENA LISSINA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1124018130	PARAG P PATEL (Individual)	770 E TREMONT AVE BRONX, NY 10460 (718) 299-1800		Non-Participating Provider	NO
1124041991	JOSEPH CHARLES SCOTTI (Individual)	1130 PELHAM PKWY S APT. 1-D BRONX, NY 10461 (718) 824-4666		Non-Participating Provider	NO
1124088877	GALINA SVERDLOVA (Individual)	2922 GRAND CONCOURSE SUITE 1A BRONX, NY 10458 (718) 364-4364		Non-Participating Provider	NO
1124112966	PEPPINO BONELLI (Individual)	1475 ASTOR AVENUE DRS DARRIGO AND BONELLI DDS LLP BRONX, NY 10469 (718) 653-2411	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1124199294	VIKAS ARORA (Individual)	660 WESTCHESTER AVE BRONX, NY 10455 (718) 292-6949	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 Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1124275425	HYE-REE SOPHIA SEO (Individual)	2737 3RD AVE BRONX, NY 10451 (718) 838-1092		Non-Participating Provider	NO
1124349873	KIREN GEHANI DDS P.C. (Organization)	3201 GRAND CONCOURSE SUITE 2L BRONX, NY 10468 (347) 271-6866		Non-Participating Provider	NO
1124519558	MICHAEL AZIZ BARBER (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5692	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 UnitedHealthcare	Non-Participating Provider	NO
1134273782	SAMY FATOUH (Individual)	1537 WESTCHESTER AVE BRONX, NY 10472 (718) 617-0624	Humana	Non-Participating Provider	NO
1134299399	DON ANDREW SAFFERSTEIN (Individual)	1 FORDHAM HILL OVAL BRONX, NY 10468 (718) 584-5300		Non-Participating Provider	YES
1134358427	174 STREET DENTAL LLC (Organization)	146 E 174TH ST BRONX, NY 10457 (213) 709-7154		Non-Participating Provider	NO
1134387467	FARIDA PARVEEN (Individual)	2002 MCGRAW AVE 1ST FLOOR BRONX, NY 10462 (718) 239-8250	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 Paramount Paramount Dental	Non-Participating Provider	NO
1134506272	PRINCE DHILLON (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (267) 237-1890	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1134979800	MARVEL SMILES LLC (Organization)	3366 BOSTON RD BRONX, NY 10469 (718) 547-5280		Non-Participating Provider	NO
1144234469	DR. JAY FENSTERSTOCK DDS P.C. (Organization)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370		Non-Participating Provider	NO
1144403734	MONROE W. KORNFELD DDS PC CIRCLE FAMILY DENTAL CENTER (Organization)	7 HUGH GRANT CIRCLE BRONX, NY 10462 (718) 792-0137		Non-Participating Provider	NO
1144428384	NEW HORIZON DENTAL, P.C (Organization)	961EAST 174 ST. SUITE B 150 BRONX, NY 10460 (718) 861-8060	UnitedHealthcare	Non-Participating Provider	NO
1144534454	MICHELLE YANOVER (Individual)	466 E FORDHAM RD FORDHAM PLAZA DENTAL ASSOCIATES BRONX, NY 10458 (718) 365-4300	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 Paramount Paramount Dental	Non-Participating Provider	YES
1144551961	TEMA STARKMAN (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (888) 732-8491		Non-Participating Provider	NO
1144613431	JESSICA MATTERN (Individual)	1516 JARRET PL BRONX, NY 10461 (718) 405-8194	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	Non-Participating Provider	NO
1144653106	JOOHYANG CHOI (Individual)	3213 3RD AVE BRONX, NY 10451 (646) 314-0196		Non-Participating Provider	NO
1144841586	ARIELLE CIERRA STATHAM (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	Humana	Non-Participating Provider	NO
1144854431	NY METRO DENTAL, PC CONCERNED DENTAL CARE OF BRONX (Organization)	55 MOSHOLU PARKWAY NORTH BRONX, NY 10467 (413) 382-7022	UnitedHealthcare	Non-Participating Provider	NO
1144883059	DEEBA CARVAN (Individual)	111 E 210TH ST BRONX, NY 10467 (348) 861-6130	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 Paramount Paramount Dental	Non-Participating Provider	NO
1144916784	ZACHARY LUAY MARJI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1154313393	SAFWAT H SALAMA (Individual)	1701 MACOMBS RD BRONX, NY 10453 (718) 299-8144	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
1154489367	MAYNARD C GOLDBERG (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3060		Non-Participating Provider	NO
1154513380	GABRIELA C OANA (Individual)	3333 HENRY HUDSON PKWY STE 9 BRONX, NY 10463 (718) 796-4550	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1154533149	DR. FARIDA PARVEEN D.D.S., P.C. PARKCHESTER DENTAL CLINIC (Organization)	2002 MCGRAW AVE 1ST FLOOR BRONX, NY 10462 (718) 239-8250		Non-Participating Provider	NO
1154533156	PARKCHESTER CHILDRENS DENTAL GROUP (Organization)	1488 METROPOLITAN AVENUE STE 7 BRONX, NY 10462 (718) 824-9612		Non-Participating Provider	NO
1154597342	SHERYL GEORGE (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	Ambetter Health Ambetter 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 Guardian Humana Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1154746238	JONATHAN JOONHO KIM (Individual)	260 E 188TH ST BRONX, NY 10458 (718) 960-9000	Ambetter Health Ambetter Health of Delaware 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 Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1164411542	IVONNE ALVAREZ (Individual)	2400 HUGHES AVE BRONX, NY 10458 (718) 295-1615	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1164515649	FELIX JUAN RODRIGUEZ (Individual)	2951 GRAND CONCOURSE SUITE NUMBER 6 BRONX, NY 10468 (718) 561-0773	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1164551628	BERGEN DENTAL CENTER LLP (Organization)	428 E 149TH ST BRONX, NY 10455 (718) 585-7612	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
1164598744	FAKHRELDIN H OSMAN (Individual)	1871 ARCHER ST BRONX, NY 10460 (748) 904-1611	Renaissance Dental	Non-Participating Provider	NO
1164627469	MONTEFIORE DENTAL DEPARTMENT (Organization)	305 E 161ST ST BRONX, NY 10451 (888) 700-6623		Non-Participating Provider	NO
1164705943	HUTCHINSON METRO DENTAL, P.C. (Organization)	1200 WATERS PL STE M107 BRONX, NY 10461 (718) 822-8787	UnitedHealthcare	Non-Participating Provider	NO
1164789566	SONIA RAHANGDALE (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1164814588	SOFIA KAVAKOGLOU (Individual)	2100 BARTOW AVE #218B BRONX, NY 10475 (718) 249-9337	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1164817433	JONATHAN SAKHAEE (Individual)	111 E 210TH ST BRONX, NY 10467 (000) 000-0000	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1164834628	KEISHA MONIQUE BUTLER (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400	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 Dominion National EMI Health Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY	Maybe Accepts Medicare	YES
1164859062	BRONX COMMUNITY DENTAL, PLLC (Organization)	471 E TREMONT AVE BRONX, NY 10457 (718) 294-1040		Non-Participating Provider	NO
1164979639	PARKCHESTER DENTAL GROUP, LLP (Organization)	7 HUGH J GRANT CIR #1 BRONX, NY 10462 (718) 792-0137		Non-Participating Provider	NO
1174062467	JEMI JACOB (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1174631493	DOINA EUGENIA OPRISU (Individual)	1473 WEST AVE BRONX, NY 10462 (718) 824-5444		Non-Participating Provider	NO
1174636187	ALEXANDER ROSHE (Individual)	3510 BAINBRIDGE AVE S4 BRONX, NY 10467 (718) 547-7474	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
1174652390	GENE SHEINKMAN (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1174665541	STEVEN BRYAN OKEN (Individual)	1550 PELHAM PKWY S BRONX, NY 10461 (718) 597-8457	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
1174801419	ZAHRA OMAR (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 483-1270	Humana	Non-Participating Provider	YES
1174891352	GARRISON EUGENE COPELAND (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 992-7669	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 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
1184011728	MARIA A. MUNIZ (Individual)	2336 GRAND CONCOURSE BRONX, NY 10458 (718) 220-0439	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 North Carolina Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1184107344	YOUR BRONX DENTIST (Organization)	3310 BAINBRIDGE AVE BRONX, NY 10467 (718) 654-3456	UnitedHealthcare	Non-Participating Provider	NO
1184283426	ALLISON JOHNSON (Individual)	234 EUGENIO MARIA DE HOSTO BLVD BRONX, NY 10451 (718) 579-5692	Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Louisiana Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Florida Combined Life HMO Louisiana Humana UnitedHealthcare	Non-Participating Provider	NO
1184316176	ASPEN WANG (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1184613564	HECTOR LUIS MERCEDES (Individual)	759 E 149TH ST BRONX, NY 10455 (718) 401-2304	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1184631939	CHRISTOPHER J DILLON (Individual)	64 METROPOLITAN OVAL SUITE 9 BRONX, NY 10462 (718) 863-0200	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1184649097	NASRIN SULTANA (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Renaissance Dental	Non-Participating Provider	NO
1184700536	ALOPARANI MOHAN MAHADKAR (Individual)	534 E 138TH ST BRONX, NY 10454 (718) 665-5001	Humana Renaissance Dental	Non-Participating Provider	NO
1184717597	DIONNE J. FINLAY (Individual)	2100 BARTOW AVE SUITE 246 BRONX, NY 10475 (718) 708-6755	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1184726556	ANTHONY J PAGANO (Individual)	1805 PARKVIEW AVE BRONX, NY 10461 (718) 792-4553	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1184766834	PEARL ROSE SUSSMAN (Individual)	5683 RIVERDALE AVE SUITE 205 BRONX, NY 10471 (718) 884-8808	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1184769549	HAVEMEYER ASSOCIATES,INC (Organization)	1231 WHITE PLAINS RD BRONX, NY 10472 (718) 822-7645		Non-Participating Provider	NO
1184774556	HOWARD STEVEN SILVERBRAND (Individual)	2136 MATTHEWS AVE BRONX, NY 10462 (718) 409-1610		Non-Participating Provider	NO
1184781551	EDWARD JOSEPH PELOSO (Individual)	3130 GRAND CONCOURSE APT #1M BRONX, NY 10458 (718) 364-7888	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	YES
1184781791	RIVERDALE ORAL & MAXILLOFACIAL SURGERY PC (Organization)	3333 HENRY HUDSON PKY SUITE 9 BRONX, NY 10463 (718) 796-4550		Non-Participating Provider	NO
1184878811	CARE FIRST DENTAL PC (Organization)	1401A OVERING STREET 1ST FLOOR BRONX, NY 10461 (718) 239-8241		Non-Participating Provider	NO
1184896607	WILLIS DENTAL CARE, P.L.L.C. A&B SCARSDALE DENTAL (Organization)	237 WILLIS AVE BRONX, NY 10454 (718) 292-6311		Non-Participating Provider	NO
1194019901	ANDY WAN (Individual)	4422 THIRD AVENUE ST. BARNABAS HOSPITAL/MILLS BUILDING - DENTAL BRONX, NY 10457 (718) 332-9888		Non-Participating Provider	NO
1194031120	RANDY ZULTOWSKY (Individual)	1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER BRONX, NY 10461 (718) 918-5124	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 Paramount Paramount Dental	Non-Participating Provider	NO
1194163212	ANNA N YOUNG (Individual)	6118 RIVERDALE AVE BRONX, NY 10471 (347) 590-9910	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	YES
1194327932	JENNIFER DANG (Individual)	2100 BARTOW AVE BRONX, NY 10475 (718) 708-6755		Non-Participating Provider	NO
1194460287	MARIA FERNANDEZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6033		Non-Participating Provider	NO
1194707083	YOLANDA M GEORGE (Individual)	1624 UNIVERSITY BLVD BRONX, NY 10453 (718) 458-3333		Non-Participating Provider	NO
1194759712	ROBERT MARGOLIN (Individual)	UNION COMMUNITY HEALTH CENTER 260 E 188 STREET BRONX, NY 10458 (718) 220-2020	UnitedHealthcare	Non-Participating Provider	NO
1194863084	ILIA ABRAMOV (Individual)	2198 BARNES AVE BRONX, NY 10462 (718) 863-4141	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1194873513	ELLIOT W SCHER (Individual)	1523 WESTCHESTER AVENUE BRONX, NY 10472 (718) 542-1444	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1194883108	KAUSHIK SUMANTLAL VANI (Individual)	214 EAST 165TH STREET BRONX, NY 10456 (718) 992-2151		Non-Participating Provider	NO
1194893917	SANGEETA SETHI (Individual)	1022 E 163 ST BRONX, NY 10459 (718) 542-2088	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1194920496	MONTEFIORE DENTAL BLONDELL DENTAL DEPARTMENT (Organization)	1575 BLONDELL AVE FIRST FLOOR BRONX, NY 10461 (888) 700-6623		Non-Participating Provider	NO
1194984773	SOON M KWON (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5000	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1205002755	BRACE DENTAL SERVICES, PC (Organization)	874 PROSPECT AVE 2ND FL BRONX, NY 10459 (718) 328-8511		Non-Participating Provider	NO
1205123163	VERONICA DIAZ (Individual)	3023 YOUNG AVE BRONX, NY 10469 (917) 558-6905		Non-Participating Provider	NO
1205177292	FORDHAM DENTAL CARE, P.C. (Organization)	573 E FORDHAM RD STORE FRONT BRONX, NY 10458 (917) 962-9990		Non-Participating Provider	NO
1205202397	LYNDSAY MARKS (Individual)	234 E 149TH ST BRONX, NY 10451 (504) 909-4146	Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Magnolia Health Ambetter from Superior HealthPlan 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 Louisiana Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental HMO Louisiana Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1205250321	DAUDRIE-ANN POWELL (Individual)	1510 UNIONPORT RD APT 1D BRONX, NY 10462 (202) 702-1054	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 Paramount Paramount Dental	Non-Participating Provider	YES
1205356292	VARUN NAKHATE (Individual)	111 E 210 ST BRONX, NY 10467 (718) 920-4321	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1205498417	JI YOO LEE (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 377-6453	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1205571593	DANIELLE LIEBERMAN (Individual)	790 CONCOURSE VLG W BRONX, NY 10451 (718) 502-6256		Non-Participating Provider	NO
1215112263	LIRAZ SPEAR (Individual)	3725 HENRY HUDSON PKWY 1C BRONX, NY 10463 (718) 725-8997		Non-Participating Provider	NO
1215289251	BRIAN ENG (Individual)	125 E BURNSIDE AVE BRONX, NY 10453 (718) 585-9204	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
1215398219	JOSE DANIEL SAEZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1215430327	KEVIN ZHANG (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000	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 UnitedHealthcare	Non-Participating Provider	YES
1215501044	WILLIAM FERRANTE (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5000	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
1215529037	ZACHARY JASON BURACK (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1225136716	TONY KUO-WEI CHEN (Individual)	100 ELGAR PL FRONT OFFICE BRONX, NY 10475 (718) 671-6650	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1225136815	FADEL C CARCAMO (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-4900	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1225141864	OLGA BELIKOV (Individual)	565 E 187 ST BRONX, NY 10458 (718) 364-3300		Non-Participating Provider	NO
1225163496	STEVEN KIERAN SCHWABE (Individual)	3898 SEDGWICK AVE BRONX, NY 10463 (718) 543-0611		Non-Participating Provider	NO
1225253545	SHIRAZ A DAMJI (Individual)	1250 SHAKESPEARE AVE BRONX, NY 10452 (718) 992-3900	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	Non-Participating Provider	NO
1225285158	SMILE-SAVERS PEDIATRIC DENTISTRY, PC (Organization)	2100 BARTOW AVE SUITE 246 BRONX, NY 10475 (718) 708-6755		Non-Participating Provider	NO
1225293160	THOMAS BRENDAN FALLON (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110	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	YES
1225342181	CHINAR MAHADKAR (Individual)	534 E 138TH ST BRONX, NY 10454 (718) 665-5001	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1225472053	BRYAN J HINKLE (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1225472814	SAM AARON MARGULIES (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	Aetna CVS Health Ambetter Health Ambetter of Alabama 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 Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1225530454	SHARMIN AKHTER (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2303	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1235128463	YURY M BABECK (Individual)	1790 RANDALL AVE BRONX, NY 10473 (718) 542-2993	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1235445628	DANIEL B. NYER (Individual)	1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER BRONX, NY 10461 (718) 918-5124	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 Renaissance Dental	Non-Participating Provider	YES
1235522988	GYU-LE SONG (Individual)	591 E TREMONT AVE BRONX, NY 10457 (646) 393-5181	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1235540675	MARYAM TOUFANI (Individual)	3530 HENRY HUDSON PKWY BRONX, NY 10463 (718) 543-3030		Non-Participating Provider	NO
1235559071	HASIFA LADNER (Individual)	1775 GRAND CONCOURSE 6TH FLOOR BRONX, NY 10453 (718) 901-8410	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee 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 North Carolina Guardian Humana UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1235567488	MOJDEH FARAZ (Individual)	1400 PELHAM PARKWAY SOUTH, JACOBI MEDICAL CENTER BRONX, NY 10461 (718) 918-5000	Anthem Blue Cross and Blue Shield Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1235645060	S&K DENTAL MANAGEMENT, PLLC (Organization)	630 COURTLANDT AVE BRONX, NY 10451 (718) 993-4300	UnitedHealthcare	Non-Participating Provider	NO
1235679309	RHYN CHUNG (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	YES
1245311992	ROSA MEJIA (Individual)	217 E 188TH ST BRONX, NY 10458 (718) 584-3724	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	NO
1245313956	DILLON KIRSHENBAUM PERUSO LLI THE DENTAL CENTER FO PELHAN PARKWAY & PARKCHESTER FAMILY DENTAL SERVIC (Organization)	2169 WHITE PLAINS RD BRONX, NY 10462 (718) 597-6314		Non-Participating Provider	NO
1245334564	LDFCB DENTISTRY PEDIATRIC DENTISTRY OF BRONX (Organization)	3201 GRAND CONCOURSE SUITE 1E BRONX, NY 10468 (718) 367-7645	Florida Blue (BlueCross BlueShield FL) Florida Blue HMO (a BlueCross BlueShield FL company) UnitedHealthcare	Non-Participating Provider	NO
1245334697	SHELDON M LINDENFELD (Individual)	4555 HENRY HUDSON PKWY #105 BRONX, NY 10471 (718) 796-2623	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 UnitedHealthcare	Non-Participating Provider	YES
1245386887	TAD A PICKER (Individual)	910 GRAND CONCOURSE BRONX, NY 10451 (718) 538-2410	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1245402254	CONCOURSE PLAZA DENTAL ASSOCIATES PC (Organization)	230 E 161ST ST CONCOURSE PLAZA SHOPPING CENTER BRONX, NY 10451 (718) 992-8200		Non-Participating Provider	NO
1245432590	AMIN JOSEPH (Individual)	2535 GRAND CONCOURSE BRONX, NY 10468 (718) 365-4900	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1245444637	CRAIG SMITH (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2826	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1245502368	TITAN DENTAL P C (Organization)	446EAST 149TH STREET SAME BRONX, NY 10455 (973) 356-4570		Non-Participating Provider	NO
1245570480	INIVA RYTA NGAKA (Individual)	3636 WALDO AVE APT # 1G BRONX, NY 10463 (859) 420-0385	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1255320305	K&D DENTAL ASSOCIATES PLLC (Organization)	5500 BROADWAY BRONX, NY 10463 (718) 562-1074		Non-Participating Provider	NO
1255320412	OVRAL J WYNTER (Individual)	1624 UNIVERSITY BLVD BRONX, NY 10453 (718) 294-3725	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1255321493	NEHA DAVE (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1255519294	JUSTINA SUNHEE CHO (Individual)	3744 3RD AVE BRONX, NY 10456 (718) 590-5090	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1255538120	MORRIS AVENUE CHILDREN & ADULT DENTISTRY (Organization)	1037 MORRIS AVE BRONX, NY 10456 (718) 293-8005		Non-Participating Provider	NO
1255597704	VINCENT WONG (Individual)	266 E 167TH ST KDM DENTAL BRONX, NY 10456 (718) 293-4100	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 Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1255738126	BRUCKNER DENTAL GROUP LLP (Organization)	910 THIERIOT AVE APT 1C BRONX, NY 10473 (718) 589-3131	UnitedHealthcare	Non-Participating Provider	NO
1255791935	AUSTIN WILSON (Individual)	6118 RIVERDALE AVE BRONX, NY 10471 (347) 590-9915	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1255856324	HARVEY SCHILOWITZ, D.D.S. HARVEY SCHILOWITZ, D.D.S. (Organization)	2740 3RD AVE BRONX, NY 10455 (718) 618-0162		Non-Participating Provider	NO
1255943064	RIVERDALE DENTAL, PC (Organization)	611 W 239TH ST BRONX, NY 10463 (718) 548-3353	UnitedHealthcare	Non-Participating Provider	NO
1255951570	RAYNA ASHLEY SILVA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1255975884	SARA RIAD ALAKKAD (Individual)	111 E 210TH ST BRONX, NY 10467 (937) 474-9375	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1265025795	DANIEL LEV (Individual)	2403 GRAND CONCOURSE BRONX, NY 10468 (212) 241-6500	Humana	Maybe Accepts Medicare	YES
1265175558	CITY ISLAND DENTAL, PC (Organization)	163 CITY ISLAND AVE BRONX, NY 10464 (718) 885-1688		Non-Participating Provider	NO
1265271217	MELANNIE M RODRIGUEZ LUGO (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1265520407	GEORGE BERNARD BLUMENTHAL (Individual)	4601 HENRY HUDSON PKWY W A 11 BRONX, NY 10471 (718) 796-3500	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
1265542096	LEEYA PAN CARABALLO (Individual)	2445 ARTHUR AVE BRONX, NY 10458 (718) 365-3344		Non-Participating Provider	NO
1265597512	FREDRIC O LEE (Individual)	1543 INWOOD AVE BRONX, NY 10452 (718) 681-8700		Non-Participating Provider	NO
1265734891	TIMOTHY PAUL LEVINE (Individual)	260 E 188TH ST UCHC BRONX, NY 10458 (718) 960-9315		Non-Participating Provider	NO
1265932883	DANIELLE ALYSSA WINTERS (Individual)	3450 WAYNE AVE APT 26J BRONX, NY 10467 (949) 419-4250	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1275068835	ELISHA TAAVAR (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1275090250	MOONES RAJABI (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	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 Florida Combined Life Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1275232316	RIDGE DENTISTRY PC (Organization)	327 E FORDHAM RD FRNT 2 BRONX, NY 10458 (718) 933-8400		Non-Participating Provider	NO
1275507766	MARITZA REYES (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400		Non-Participating Provider	NO
1275698722	ANDREI A GRUN (Individual)	951 PROSPECT AVE BRONX, NY 10459 (718) 860-8440	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1275706715	VARSHA D SHAH DDS PC (Organization)	3005 GRAND CONCOURSE BRONX, NY 10468 (718) 933-0998		Non-Participating Provider	NO
1275710519	MONTEFIORE MEDICAL CENTER MMC DENTAL (Organization)	111 E 210TH ST MMC DENTAL BRONX, NY 10467 (718) 920-4167		Non-Participating Provider	NO
1275753097	SHAHRIAR MOINAMINI (Individual)	120 ELGAR PL UNIT B BRONX, NY 10475 (718) 708-7171	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	Non-Participating Provider	NO
1285022533	RIVERDALE ORAL HEALTH & IMPLANT CENTER, LLC (Organization)	611 W 239TH ST BRONX, NY 10463 (715) 548-3353		Non-Participating Provider	NO
1285331827	JONATHAN CHESTNUT (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (843) 359-3948		Non-Participating Provider	NO
1285609594	ANA S. ROJAS (Individual)	6201A SPENCER TER BRONX, NY 10471 (718) 601-7503	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1285623298	MICHAEL S NORINSKY (Individual)	4000 BAYCHESTER AVE (1ST FLOOR) BRONX, NY 10466 (718) 324-3226		Non-Participating Provider	NO
1285624718	CHRISTOPHER S CHOE (Individual)	2426 EASTCHESTER RD SUITE 207 BRONX, NY 10469 (718) 325-3250	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1285684209	SARAH SUN-YOUNG AHN (Individual)	2016 BRONXDALE AVE SUITE 303 BRONX, NY 10462 (718) 792-7972	Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1285713024	JULIE KAZIMIROFF (Individual)	111 E 210TH ST BRONX, NY 10467 (171) 892-0626		Non-Participating Provider	NO
1285724427	KENNETH H TREITEL,DDS AND JOEL C GREEN, DDS, PC (Organization)	918 PELHAM PKWY S BRONX, NY 10462 (718) 823-7312		Non-Participating Provider	NO
1285776021	SANDRA MOLINAS (Individual)	2734 ARLINGTON AVE BRONX, NY 10463 (917) 885-4714	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	YES
1285794859	PAULA MARMOL (Individual)	1719 WESTCHESTER AVENUE BRONX, NY 10472 (718) 542-7204	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1285800458	DEEPA RAO (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1285899179	TOBIAS J HWANG (Individual)	1963 GRAND CONCOURSE LOWER LEVEL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	YES
1285933390	RONIT ETRA (Individual)	731 WHITE PLAINS RD BRONX, NY 10473 (718) 589-8775	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1285985028	KRISHNAN RAMAMURTHI (Individual)	1894 WALTON AVE BRONX, NY 10453 (718) 583-2700	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1295050789	JASON M CHEUNG (Individual)	111 E 210TH ST DEPARTMENT OF DENTISTRY BRONX, NY 10467 (415) 710-7244	Florida Combined Life Humana	Non-Participating Provider	NO
1295161081	ABC DENTAL PC (Organization)	1268 WHITE PLAINS RD BRONX, NY 10472 (718) 792-6991		Non-Participating Provider	NO
1295275220	GUN HILL DENTAL PC DENTAL SPECIALTIES OF NY (Organization)	301 E GUN HILL RD BRONX, NY 10467 (718) 740-6000		Non-Participating Provider	NO
1295708956	MONICA MORIN (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400		Non-Participating Provider	NO
1295724342	JAY FENSTERSTOCK (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Paramount Paramount Dental	Non-Participating Provider	NO
1295726388	BARRY M KATZEN (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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
1295772366	WEI HUA CHANG (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (646) 241-7241	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1295790335	DAVID KLIGER (Individual)	810 PELHAM PKWY SO STE A BRONX, NY 10462 (718) 824-4383		Non-Participating Provider	NO
1295834232	THOMAS JOSEPH PESCE (Individual)	3926 EAST TREMONT AVE BRONX, NY 10465 (718) 892-6550	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	YES
1295842136	INDER PAL SINGH (Individual)	7 HUGH J GRANT CIR BRONX, NY 10462 (718) 792-0137	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
1295895860	LIN HU (Individual)	MMC - DEPT. OF DENTISTRY 3332 ROCHAMBEAU AVENUE, 2ND FL BRONX, NY 10467 (718) 920-6266		Non-Participating Provider	NO
1295896413	LAARNI AREVALO ABANTO (Individual)	4300 KATONAH AVE BRONX, NY 10470 (718) 325-7356		Non-Participating Provider	YES
1295925055	ELIAS ALTAGRACIA PIMENTEL (Individual)	1600 MACOMBS RD BRONX, NY 10452 (718) 466-8800	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1295947372	PETER GROSS DMD PC (Organization)	2967 MORGAN AVENUE BRONX, NY 10469 (718) 655-1972	UnitedHealthcare	Non-Participating Provider	NO
1295981157	KAREEM FATOUH (Individual)	1537 WESTCHESTER AVE BRONX, NY 10472 (718) 617-0624	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
1306028386	LEONARD SAMUEL KLEIN (Individual)	3161 E TREMONT AVE BRONX, NY 10461 (718) 518-8100		Non-Participating Provider	NO
1306050869	FORDHAM ROAD DENTAL PC EXECUTIVE ASSOCIATES, LLC (Organization)	327 E FORDHAM RD 2ND FLOOR BRONX, NY 10458 (718) 933-8400	UnitedHealthcare	Non-Participating Provider	NO
1306062450	SAFWAT AFIFI (Individual)	755 E 149TH ST BRONX, NY 10455 (718) 292-9980		Non-Participating Provider	NO
1306093083	LIEBERMAN AND BARNETT DDS PC (Organization)	1645 GRAND CONCOURSE BRONX, NY 10452 (718) 299-7012	UnitedHealthcare	Non-Participating Provider	NO
1306112560	ZEN DENTAL P.C. (Organization)	563 E TREMONT AVE BRONX, NY 10457 (845) 527-7772		Non-Participating Provider	NO
1306239496	GABRIELLA NOCERINO (Individual)	1608 KENNELLWORTH PL BRONX, NY 10465 (347) 996-6432		Non-Participating Provider	NO
1306261854	586 MORRIS DENTAL PC (Organization)	586 MORRIS AVENUE 586 MORRIS DENTAL PC BRONX, NY 10451 (917) 962-9990		Non-Participating Provider	NO
1306385166	CHIEN LAM (Individual)	LINCOLN HOSPITAL 234 E 149TH ST BRONX, NY 10451 (718) 579-5690		Non-Participating Provider	YES
1306386263	SARA NAJAM (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1306407994	KAMBIZ VATANDOOST (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5690	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1306587845	ALEXANDER WEINSTEIN (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1316000763	YAKOV PILTSER (Individual)	2134 BARNES AVE 2 FL BRONX, NY 10462 (718) 863-4777		Non-Participating Provider	NO
1316085202	EDWARD CRONIN (Individual)	339 E FORDHAM RD BRONX, NY 10458 (718) 933-8400	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1316112402	GINA PERRETTA (Individual)	1933 WILLIAMSBRIDGE RD BRONX, NY 10461 (718) 823-4719	Humana Renaissance Dental	Non-Participating Provider	YES
1316128341	NEIGHBORHOOD FAMILY & COSMETIC DENTISTRY, PC (Organization)	289 E 149TH ST SUITE 2 BRONX, NY 10451 (718) 742-7400		Non-Participating Provider	NO
1316136146	JEFFREY H KIM (Individual)	1231 WEBSTER AVE BRONX, NY 10456 (646) 402-8989	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1316143225	NEW YORK DENTAL ALLIANCE (Organization)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-7259		Non-Participating Provider	NO
1316476682	IVET ROMERO VAZQUEZ (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (305) 753-4515	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 Guardian Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1316552409	ZUBIA IFTIKHAR (Individual)	326 E 149TH ST BRONX, NY 10451 (718) 618-7564	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1326127218	CHRISTOPHER MATTHEW AMENEDO (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1326127713	ADEWALE OLAOLU ADEPETU (Individual)	754 E 151ST ST BRONX, NY 10455 (718) 401-5431	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1326214594	DALILA M. SIMPSON (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110		Non-Participating Provider	NO
1326240458	JASON R GORDON (Individual)	724 PELHAM PKWY S BRONX, NY 10462 (917) 658-1996	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 UnitedHealthcare	Non-Participating Provider	YES
1326291303	UNIQUE DENTAL, P.C. (Organization)	4521 3RD AVE BRONX, NY 10457 (718) 220-2030		Non-Participating Provider	NO
1326340209	ERH TUNG BEN KANG (Individual)	234 E 149TH ST BRONX, NY 10451 (732) 986-7434		Non-Participating Provider	NO
1326480005	NEW YORK DENTAL HEALTH P.C. (Organization)	1550 UNIVERSITY AVE BRONX, NY 10452 (917) 893-8777		Non-Participating Provider	NO
1326538141	AHMED ALSHAREEF (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1326683129	STEVEN KALENDARIOV (Individual)	1963 GRAND CONCOURSE # LL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	NO
1326707126	CHRISTINA ANDREA APONTE (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1326795212	STEVEN LORBER (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	YES
1336323294	PHILLIP H LAM (Individual)	1530 UNIONPORT RD BRONX, NY 10462 (718) 892-2200	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 UnitedHealthcare	Non-Participating Provider	YES
1336327451	DOWNTOWN BRONX DENTAL ASSOCIATES, PC (Organization)	234 E 149TH ST 8D-200 BRONX, NY 10451 (718) 579-6200		Non-Participating Provider	NO
1336331321	BIANCA DEARING (Individual)	234 EUGENIO MARIA DE HOSTO BLVD BRONX, NY 10451 (718) 579-5000		Non-Participating Provider	NO
1336419332	DAVID TASHMAN DDS PC (Organization)	4601 HENRY HUDSON PKWY W A-11 BRONX, NY 10471 (718) 519-0500		Non-Participating Provider	NO
1336599786	VANESSA CHONG (Individual)	555 E FORDHAM RD BRONX, NY 10458 (347) 801-8888		Non-Participating Provider	NO
1336649573	JAE HONG PARK (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (214) 228-7043	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1336652593	TREMONT SMILES DENTAL PC (Organization)	563 E TREMONT AVE BRONX, NY 10457 (718) 466-4500	UnitedHealthcare	Non-Participating Provider	NO
1346239589	JESUS MANUEL ALVAREZ (Individual)	2400 HUGHES AVE BRONX, NY 10458 (718) 295-1615	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 Paramount Paramount Dental	Non-Participating Provider	YES
1346251352	BENJAMIN VLAD KATAYEV (Individual)	1401 DEKRUIE PLACE BRONX, NY 10475 (718) 379-1700	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1346331451	DANNY RAMONA ALCANTARA (Individual)	841 CONCOURSE VLG W BRONX, NY 10451 (347) 590-2851	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1346396017	YURIY MURDAKHAYEV (Individual)	910 GRAND CONCOURSE BRONX, NY 10451 (718) 538-2410	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1346424702	BRONX REGIONAL HIGH SCHOOL SCHOOL HEALTH (Organization)	979 ROGERS PL BRONX, NY 10459 (718) 696-4071		Non-Participating Provider	NO
1346431590	BIRGITTA URSULA WARVAROVSKY (Individual)	1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER BRONX, NY 10461 (301) 295-4339		Non-Participating Provider	NO
1346458452	BYUNG HAK PAK (Individual)	1645 GRAND CONCOURSE BRONX, NY 10452 (718) 299-7012	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	YES
1346496858	NYC COMMUNITY DENTAL CARE, PC (Organization)	47 E 167TH ST BRONX, NY 10452 (718) 293-1603	UnitedHealthcare	Non-Participating Provider	NO
1346609781	MADINA KHABIYEVA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1346680022	JEMIMA MAXINE LOUIS (Individual)	1400 PELHAM PKWY S JACOBI MEDICAL CENTER BRONX, NY 10461 (267) 670-2535		Non-Participating Provider	NO
1346739315	HYUNG ROK YOU (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2341		Non-Participating Provider	NO
1346810413	AMBIKA KUMARAN (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 590-1800	Ambetter Health Ambetter Health of Delaware 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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1346948684	PREETHI SINGH (Individual)	JACOBI MEDICAL CENTER 1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	YES
1356034078	MOHAMMAD HAIDER ISHTIAQ (Individual)	111 EAST 210 STREET BRONX, NEW YORK BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1356314009	RONALD SALYK (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400		Non-Participating Provider	NO
1356363584	JOSEPH SCHACHNER (Individual)	3201 GRAND CONCOURSE SUITE 2K BRONX, NY 10468 (718) 584-9777		Non-Participating Provider	NO
1356380141	WANDA ORTIZ (Individual)	731 WHITE PLAINS RD BRONX, NY 10473 (718) 589-8324		Non-Participating Provider	NO
1356420681	MARIE MCKENZIE-TOLA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1356420970	BRONX DENTAL,P.C. (Organization)	2604 3RD AVE 3RD FLOOR BRONX, NY 10454 (718) 292-3800		Non-Participating Provider	NO
1356464366	BARRY LITT (Individual)	2063-B BARTOW AVENUE BRONX, NY 10475 (718) 379-4734		Non-Participating Provider	NO
1356652408	ANN AKUYO LAYVEY-TARDALO (Individual)	1775 GRAND CONCOURSE # 21 BRONX, NY 10453 (646) 228-4306	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 Humana Renaissance Dental	Non-Participating Provider	NO
1356662787	NISHITA R GANDHI (Individual)	586 MORRIS AVE BRONX, NY 10451 (646) 401-7878	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1356915482	PEDRO ALEXIS BERRIOS-REYES (Individual)	111 E 210TH ST BRONX, NY 10467 (717) 920-4321		Non-Participating Provider	NO
1366005969	JANET JEONGHWA LEE (Individual)	260 E 188TH STREET , ST. BARNABAS HOSPITAL 1ST FLOOR , DIVISION OF ORTHODONTICS BRONX, NY 10458 (718) 618-8935		Non-Participating Provider	NO
1366423444	JACQUELINE J SAMUELS (Individual)	120 ALCOTT PL GROUND FLOOR BRONX, NY 10475 (718) 320-3181	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1366464885	BETH R BERSON (Individual)	611 W 239TH ST C/O RIVERDALE ORAL HEALTH BRONX, NY 10463 (718) 601-1570		Non-Participating Provider	YES
1366525065	SHAHNAAZ GILL (Individual)	R.G.DENTAL 330 EAST 204TH STREET BRONX, NY 10467 (718) 652-0290	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 Humana	Non-Participating Provider	NO
1366566622	REENA S MITTLE (Individual)	466 E FORDHAM RD BRONX, NY 10458 (718) 365-4300		Non-Participating Provider	NO
1366601189	BERNABE GENERAL DENTISTRY PC (Organization)	1916 GRAND CONCOURSE SUITE 1A BRONX, NY 10457 (718) 716-1400	UnitedHealthcare	Non-Participating Provider	NO
1366613499	GRANT AND KANTOR DDS P.C. (Organization)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389		Non-Participating Provider	NO
1366618670	HONEY OJHA (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1366624314	ROBERT GARFINKEL (Individual)	770 ALLERTON AVE BRONX, NY 10467 (718) 231-9500	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	NO
1366635229	OCTO-DENTAL PC (Organization)	293 E 149TH ST BRONX, NY 10451 (646) 404-5005		Non-Participating Provider	NO
1366653388	SANDRA TENZER (Individual)	2063B BARTOW AVENUE BRONX, NY 10475 (718) 379-4734	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1366751364	MANDANA KHALATBARI (Individual)	86 W 183RD ST BRONX, NY 10453 (718) 367-4222	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1366803728	KIND-RON SO (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Renaissance Dental	Non-Participating Provider	NO
1366882102	MEYER ZAHLER (Individual)	1650 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8132	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	Non-Participating Provider	NO
1366900573	DULCE NAHIMIR HERNANDEZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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
1366976763	MICHELLE MARCIANO (Individual)	530 W 236TH ST 2E BRONX, NY 10463 (201) 835-3443	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	Non-Participating Provider	NO
1366978736	LAWRENCE CHEN (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-6628	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1376230227	ADRIANA BEATRIZ VEGA (Individual)	890 PROSPECT AVE BRONX, NY 10459 (718) 991-0605		Non-Participating Provider	NO
1376240887	JESSICA PINKHASOV (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	NO
1376606137	HARVEY LOEB (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3060		Non-Participating Provider	NO
1376687343	RAMY ZAIFMAN (Individual)	1387 CASTLE HILL AVE WEST HILL DENTAL LLP BRONX, NY 10462 (718) 863-2777	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
1376709899	SMILE DENTAL OFFICE P.C (Organization)	1427 WEBSTER AVE BRONX, NY 10456 (718) 293-1728		Non-Participating Provider	NO
1376783654	JONATHAN J BARON (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5636	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 UnitedHealthcare	Non-Participating Provider	NO
1376878983	MIRIAM DENTAL L.L.C MIRIAM DENTAL (Organization)	1727 WHITE PLAINS ROAD, SUITE 1 BRONX, NY 10462 (347) 657-1927		Non-Participating Provider	NO
1386041531	SCOTT LEVITZ (Individual)	2735 SEDGWICK AVE 4E BRONX, NY 10468 (203) 506-4835	Humana UnitedHealthcare	Non-Participating Provider	NO
1386041531	SCOTT LEVITZ (Individual)	2735 SEDGWICK AVE 4E BRONX, NY 10468 (203) 506-4835	Humana UnitedHealthcare	Non-Participating Provider	NO
1386055929	JOHN KUO (Individual)	1225 GERARD AVE BRONX, NY 10452 (718) 960-2911	Renaissance Dental	Non-Participating Provider	YES
1386639052	CHETAN NAGINLAL SHAH (Individual)	769 CONCOURSE VLG W BRONX, NY 10451 (718) 665-1843		Non-Participating Provider	NO
1386767119	ROBERT WILLIAM FRANKEL (Individual)	3317 BAINBRIDGE AVE BRONX, NY 10467 (718) 547-2833	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 UnitedHealthcare	Non-Participating Provider	NO
1386820926	SALVATORE CHARLES ALBANESE (Individual)	3725 HENRY HUDSON PKWY BRONX, NY 10463 (718) 601-0100	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1386827095	MOISE NAWLO (Individual)	225 A EAST 149TH ST BRONX, NY 10451 (718) 993-0074	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	NO
1386837805	LLISENIA E. RIVERA (Individual)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1386840734	DAVID TAVELIN (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000	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	YES
1386845543	KERN HO LEE (Individual)	3600 FIELDSTON RD 2C BRONX, NY 10463 (718) 884-2600	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1386868990	CASTLEHILL DENTAL PC CASTLEHILL DENTAL GROUP (Organization)	735 CASTLE HILL AVENUE BRONX, NY 10473 (718) 824-1122		Non-Participating Provider	NO
1396001251	ROBERT VAVOLIZZA (Individual)	3585 E TREMONT AVE BRONX, NY 10465 (718) 829-7300		Non-Participating Provider	NO
1396088480	LAUREN PITLUCK (Individual)	4422 3RD AVE ST. BARNABAS HOSPITAL, DEPARTMENT OF DENTISTRY BRONX, NY 10457 (718) 960-9000	Anthem Blue Cross and Blue Sheld 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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1396192308	PARASTOU MODJARRAD (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1396339800	EVAN YIFAN YU (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1396740270	GUNANAND PERSAUD (Individual)	1606 TOWNSEND AVE. BRONX, NY 10452 (718) 299-1724	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1396741328	MARC D BROWN (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1396836482	MANOOCHER NAJAFI (Individual)	1751 BOSTON RD BRONX, NY 10460 (718) 589-9562		Non-Participating Provider	NO
1396884300	MAGED F KARAM (Individual)	2190 BOSTON ROAD SUITE 1L BRONX, NY 10462 (718) 823-7707	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1396891925	MICHAEL SMALLINE (Individual)	910 GRAND CONCOURSE BRONX, NY 10451 (718) 538-2410		Non-Participating Provider	NO
1396949376	SERGEY SANDLER (Individual)	3366 BOSTON ROAD BRONX, NY 10469 (718) 547-5280	Renaissance Dental	Non-Participating Provider	NO
1407037369	CHARLES W TAYLOR (Individual)	1245 SOUTHERN BLVD. BRONX, NY 10459 (718) 893-3560		Non-Participating Provider	NO
1407224454	ANN CHERUKARA SIMON (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Delta Dental PPO Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1407553381	CATHERINE GISSEL PAYANO (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	NO
1407691165	BIG CITY DENTAL P.C. (Organization)	910 GRAND CONCOURSE APT 1A BRONX, NY 10451 (718) 538-2410		Non-Participating Provider	NO
1407837594	SHAHROUKH YAGHOUBIAN (Individual)	1037 MORRIS AVE BRONX, NY 10456 (717) 293-8005	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	YES
1407862394	THOMAS BENJAMIN (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440		Non-Participating Provider	NO
1407868730	AMIRO EDUARDO ROMAN (Individual)	2406 WALTON AVE #SOB BRONX, NY 10468 (718) 364-7791		Non-Participating Provider	NO
1407900285	YANA ZAMECHEK (Individual)	1022 E 163RD ST BRONX, NY 10459 (718) 542-2088	Humana Renaissance Dental	Non-Participating Provider	YES
1407959703	JENNIFER WEI CHANG (Individual)	130 W. KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1407968688	XIAO MENG ZHANG (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1417029844	MANOOCHER NAJAFI DDS PC (Organization)	1751 BOSTON RD BRONX, NY 10460 (718) 589-9562		Non-Participating Provider	NO
1417129974	KWAK DENTAL MANAGEMENT, PLLC (Organization)	638 EAST 169TH STREET 2ND FLOOR BRONX, NY 10456 (718) 991-8668		Non-Participating Provider	NO
1417130733	WAYNE MARK TONG (Individual)	1821 MAHAN AVE BRONX, NY 10461 (718) 828-4540	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Opted out of Medicare	YES
1417151945	NODARI DAVITIASHVILI (Individual)	3902 SEDGWICK AVE BRONX, NY 10463 (917) 495-1000		Non-Participating Provider	NO
1417212937	JOSE ANTONIO RIVERO SUTIL (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-3730		Maybe Accepts Medicare	YES
1417325382	CONCOURSE PLAZA FAMILY DENTAL LLC (Organization)	230 E 161ST ST BRONX, NY 10451 (718) 992-8200		Non-Participating Provider	NO
1417375858	WE SMILE DENTAL TWO PC GREATER DENTAL (Organization)	3213 3RD AVE BRONX, NY 10451 (646) 314-0196	UnitedHealthcare	Non-Participating Provider	NO
1417521378	RAUF ARSHAD (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 536-8844	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
1417605379	ANISA TOCILLA (Individual)	THIRD AVE & 183RD STREET BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	YES
1417649369	SANA KARIM (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1417840893	ANEESHA MANTRIPRAGADA (Individual)	1775 GRAND CONCOURSE # 6 BRONX, NY 10453 (718) 901-8400		Non-Participating Provider	NO
1417938655	JEFFREY GOLDSTEIN (Individual)	339 E FORDHAM RD EXECUTIVE ASSOCIATES BRONX, NY 10458 (718) 933-8400	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 UnitedHealthcare	Non-Participating Provider	YES
1427021708	PAINLESS DENTAL CARE PC (Organization)	761 LYDIG AVE GROUND FLOOR BRONX, NY 10462 (718) 792-4782	UnitedHealthcare	Non-Participating Provider	NO
1427114842	KEITH STUART MARGULIS (Individual)	3424 KOSSUTH AVE SUITE 2A BRONX, NY 10467 (718) 519-2023		Non-Participating Provider	YES
1427137876	LEONARD MARK (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167	Humana	Non-Participating Provider	YES
1427220540	BRUCKNER PLAZA DENTAL SERVICE (Organization)	1967 TURNBULL AVE STE 21A BRONX, NY 10473 (718) 823-3393		Non-Participating Provider	NO
1427257666	ALBERT RABIZADEH (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Paramount Paramount Dental	Non-Participating Provider	YES
1427361872	KENNETH BRUCE COOPERMAN (Individual)	355 E 149TH ST SUITE 202 BRONX, NY 10455 (718) 993-5454	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1427440445	PAUL MICHAEL WILLIAMS (Individual)	2100 BARTOW AVE 218B BRONX, NY 10475 (646) 961-3485	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
1427442177	RAQUEL MARIE FONTANEZ (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110	Ambetter Health Ambetter of Alabama 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 Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1427449990	DANIEL SULTAN (Individual)	234 E 149TH ST STE 2-A8 BRONX, NY 10451 (718) 579-5892	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1427679356	JONATHAN RODNEY (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2826	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1427733815	BAYCHESTER MULTISPECIALTIES LLC (Organization)	4000 BAYCHESTER AVE BRONX, NY 10466 (718) 777-8200		Non-Participating Provider	NO
1427747898	GIZELLE INNABI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1437123015	KARLA WENDY ISAACS (Individual)	565 EAST 184TH STREET BRONX, NY 10458 (718) 220-8800	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1437169927	ESPERANZA A. RODRIGUEZ (Individual)	2406 WALTON AVE DENTAL OFFICE BRONX, NY 10468 (718) 364-7791	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1437171915	SIDNEY L ADLER (Individual)	611 W 239TH ST C/O RIVERDALE ORAL HEALTH BRONX, NY 10463 (718) 548-3353		Non-Participating Provider	NO
1437224219	RICHARD A COOPER (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2385	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	Non-Participating Provider	NO
1437268372	ANTIGONI MARIA TSAMPARLIS (Individual)	2300 WESTCHESTER AVE SUITE 301 BRONX, NY 10462 (718) 828-8787	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1437272242	HERRICK LAI (Individual)	64 METROPOLITAN OVAL SUITE #9 BRONX, NY 10462 (718) 892-5095		Non-Participating Provider	NO
1437294543	ELA ACUESTA-LAURETA (Individual)	7 HUGH GRANT CIRCLE SUITE 3 BRONX, NY 10462 (718) 792-5959	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1437379997	MARK P WELLER (Individual)	949 E TREMONT AVE BRONX, NY 10460 (718) 589-8604		Non-Participating Provider	NO
1437478914	ANGELA B BUKSTEIN (Individual)	86 W 225TH ST BRONX, NY 10463 (201) 308-8181	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1437519675	JILBERT BENJAMIN NEMAN (Individual)	1387 CASTLE HILL AVE BRONX, NY 10462 (718) 863-2777	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1437598935	PUNIT KIRAN SHAH (Individual)	1400 PELHAM PKWY S BUILDING 1, ROOM 3NE1 BRONX, NY 10461 (718) 918-3419	UnitedHealthcare	Non-Participating Provider	NO
1437617339	JORGE EDUARDO RUIZ LOURIDO (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	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 UnitedHealthcare	Non-Participating Provider	NO
1437651312	CHAO YING CHEN (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623		Non-Participating Provider	YES
1437656782	YITZCHOK ABED (Individual)	4487 3RD AVE BRONX, NY 10457 (718) 960-9000	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 Humana Renaissance Dental	Non-Participating Provider	NO
1437734647	WENBIN FENG (Individual)	111 EAST 210TH STREET DEPARTMENTAL TELEPHONE AND FAX NUMBERS BRONX, NY 10467 (408) 780-6298	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1437739737	RAFAEL ADOLFO TORRECH (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2063		Non-Participating Provider	YES
1437849890	ADITYA SHARMA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1437890688	MONA SAMMY ELABBASY (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440	Humana	Non-Participating Provider	YES
1447232293	DAOUD KNABIMDITHASBANI (Individual)	1870 GRAND CONCOURSE BRONX, NY 10457 (718) 731-6377	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1447365432	GREGORY SCOTT GANG (Individual)	140 CASALS PL OFC 1 BRONX, NY 10475 (718) 671-6000	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1447464847	BEENAKUMARI VIJU DDS PC (Organization)	3201 GRAND CONCOURSE SUITE 1K BRONX, NY 10468 (718) 933-5510		Non-Participating Provider	NO
1447469259	VICTOR OELBAUM (Individual)	2335 EASTCHESTER RD BRONX, NY 10469 (718) 882-7202		Non-Participating Provider	NO
1447517727	MONICA SONG (Individual)	432 E 149TH ST BRONX, NY 10455 (718) 618-7564	Florida Combined Life	Non-Participating Provider	NO
1447817382	PRISCILLA CATHERINE TONG (Individual)	1808 CROTONA PKWY BRONX, NY 10460 (888) 833-8441	Anthem Blue Cross and Blue Sheld 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1447819362	AYOMIDE ADEOLA OSUNKOYA (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma 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 Delta Dental PPO DeltaCare USA EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1457420895	ZOHREH RASOULINEJAD (Individual)	1231 WHITE PLAINS RD BRONX, NY 10472 (718) 822-7645		Non-Participating Provider	NO
1457449456	ROIS MIAH BARI (Individual)	1225 GERARD AVE BRONX, NY 10452 (718) 960-2853	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
1457474629	WINSTON FRANKLYN BURTON (Individual)	4133 WHITE PLAINS ROAD BRONX, NY 10466 (718) 652-3699		Non-Participating Provider	NO
1457525271	SRP DENTAL CARE, P.C. (Organization)	48 E KINGSBRIDGE RD BRONX, NY 10468 (718) 933-9603		Non-Participating Provider	NO
1457556151	DOV KAHANE (Individual)	3333 HENRY HUDSON PKWY BRONX, NY 10463 (718) 796-4100	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1457612764	EMPIRE DENTAL CARE P.C. (Organization)	1963 GRAND CONCOURSE SUITE LL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	NO
1457648552	MARIA AZURIN HONRADO (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5993	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1457846164	IVAN BORAS (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000		Non-Participating Provider	YES
1467031542	TAMAR REBECCA SHILLER (Individual)	611 W 239TH ST BRONX, NY 10463 (718) 548-3353	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 Ohio EMI Health Florida Combined Life Humana TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1467425462	YAKDIEL JIMENEZ (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400	Humana	Non-Participating Provider	YES
1467458547	HOWARD WEINER (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1467518191	JOSEPHINE ELISABETH SULLIVAN (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3060	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	Non-Participating Provider	YES
1467526608	PETER K LAM (Individual)	150 WEST 228TH STREET BRONX, NY 10463 (718) 561-0886	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	Non-Participating Provider	NO
1467563262	MARLON K MOORE (Individual)	1776 EASTCHESTER RD STE 230 BRONX, NY 10461 (718) 518-1776	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1467576835	ROBERT ELLIOT BOGAN (Individual)	5606 BROADWAY BRONX, NY 10463 (718) 549-5544	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	Non-Participating Provider	NO
1467697326	GABRIEL Y SHALMI (Individual)	5678 RIVERDALE AVE SUITE 200 BRONX, NY 10471 (718) 601-0900	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1467708958	CROWN DENTAL, PLLC (Organization)	604 CASTLE HILL AVE BRONX, NY 10473 (718) 239-6929		Non-Participating Provider	NO
1467757914	ROLANDO GIOVANNI REYES (Individual)	3450 WAYNE AVE APT. 12E BRONX, NY 10467 (787) 469-2394	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 Renaissance Dental	Non-Participating Provider	NO
1467801621	MISOO CHO (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 921-4321	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 Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1467807123	NINGKUN LI (Individual)	1276 FULTON AVE RM 208 BRONX, NY 10456 (718) 901-8918	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1477227908	AIYUN YANG (Individual)	326 E 149TH ST BRONX, NY 10451 (718) 618-7564	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1477228971	ST. BARNABAS HOSPITAL ST. BARNABAS HOSPITAL DENTAL DEPARTMENT (Organization)	4422 3RD AVE DENTAL DEPARTMENT BRONX, NY 10457 (718) 960-6839		Non-Participating Provider	NO
1477526218	JULIANE GOLDEN-WOLOVNICK (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Paramount Paramount Dental	Non-Participating Provider	NO
1477611226	FARHAD YEROSHALMI (Individual)	1400 PELHAM PKWY S BUILDING #1, SUITE 3NE1 BRONX, NY 10461 (718) 918-3180	Anthem Blue Cross and Blue Shield	Non-Participating Provider	YES
1477634962	NADINE LORRAINE NEWSOME (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2418		Non-Participating Provider	NO
1477686202	APTIN GHODS (Individual)	2505 UNIVERSITY AVE BRONX, NY 10468 (718) 733-6600	Renaissance Dental	Non-Participating Provider	NO
1477780823	JUSTIN WILLIAM BEN ZVI (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110		Non-Participating Provider	NO
1477821411	DENTAL CORNER, PC (Organization)	660 WESTCHESTER AVE BRONX, NY 10455 (718) 292-6946		Non-Participating Provider	NO
1477970341	CHRISTOPHER WISPELWEY (Individual)	4422 3RD AVE ST. BARNABAS HOSPITAL BRONX, NY 10457 (917) 656-6285	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
1477979730	LIBEL EDUARDO GEREZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	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 Guardian Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1487245577	DALLIN COLE MONTIERTH (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	NO
1487304275	IDELINA ALMANZAR (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623		Non-Participating Provider	NO
1487473526	AYNAZ KHODAYARI (Individual)	260 E 188TH ST BRONX, NY 10458 (347) 640-1403		Maybe Accepts Medicare	YES
1487809893	RICHIE BANKS (Individual)	910 GRAND CONCOURSE B&B DENTAL, PC BRONX, NY 10451 (718) 538-2410		Non-Participating Provider	NO
1487811287	FRANCIS C NINIVAGGIO (Individual)	1058 MORRIS PARK AVE BRONX, NY 10461 (718) 792-4121	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	Non-Participating Provider	NO
1487967931	UPTOWN HEALTHCARE MANAGEMENT INC. (Organization)	930 EAST FREMONT AVE BRONX, NY 10460 (718) 764-1662		Non-Participating Provider	NO
1497038608	ADVANCED BRONX DENTAL PLLC ADVANCED BRONX ORAL SURGERY (Organization)	237 WILLIS AVE BRONX, NY 10454 (718) 292-6209	Humana UnitedHealthcare	Non-Participating Provider	NO
1497056378	RICHARD WAYNE LEE (Individual)	4422 THIRD AVENUE ST BARNABAS HOSPITAL BRONX, NY 10457 (917) 215-5172		Non-Participating Provider	NO
1497334650	AVIVA DIAMOND (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-6173		Non-Participating Provider	NO
1497744544	VADIM VASSERMAN (Individual)	1144 PELHAM PKWY S #A BRONX, NY 10461 (718) 822-6896	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1497879308	NIRUPA M. GANDHI (Individual)	245 E 149TH ST BRONX, NY 10451 (718) 665-7565		Non-Participating Provider	NO
1497935381	ANITA OMIDI (Individual)	2505 UNIVERSITY AVE BRONX, NY 10468 (718) 733-6600	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1497943971	RONALD FENER, D.D.S. (Organization)	1049 E 163RD ST BRONX, NY 10459 (718) 842-5020		Non-Participating Provider	NO
1497944359	JAY HOWARD DUKE (Individual)	210 EAST 201ST STREET SUITE 1B BRONX, NY 10458 (718) 733-8938		Non-Participating Provider	NO
1508012667	JAEJIN HONG (Individual)	3744 3RD AVE BRONX, NY 10456 (718) 590-5094	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	NO
1508013350	MIRIAM RAMIREZ (Individual)	1727 WHITE PLAINS RD SECOND FLOOR BRONX, NY 10462 (347) 657-1927		Non-Participating Provider	NO
1508195280	JASON W.K. CHOI (Individual)	3332 ROCHAMBEAU AVE 2ND FLOOR BRONX, NY 10467 (718) 515-5419		Non-Participating Provider	NO
1508224155	SHELLY TAYLOR (Individual)	1894 WALTON AVE BRONX, NY 10453 (718) 583-2700	Ambetter Health Ambetter of Alabama 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 Renaissance Dental	Non-Participating Provider	YES
1508240573	MEDPRO DEVELOPMENT METRO FAMILY DENTAL (Organization)	251 W KINGSBRIDGE RD BRONX, NY 10463 (718) 884-7400		Non-Participating Provider	NO
1508607094	MANDANA TEHRANI (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 901-8410		Non-Participating Provider	NO
1508989013	STEIVE KIM (Individual)	630 COURTLANDT AVE BRONX, NY 10451 (718) 993-4300	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1518161611	ELENA VERNESCU (Individual)	860 GRAND CONCOURSE APT. 2R BRONX, NY 10451 (718) 402-7377		Non-Participating Provider	NO
1518187632	PAUL JON MARSH (Individual)	505 CLAREMONT PARKWAY BRONX, NY 10457 (718) 299-3600		Non-Participating Provider	NO
1518245711	NIULKA SANCHEZ DDS PC DN FAMILY DENTAL CARE (Organization)	3207 BAINBRIDGE AVE BRONX, NY 10467 (347) 843-8100		Non-Participating Provider	NO
1518325703	EXCELLENT DENTAL INC (Organization)	1197 RIVER AVE BRONX, NY 10452 (718) 681-0020		Non-Participating Provider	NO
1518412998	JERICA L COOK (Individual)	1775 GRAND CONCOURSE 6TH FLOOR BRONX, NY 10453 (718) 901-8110	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1518453844	RAVEENA SINGH (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110		Non-Participating Provider	NO
1518544113	NATALIE BAKHSHI (Individual)	111 E 210TH ST BRONX, NY 10467 (858) 205-9609	Anthem Blue Cross and Blue Shield Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1518592120	MARINA AKNOUK (Individual)	1473 WEST AVE BRONX, NY 10462 (718) 824-5444		Non-Participating Provider	NO
1518852573	HELEN SANCHEZ (Individual)	5545 NETHERLAND AVE APT 3C BRONX, NY 10471 (718) 312-2416		Non-Participating Provider	NO
1528064946	GILDA BARBOUR (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1528104825	GEORGE J. CISNEROS (Individual)	2016 BRONXDALE AVE BRONX, NY 10462 (718) 792-7972	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
1528140407	BANKIM D PARIKH (Individual)	3455 BOSTON RD BRONX, NY 10469 (718) 654-6900	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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1528161007	JED BERMAN (Individual)	163 CITY ISLAND AVE BRONX, NY 10464 (718) 885-1688		Non-Participating Provider	YES
1528201613	MANHATTAN ORAL FACIAL SURGERY LLC (Organization)	6118 RIVERDALE AVE BRONX, NY 10471 (929) 222-3070	UnitedHealthcare	Non-Participating Provider	NO
1528208766	LYDRA TAPIJA (Individual)	2130 WILLIAMSBRIDGE RD SUITE 1 H BRONX, NY 10461 (718) 792-1000	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1528218567	COMFORT DENTAL CARE PLLC (Organization)	591 E TREMONT AVE BRONX, NY 10457 (718) 901-7555	UnitedHealthcare	Non-Participating Provider	NO
1528326964	NANCY FERRETTI STRANIX (Individual)	355 E 149TH ST #202 BRONX, NY 10455 (718) 993-5454		Non-Participating Provider	NO
1528414455	MELISSA ANNE MONDESIR (Individual)	3201 GRAND CONCOURSE APT 1E BRONX, NY 10468 (718) 367-7645	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1528650710	LISA ANN JEDACEK (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000		Non-Participating Provider	NO
1538165808	ELAINE LINDA GREENBERG (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1538304548	ADRIAN PERRY (Individual)	1475 WALTON AVE 5A BRONX, NY 10452 (615) 714-1683	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
1538309349	RUSHA A. ALYAFI (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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
1538315130	JACK BROWN (Individual)	48 E KINGSBRIDGE RD FRNT 1 BRONX, NY 10468 (718) 933-9603	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1538335633	SITKI MURAT DOGUS (Individual)	3332 ROCHEMBEAU AVE FLOOR 2 BRONX, NY 10467 (718) 920-2373	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1538353222	CARIBBEAN DENTAL ASSOCIATES (Organization)	509 WILLIS AVE BRONX, NY 10455 (718) 292-8966		Non-Participating Provider	NO
1538370374	CHRIS CHOE DENTISTRY, PLLC (Organization)	2426 EASTCHESTER RD SUITE 207 BRONX, NY 10469 (718) 325-3250		Non-Participating Provider	NO
1538534854	ORAL SURGERY OF RIVERDALE, P.C. (Organization)	3333 HENRY HUDSON PKWY SUITE 9 BRONX, NY 10463 (718) 796-4550		Non-Participating Provider	NO
1538551296	BRONX ORAL SURGERY, PC (Organization)	355 E 149TH ST RM 206 BRONX, NY 10455 (718) 292-7117		Non-Participating Provider	NO
1538658885	KATERINA MLEJNKOVA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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	Non-Participating Provider	NO
1538752241	STEPHANIE JARMOLOW (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	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 Humana	Non-Participating Provider	NO
1548259591	HEE JOON KWAK (Individual)	638 E 169TH ST BRONX, NY 10456 (718) 991-8668	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1548330608	JACQUELINE POLANCO (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	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 Humana	Non-Participating Provider	NO
1548343080	MONICA MEHRA (Individual)	997 PROSPECT AVENUE BRONX, NY 10459 (718) 842-6030	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1548385065	TUAN GIANG BUI (Individual)	1332 METROPOLITAN AVE BRONX, NY 10462 (718) 828-6200	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 North Dakota Florida Combined Life Sanford Health Plan	Non-Participating Provider	YES
1548430788	GORGEOS SMILE DENTAL (Organization)	871 E TREMONT AVE BRONX, NY 10460 (718) 299-5900		Non-Participating Provider	NO
1548463425	SUR LEE (Individual)	2535 GRAND CONCOURSE BRONX, NY 10468 (718) 365-4900	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 Paramount Paramount Dental	Non-Participating Provider	NO
1548494826	GENESIS DENTISTRY PC (Organization)	375 E FORDHAM RD 2 FLOOR BRONX, NY 10458 (718) 584-3826		Non-Participating Provider	NO
1548498678	ANDREW TODD SAROWITZ (Individual)	47E 167 ST BRONX, NY 10452 (718) 293-1603	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	Non-Participating Provider	NO
1548517576	AUFAUGH EMAM (Individual)	124 E 170TH ST BRONX, NY 10452 (347) 282-0311	Ambetter from Absolute Total Care Ambetter Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee 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 Paramount Paramount Dental UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1548531007	ROBERT EVAN STEINBERGER (Individual)	3875 E TREMONT AVE BRONX, NY 10465 (718) 823-3000		Non-Participating Provider	YES
1548558836	GLAD DENTAL P.C. (Organization)	293 E 149TH ST BRONX, NY 10451 (646) 404-5005	UnitedHealthcare	Non-Participating Provider	NO
1548836141	DANIELLE MESSINA (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 863-5077	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1548882574	MICHELLE RABIZADEH (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1558089896	AHMED DENTISTRY PC (Organization)	2181 STARLING AVE BRONX, NY 10462 (718) 823-4444		Non-Participating Provider	NO
1558440743	ANITA AGARWAL (Individual)	1400 PELHAM PKWY S ROOM 3C15 BRONX, NY 10461 (718) 918-3060		Non-Participating Provider	YES
1558446591	FAHIMEH TAFRESHI (Individual)	1231 WHITE PLAINS RD BRONX, NY 10472 (718) 822-7645	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1558467282	HERMINIO PEREZ (Individual)	1770 GRAND CONCOURSE APT 2F BRONX, NY 10457 (718) 901-8110	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1558521542	KENNETH HENRY TREITEL (Individual)	918 PELHAM PKWY S BRONX, NY 10462 (718) 823-7312		Non-Participating Provider	NO
1558930503	ASNIS DENTAL PLLC (Organization)	815 HUTCHINSON RIVER PKWY STE 845 BRONX, NY 10465 (718) 509-9152		Non-Participating Provider	NO
1558984963	SIMARDEEP NAGYAL (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1568410462	DAVID EIDMAN DDS PC KINGSBRIDGE DENTAL ASSOCIATES (Organization)	2685 UNIVERSITY AVE BRONX, NY 10468 (718) 543-7283		Non-Participating Provider	NO
1568452142	TODD ROSS (Individual)	505 CLAREMONT PKWY BRONX, NY 10457 (718) 299-3600	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 Humana Renaissance Dental	Non-Participating Provider	NO
1568452654	JANET KEANE (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1568465565	ALAN BRUCE SPECTOR (Individual)	3310 BAINBRIDGE AVE BRONX, NY 10467 (718) 654-3456	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
1568506780	WHITEPLAINS DENTAL SERVICES,INC. (Organization)	1231 WHITE PLAINS RD BRONX, NY 10472 (718) 822-7645		Non-Participating Provider	NO
1568515609	MICHAEL PERRETTA (Individual)	1933 WILLIAMSBRIDGE RD BRONX, NY 10461 (718) 823-4719	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1568517431	MOHAMMAD KAZEM SADEGHI (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2823	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1568537561	SETHI DENTAL (Organization)	1022 E 163 ST BRONX, NY 10459 (718) 542-2088	UnitedHealthcare	Non-Participating Provider	NO
1568684280	ILYA AMES (Individual)	1200 WATERS PL SUITE M107 BRONX, NY 10461 (718) 822-8787	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1568745578	FARHAN KAZMI (Individual)	327 E FORDHAM RD 2ND FLOOR BRONX, NY 10458 (718) 933-8400	Anthem Blue Cross and Blue Sheld 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1568843290	BROADWAY DENTAL (Organization)	48 E KINGSBRIDGE RD BRONX, NY 10468 (718) 933-9603		Non-Participating Provider	NO
1568869501	EBBIE BOUTEHSAZ (Individual)	3310 BAINBRIDGE AVE BRONX, NY 10467 (718) 654-3456	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1568921229	SANGHOON KWON (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 579-2500	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	Non-Participating Provider	NO
1568990745	KAREN LEUNG (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110	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 Delta Dental PPO DeltaCare USA EMI Health Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1578192530	DIANA M CARVEL (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5997	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 Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1578259420	EMANUEL YUSHVAYEV (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1578642443	RICHARD ALAN KRAUT (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4984		Non-Participating Provider	NO
1578661740	SELENE WUN (Individual)	234 E 149TH ST # 2A8 BRONX, NY 10451 (718) 579-5000	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 Renaissance Dental	Non-Participating Provider	YES
1578749933	JEFFREY SUSMAN (Individual)	3161 E TREMONT AVE BRONX, NY 10461 (718) 518-8100		Non-Participating Provider	NO
1578766853	GORDON CHARLES GAYNOR (Individual)	3515 HENRY HUDSON PKWY BRONX, NY 10463 (718) 543-4300		Non-Participating Provider	NO
1578776852	DILRUBA ISLAM (Individual)	1973 UNIVERSITY AVE. BRONX, NY 10453 (718) 299-2087		Non-Participating Provider	NO
1588064612	JUSTIN BAIR (Individual)	1423 OVERING ST BRONX, NY 10461 (412) 477-2469	Florida Combined Life	Non-Participating Provider	NO
1588105480	STEPHANIE ASUSTA (Individual)	111 EAST 210TH STREET BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	NO
1588166185	JAEHYUK CHOI (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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 UnitedHealthcare	Non-Participating Provider	YES
1588283964	LORENA FELIU (Individual)	111 E 210TH ST BRONX, NY 10467 (787) 568-0260		Non-Participating Provider	NO
1588290746	JESSICA CHANG (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419	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 Humana	Non-Participating Provider	NO
1588702898	DANIEL FAIWISZEWSKI (Individual)	3901 INDEPENDENCE AVE BRONX, NY 10463 (718) 549-6453	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1588729842	WINSTON E BYFIELD (Individual)	1205 E 233RD ST BRONX, NY 10466 (718) 654-1880	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1588749881	CONCOURSE WEST MANAGEMENT INC (Organization)	880 RIVER AVE BRONX, NY 10452 (718) 992-0410		Non-Participating Provider	NO
1588756126	PETER TODD WASSERMAN (Individual)	6011 RIVERDALE AVE BRONX, NY 10471 (718) 548-6900	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	YES
1588768931	PHILIP JOHN DARRIGO (Individual)	1475 ASTOR AVE BRONX, NY 10469 (718) 653-2411	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	Non-Participating Provider	NO
1588830624	FJR DENTAL OFFICE PC (Organization)	2951 GRAND CONCOURSE APT 6 BRONX, NY 10468 (718) 561-0773	UnitedHealthcare	Non-Participating Provider	NO
1588867055	MONTEFIORE DENTAL DEPARTMENT (Organization)	3332 ROCHAMBEAU AVE 2ND FLOOR BRONX, NY 10467 (888) 700-6623		Non-Participating Provider	NO
1588869986	MONTEFIORE DENTAL SCHIFF DENTAL DEPARTMENT (Organization)	3444 KOSSUTH AVE FIRST FLOOR BRONX, NY 10467 (888) 700-6623		Non-Participating Provider	NO
1588870059	ANDREW F GOLD D.D.S. (Organization)	505 CLAREMONT PKWY BRONX, NY 10457 (718) 299-3600		Non-Participating Provider	NO
1588870117	NIGEL JASON KIM (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 483-1270		Non-Participating Provider	NO
1588872451	MARK A MISITI (Individual)	64 METROPOLITAN OVAL BRONX, NY 10462 (718) 829-3333		Non-Participating Provider	NO
1588901771	STUART TEICHER (Individual)	1088 MORRIS PARK AVE BRONX, NY 10461 (718) 823-8830	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
1598010381	DAVID J LEE (Individual)	3444 KOSSUTH AVE SCHIFF DENTAL CLINIC BRONX, NY 10467 (407) 330-4717	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 Paramount Paramount Dental	Non-Participating Provider	NO
1598078693	MIRIAM DENTAL CENTER (Organization)	220 MIRIAM ST 1A BRONX, NY 10458 (718) 367-6898		Non-Participating Provider	NO
1598128381	NATALIE GARCIA RODRIGUEZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Dominion National Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1598134801	RIVERDALE URGENT CARE DENTAL, LLC (Organization)	3509 JOHNSON AVE BRONX, NY 10463 (914) 769-0799		Non-Participating Provider	NO
1598192569	HANUMAN ORAL SURGERY PLLC (Organization)	2070 GRAND CONCOURSE BRONX, NY 10457 (718) 716-8400		Non-Participating Provider	NO
1598293789	DIALA GIBSON (Individual)	1650 GRAND CONCOURSE BRONX, NY 10457 (718) 590-1800	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	Non-Participating Provider	YES
1598320681	CHRISTINA VICTORIA HANNA (Individual)	86 W 225TH ST BRONX, NY 10463 (929) 388-4388	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1598322471	MEGAN CLOIDT (Individual)	1400 PELHAM PKWY S BLDG 1 BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	YES
1598357824	MICHELLE WEINBERG (Individual)	3201 GRAND CONCOURSE APT 1E BRONX, NY 10468 (718) 367-7645	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1598360471	NEGO ROBERTS (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2826	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee 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 Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1598453193	FRANCLESSA LOUIS (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440		Non-Participating Provider	YES
1598738130	PHIE BEE DAI (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400	Humana	Non-Participating Provider	NO
1598754707	PRITI NIMISH PARIKH (Individual)	1211B PUGSLEY AVE BRONX, NY 10472 (718) 794-0384	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1598807240	BARRY MASER (Individual)	888 GRAND CONCOURSE 4E BRONX, NY 10451 (718) 665-8792		Non-Participating Provider	NO
1598825168	REGINA M KOENIG (Individual)	3444 KOSSUTH AVE DTC/ SCHIFF PAVILION BRONX, NY 10467 (718) 920-2303	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 Humana	Non-Participating Provider	NO
1598841207	JEFFREY L. KERMAN (Individual)	1238 CASTLE HILL AVE BRONX, NY 10462 (718) 792-1144	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	YES
1598919664	BURNSIDE DENTAL AND ORTHODONTICS (Organization)	1942 HARRISON AVE BRONX, NY 10453 (718) 299-2972		Non-Participating Provider	NO
1598960817	MONTEFIORE DENTAL DEPARTMENT (Organization)	951 PROSPECT AVE BRONX, NY 10459 (888) 700-6623		Non-Participating Provider	NO
1598979569	DAVID A FEIMAN (Individual)	600 W 239TH ST 1 N BRONX, NY 10463 (718) 543-4040		Non-Participating Provider	NO
1609180181	DAVID TYLER CHO (Individual)	871 E TREMONT AVE BRONX, NY 10460 (718) 299-5900	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1609283951	JUNE HAREWOOD (Individual)	1400 PELHAM PARKWAY SOUTH JACOBI HOSPITAL BRONX, NY 10461 (646) 579-6241	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	YES
1609284017	JUSTIN ZIMMER (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5993	Ambetter Health Ambetter Health of Delaware 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
1609364850	JUNGSUN LEE (Individual)	111 E 210TH ST BRONX, NY 10467 (347) 577-4950	Ambetter Health Ambetter Health of Delaware Humana	Non-Participating Provider	NO
1609443019	NICOLA MARIANO CINQUEPALMI (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	Anthem Blue Cross and Blue Shield Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1609458421	JAMAAD YUSUF ABDI (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1609509934	BIHAC MAZIGH (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8400		Non-Participating Provider	NO
1609762400	JENNIFER HERNANDEZ (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 901-8400		Non-Participating Provider	NO
1609854108	PRAVIN NANALAL GOLWALA (Individual)	2106 GRAND CONCOURSE BRONX, NY 10457 (718) 584-9396		Non-Participating Provider	NO
1609867530	LEE A TURET (Individual)	3411 JEROME AVE BRONX, NY 10467 (718) 231-0303	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1609903251	PHILIP LLOYD EISENBERG (Individual)	910 PELHAM PARKWAY SOUTH BRONX, NY 10462 (718) 597-1825		Non-Participating Provider	NO
1609947019	ANTHONY MAGANZINI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2385		Non-Participating Provider	NO
1609970052	VALERIE LINDENFELD (Individual)	4555 HENRY HUDSON PKWY #105 BRONX, NY 10471 (718) 796-0009	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1609996248	OLIA CHERN TRICOT (Individual)	880 RIVER AVE BRONX, NY 10452 (718) 992-0410		Non-Participating Provider	NO
1619092160	JUN KWANG KWON (Individual)	2737 3RD AVE BRONX, NY 10451 (718) 838-1092		Non-Participating Provider	NO
1619125184	SUKHJINDER K SANDHU (Individual)	910 GRAND CONCOURSE BRONX, NY 10451 (718) 538-2410	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee 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 Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Guardian Humana MedMutual Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1619401890	CHANTAL TAVAREZ MONEGRO (Individual)	1924 UNIVERSITY AVE APT 1B BRONX, NY 10453 (413) 355-1321	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1619941788	ROMAN MAGIDENKO (Individual)	761 LYDIG AVE GROUND FLOOR BRONX, NY 10462 (718) 792-4782	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1619942208	SHAKUNTALA J MARKALE (Individual)	1171 GRAND CONCOURSE BRONX, NY 10452 (718) 588-7878	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
1619967585	SARAH MICHELLE GAYLE (Individual)	1205 E 233RD ST BRONX, NY 10466 (914) 843-5957	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1619987211	WHITE PLAINS RD MEDICAL PC (Organization)	3050 WHITE PLAINS RD BRONX, NY 10467 (718) 655-5444		Non-Participating Provider	NO
1629157250	LIGIA V STATE (Individual)	423 E 138TH ST 2ND FLOOR BRONX, NY 10454 (718) 292-3800	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	Non-Participating Provider	NO
1629172077	VINCENT PETRAZZUOLO (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1629226568	KENNETH GREGORY FELLERMAN (Individual)	55 EAST 210TH ST SUITE 1B BRONX, NY 10467 (718) 547-8200	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	Non-Participating Provider	NO
1629301395	JASON R. GORDON D.D.S. P. C. (Organization)	724 PELHAM PKWY S BRONX, NY 10462 (347) 281-9444	UnitedHealthcare	Non-Participating Provider	NO
1629456868	DEBRA MANDELBAUM (Individual)	234 E 149TH ST BRONX, NY 10451 (516) 236-4657	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
1629461678	MARK MAKILING (Individual)	1911 21 JEROME AVENUE BRONX, NY 10453 (718) 943-1341	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 Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1629514997	MOHAMMAD MEHDI DOWLATY (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1629616198	ARK ORTHODONTICS PLLC (Organization)	1332 METROPOLITAN AVE A/B BRONX, NY 10462 (917) 432-7523		Non-Participating Provider	NO
1639144223	JAGDISH N MARKALE (Individual)	1171 GRAND CONCOURSE BRONX, NY 10452 (718) 588-7878	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 Paramount Paramount Dental	Non-Participating Provider	NO
1639222011	THOMAS ELLIOTT (Individual)	545 E 142ND ST BRONX, NY 10454 (718) 579-1723		Non-Participating Provider	YES
1639273931	US DENTAL CARE P.C. (Organization)	1963 GRAND CONCOURSE LOWER LEVEL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	NO
1639289457	ELIZABETH JOAN TAMPONE (Individual)	1000 PELHAM PKWY SOUTH MORNINGSIDE HOUSE NURSING HOME BRONX, NY 10461 (718) 409-8243		Non-Participating Provider	NO
1639311319	US DENTAL CHOICE P.L.L.C (Organization)	1963 GRAND CONCOURSE LOWER LEVEL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	NO
1639323363	SONIA ESPINAL (Individual)	1401-A OVERING STREET 1ST FLOOR BRONX, NY 10461 (917) 701-1639	Ambetter from Arkansas Health & Wellness Ambetter from Home State Health Ambetter from Magnolia Health Ambetter of Alabama Ambetter of North Carolina Ambetter of Tennessee 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 BlueCross BlueShield of Tennessee EMI Health Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1639388531	SAMUEL TALLER (Individual)	3601 WALDO AVE BRONX, NY 10463 (718) 543-3700	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	Non-Participating Provider	YES
1639445745	WE SMILE DENTAL P.C. GREATER DENTAL P.C. (Organization)	1959A WESTCHESTER AVE BRONX, NY 10462 (718) 822-6086		Non-Participating Provider	NO
1639466733	AMINE BELLIL (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5993	Ambetter from Home State Health Ambetter from Nebraska Total Care Ambetter from NH Healthy Families Ambetter from Sunflower Health Plan 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 Nebraska Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Nebraska Dentegra Insurance Company Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare Wellmark of South Dakota Inc.	Non-Participating Provider	YES
1639484611	REBECCA LEE POLING (Individual)	2386 JEROME AVE BRONX, NY 10468 (917) 972-0304		Non-Participating Provider	NO
1639667181	LAURA GUERRA GARCIA (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110	Anthem Blue Cross and Blue Shield Florida Combined Life Humana	Non-Participating Provider	NO
1639738222	RAJAN JAIN (Individual)	327 E FORDHAM RD FRNT 2 BRONX, NY 10458 (702) 449-6502	Ambetter Health Ambetter Health of Delaware Anthem Blue Cross and Blue Sheld 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 Florida Combined Life Humana Renaissance Dental	Non-Participating Provider	YES
1639813421	BRAULIO LAJARA (Individual)	591 E TREMONT AVE BRONX, NY 10457 (646) 393-5181	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1649276635	STEPHEN SHEINBERG (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1649312265	DAVID H FISHER (Individual)	1332 METROPOLITAN AVE BRONX, NY 10462 (718) 828-6200	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
1649378068	JEWAN SINGH (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1649425265	JOSE ESTEBAN DIAZ (Individual)	109 EAST 167TH STREET BRONX, NY 10452 (516) 356-6381		Non-Participating Provider	NO
1649510025	KRISTINE LUNGER (Individual)	1963 GRAND CONCOURSE SUITE LL BRONX, NY 10453 (718) 294-8800		Non-Participating Provider	NO
1649538596	BIBEKA BHATTARAI KOIRALA (Individual)	3310 BAINBRIDGE AVE BRONX, NY 10467 (718) 654-3456		Non-Participating Provider	YES
1649617093	NICHOLAS VERTUCCI RICCIO (Individual)	3332 ROCHAMBEAU AVE BRONX, NY 10467 (718) 920-5997	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
1649619065	PETER ANTHONY LOBUE (Individual)	1120 MORRIS PARK AVE. BRONX, NY 10461 (718) 409-9639		Non-Participating Provider	NO
1649826629	MARIA DEL MAR JORGE (Individual)	111 E 210TH ST BRONX, NY 10467 (800) 636-6683		Non-Participating Provider	NO
1659024735	JONATHAN HYUNGJUNE KIM (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 590-1800	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Renaissance Dental	Non-Participating Provider	NO
1659437911	PANNA DEEPAK GANDHI (Individual)	1731 UNIVERSITY AVE BRONX, NY 10453 (718) 716-5711		Non-Participating Provider	NO
1659446367	RICHARD ALFONSO LANGIULLI (Individual)	2016 BRONXDALE AVE THIRD FLOOR SUITE 303 BRONX, NY 10462 (718) 792-7972	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
1659451540	DOMENICK F D'ANGELICA (Individual)	1425 EAST GUN HILL ROAD BRONX, NY 10469 (718) 671-0480		Non-Participating Provider	NO
1659586881	WILLIAM WOLFSON,D.M.D.,P.C. (Organization)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 863-5077		Non-Participating Provider	NO
1659718138	MIGUEL A ORTIZ (Individual)	375 E FORDHAM RD BRONX, NY 10458 (718) 584-4061	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 Humana	Non-Participating Provider	NO
1659735470	AZAHIRA G SANCHEZ (Individual)	1200 WATERS PL STE M107 BRONX, NY 10461 (718) 822-8787	Ambetter Health Ambetter of Alabama 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 Delta Dental Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1669169538	WILLENDY ALCENAT (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	Anthem Blue Cross and Blue Sheld 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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1669428041	PETHAN TIN (Individual)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1669516639	JUDY H CHANG (Individual)	1387 CASTLE HILL AVE WEST HILL DENTAL LLP BRONX, NY 10462 (718) 863-2777	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1669535217	BENJAMIN V KATAYEV DDS PC (Organization)	1401 DEKRUIF PLACE BRONX, NY 10475 (718) 379-1700	UnitedHealthcare	Non-Participating Provider	NO
1669558383	RIVERDALE DENTAL CARE (Organization)	5678 RIVERDALE AVE SUITE 200 BRONX, NY 10471 (718) 601-0900		Non-Participating Provider	NO
1669660031	810 DENTAL ASSOCIATION (Organization)	810 PELHAM PKWY S STE. A BRONX, NY 10462 (718) 824-4383		Non-Participating Provider	NO
1669677605	ALAN J. ROSENTHAL (Individual)	3530 HENRY HUDSON PKWY BRONX, NY 10463 (171) 854-3303		Non-Participating Provider	NO
1679194062	ROBERT PESTOVSKY (Individual)	3RD AVENUE AND 183RD STREET ST. BARNABAS HOSPITAL BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1679199210	MICHELE M COLLINS (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 992-7669		Non-Participating Provider	YES
1679222160	ANNA LAM (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000		Non-Participating Provider	NO
1679557045	REGINALD BORGELLA (Individual)	3102 KINGSBRIDGE AVE #1E BRONX, NY 10463 (718) 543-9786	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1679563761	DWIGHT WILLIAMS (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1679579080	STEVEN HOBSON (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Renaissance Dental	Non-Participating Provider	NO
1679636625	DENNY CHERN-KELK (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1679651079	WEBSTER DENTAL PLAZA, P.C. (Organization)	1231 WEBSTER AVE BRONX, NY 10456 (646) 402-8989		Non-Participating Provider	NO
1679670111	GERALD F SABOL (Individual)	130 WEST KINGSBRIDGE ROAD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1679729586	EDWARD M SIRECI (Individual)	2861 BRUCKNER BLVD BRONX, NY 10465 (718) 829-0455		Non-Participating Provider	NO
1679745731	SONAL H CHOKSHI (Individual)	466 E FORDHAM RD BRONX, NY 10458 (718) 365-4300	Renaissance Dental	Non-Participating Provider	NO
1679805733	RIMA PARIKH (Individual)	2750 FISH AVE 2ND FL BRONX, NY 10469 (917) 544-7082		Non-Participating Provider	NO
1679816276	JOSEPH MICHAEL LANDISI (Individual)	1750 CROSBY AVE BRONX, NY 10461 (718) 892-1522	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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1689028276	ALYSSA PAIGE LEVY (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (631) 398-9496	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1689318883	NAUDE C PIERRE (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167		Non-Participating Provider	NO
1689714990	MANJU GOPINATHAN (Individual)	1530 UNIONPORT RD BRONX, NY 10462 (212) 980-1408		Non-Participating Provider	NO
1689764631	SHILPI AHLUWALIA (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440		Non-Participating Provider	NO
1689781833	RAMESH K VINJAMURI (Individual)	823 WESTCHESTER AVE BRONX, NY 10455 (718) 893-0080	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1689787947	SAMEH AKNOUK (Individual)	1473 WEST AVE BRONX, NY 10462 (718) 824-5444	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1689799876	JOSEPH M RAGOSTA DDS PC (Organization)	2411 EASTCHESTER ROAD BRONX, NY 10469 (718) 652-4706		Non-Participating Provider	NO
1689804569	KATHERINE KYOUNG-JIN LEE (Individual)	1210 LAKEWOOD PL BRONX, NY 10461 (917) 334-0636		Non-Participating Provider	NO
1689821027	MELISSA DAVIS (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1689853459	PARK SOUTH DENTAL P.L.L.C. (Organization)	1530 UNIONPORT RD BRONX, NY 10462 (718) 892-2200	UnitedHealthcare	Non-Participating Provider	NO
1689858565	CUTE DENTAL CARE (Organization)	1749 GRAND CONCOURSE GROUND FL BRONX, NY 10453 (718) 466-2222	UnitedHealthcare	Non-Participating Provider	NO
1689883910	ALEXANDER CHU (Individual)	1221 WHITE PLAINS RD SUITE 106 BRONX, NY 10472 (718) 792-6991		Non-Participating Provider	NO
1689896300	VICTORIA KUSHENSKY (Individual)	1200 WATERS PL SUITE M107 BRONX, NY 10461 (718) 822-8787	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1689994543	UPTOWN HEALTHCARE MANAGEMENT, INC. DBA'S: EAST TREMONT MEDICAL CENTER, NEW YORK NEURO S REHAB CENTER, JER (Organization)	930 EAST TREMONT AVENUE BRONX, NY 10460 (718) 860-1111		Non-Participating Provider	NO
1699108563	SUNG KWANG KIM (Individual)	2740 3RD AVE BRONX, NY 10455 (917) 263-1604	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1699137547	LAURA PATRICIA FIGUEROLA HERNANDEZ (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1699158956	JULIA MCKAY (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5993	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1699178467	AFAQ M ZRAIKAT (Individual)	505 CLAREMONT PKWY BRONX, NY 10457 (718) 299-3600	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1699252916	STARBRITE DENTAL PLLC (Organization)	2580 E TREMONT AVE BRONX, NY 10461 (516) 316-5282		Non-Participating Provider	NO
1699268045	MARIOLYS TAMAYO (Individual)	6299 BROADWAY APT C11 BRONX, NY 10471 (347) 606-0228		Non-Participating Provider	NO
1699288084	BLAKE ADAMS (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 590-1800		Non-Participating Provider	NO
1699418459	OLIVIA CHANDLER DREW (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1699742353	ERIC ROBERT ROSENSTOCK (Individual)	7 HUGH J GRANT CIR BRONX, NY 10462 (718) 792-0137	Ambetter Health Ambetter of Alabama 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 Delta Dental Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1699783449	VIDYA PANDHI (Individual)	2702 3RD AVE BRONX, NY 10454 (718) 585-5220	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	Non-Participating Provider	NO
1699784876	MARTIN JEROME KIMMEL (Individual)	4422 3RD AVE DENTAL DEPARTMENT-ST. BARNABAS HOSPITAL BRONX, NY 10457 (718) 960-9000	Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1699830505	JOSEPH DAVID DEBLONDE (Individual)	1600 MACOMBS RD BRONX, NY 10452 (718) 466-8800		Non-Participating Provider	NO
1699859074	JACQUELINE FOSQUE-JOHNSON (Individual)	305 E 161ST ST BRONX, NY 10451 (718) 579-2500		Non-Participating Provider	NO
1699946467	R G DENTAL OFFICE P.C. (Organization)	330 E 204TH ST BRONX, NY 10467 (718) 652-0290		Non-Participating Provider	NO
1700135076	LUIS RENE DELGADO (Individual)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347	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	Accepts Medicare	YES
1700187259	MARVIN FRIMMER (Individual)	2303 BRONXWOOD AVE BRONX, NY 10469 (718) 547-7505	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
1700343233	BONITA SONRISA DENTAL IPA (Organization)	1624 DR MARTIN L KING JR BLVD BRONX, NY 10453 (845) 793-4469		Non-Participating Provider	NO
1700817178	DARA JEAN ROSENBERG (Individual)	183RD STREET AND THIRD AVENUE ST BARNABAS HOSPITAL, DEPARTMENT OF DENTISTRY BRONX, NY 10457 (718) 960-6498	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
1700924362	MOHAMMAD WAHEDUR RAHMAN (Individual)	1749 GRAND CONCOURSE 1E BRONX, NY 10453 (718) 466-2222	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1710013370	LAURENCE ROBERT SCHIMMEL (Individual)	3800 INDEPENDENCE AVE BRONX, NY 10463 (718) 548-4768	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 Humana	Non-Participating Provider	NO
1710064951	MIKE MOHAMMADREZA ZARRINNEGAR (Individual)	1231 WEBSTER AVE BRONX BRONX, NY 10456 (646) 402-8989	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 Humana Paramount Paramount Dental	Non-Participating Provider	YES
1710066691	JOHN DENNIS DYER (Individual)	111 E 210TH ST DENTAL DEPARTMENT BRONX, NY 10467 (718) 920-4984	Anthem Blue Cross and Blue Shield Humana	Non-Participating Provider	NO
1710069190	ALICE LEE (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 405-8040	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1710142260	VALENTINE DENTAL OFFICE P.C (Organization)	217 E 188TH ST BRONX, NY 10458 (718) 584-3724		Non-Participating Provider	NO
1710161161	CLINTON HIGH SCHOOL SCHOOL HEALTH PROGRAM (Organization)	100 W MOSHOLU PKWY S BRONX, NY 10468 (718) 696-4071		Non-Participating Provider	NO
1710197694	JENNIFER FLIGR (Individual)	3725 HENRY HUDSON PKWY BRONX, NY 10463 (718) 601-0100	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	YES
1710246533	GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C. (Organization)	563 E TREMONT AVE BRONX, NY 10457 (718) 466-4500		Non-Participating Provider	NO
1710290887	SEUNGHYUN LEE (Individual)	1770 GRAND CONCOURSE APT 2F BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1710370218	ELENI MAVRAKIS (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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	Non-Participating Provider	NO
1710428594	RIVERDALE FAMILY DENTISTRY (Organization)	3534 RIVERDALE AVE. BRONX, NY 10463 (718) 601-0100		Non-Participating Provider	NO
1710484068	ALIZA KAYE (Individual)	5683 RIVERDALE AVE BRONX, NY 10471 (718) 884-8808		Non-Participating Provider	NO
1710517511	SMILE ZONE DENTAL (Organization)	770 ALLERTON AVE BRONX, NY 10467 (718) 325-5555		Non-Participating Provider	NO
1710947932	JEANNINE LORI WEISS (Individual)	234 E 149TH ST LINCOLN HOSPITAL DENTAL DEPARTMENT BRONX, NY 10451 (718) 579-5691	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	NO
1720164890	JAMES SCOTT MARTYNIAK (Individual)	111 E 210TH ST MONTIFIORE MEDICAL CENTER BRONX, NY 10467 (718) 405-4080		Non-Participating Provider	NO
1720186745	GURAM YAKOBASHVILI (Individual)	293 E 149TH ST BRONX, NY 10451 (646) 404-5005		Non-Participating Provider	YES
1720202708	MARIA KAROUNOS (Individual)	2809 MIDDLETOWN RD BRONX, NY 10461 (718) 597-8800	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 UnitedHealthcare	Non-Participating Provider	YES
1720270424	MARIA DE LOS ANGELES FIGUEROA (Individual)	234 E 149TH ST STE 2A8 BRONX, NY 10451 (718) 579-4900	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1720287964	SEEMA MALIK (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1720410707	AFUNRHE OGHRE-IKANONE (Individual)	1770 GRAND CONCOURSE APT 2F BRONX, NY 10457 (718) 901-8110	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 PPO Humana Renaissance Dental TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1720425127	BEENAKUMARI VIJU (Individual)	3201 GRAND CONCOURSE SUITE I-K BRONX, NY 10468 (718) 933-5510		Non-Participating Provider	NO
1720474315	ISMARIE VELAZQUEZ (Individual)	111 E 210TH ST MONTEFIORE MEDICAL CENTER DEPT OF DENTISTRY BRONX, NY 10467 (718) 920-6039	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1720668189	MAYA ABDIN (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 405-8057	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1730164773	IRENE RACHOWIN (Individual)	33 E 208TH ST BRONX, NY 10467 (718) 652-0769		Non-Participating Provider	NO
1730170457	SHARON A DISTANT JOHNSON (Individual)	1575 BLONDELL AVE BRONX, NY 10461 (718) 405-8197	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1730219288	BYOUNG EE HONG (Individual)	3010 GRAND CONCOURSE L4 BRONX, NY 10458 (718) 220-3998	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 Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	NO
1730263534	NANCY JEAN DOUGHERTY (Individual)	1400 PELHAM PKWY S ACP, RM 3C15 BRONX, NY 10461 (718) 918-3602		Non-Participating Provider	YES
1730264763	SHARON LEE (Individual)	1231 WHITE PLAINS ROAD BRONX, NY 10472 (718) 822-7645	Ambetter Health Ambetter Health of Delaware 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	YES
1730268970	VICTOR BADNER (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3060		Non-Participating Provider	YES
1730270166	KENNETH HAHN (Individual)	2016 BRONXDALE AVE THIRD FLOOR SUITE 303 BRONX, NY 10462 (718) 792-7972		Non-Participating Provider	NO
1730331190	MARTHA M DUVAL (Individual)	1894 WALTON AVENUE BRONX, NY 10453 (718) 583-2700	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	Non-Participating Provider	NO
1730360280	CARMEN DORIS ARZOLA (Individual)	1414 METROPOLITAN AVE SUITE 7 BRONX, NY 10462 (718) 430-6996	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1730370230	MALVIKA TICKOO (Individual)	3366 BOSTON RD BRONX, NY 10469 (718) 547-5280	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1730396490	KIRTI TEWARI (Individual)	3754 WHITE PLAINS ROAD BRONX, NY 10467 (718) 547-7570	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1730406695	MARC HUANG PAN (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1730477662	AMY TON (Individual)	600 E 233RD ST BRONX, NY 10466 (703) 943-8686	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 Humana Renaissance Dental	Non-Participating Provider	NO
1730647900	WILLAN FRANCISCO JUMBO CUEVA (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1730742362	ELEN KIRILOVSKI (Individual)	234 E 149TH ST DEPT OF BRONX, NY 10451 (718) 579-5691	Ambetter from Meridian Ambetter Health Guardian TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1730823808	MARIE ROBLES (Individual)	4422 3RD AVE BLDG DENTAL BRONX, NY 10457 (718) 960-6619		Non-Participating Provider	NO
1740303619	WILLIAM WOLFSON (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 863-5077	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
1740358993	CATHY J HAN (Individual)	2016 BRONXDALE AVE THIRD FLOOR SUITE 303 BRONX, NY 10462 (718) 792-7972	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1740367119	EDLEY BOBO-MESILAS (Individual)	754 E 151ST ST BRONX, NY 10455 (718) 402-2800	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1740438787	DOMENICK F. D'ANGELICA (Organization)	1425 E GUN HILL RD BRONX, NY 10469 (718) 671-0480		Non-Participating Provider	NO
1740493543	WESTCHESTER SQUARE FAMILY DENTAL LLC (Organization)	47 WESTCHESTER SQ BRONX, NY 10461 (718) 239-4300		Non-Participating Provider	NO
1740504299	ESPERANZA A. RODRIGUEZ, DDS PC (Organization)	2406 WALTON AVE #SOB BRONX, NY 10468 (718) 364-7791		Non-Participating Provider	NO
1740598739	HOWARD KIMAN CHOI (Individual)	55 E. MOSHOLU PKWY N. BRONX, NY 10467 (718) 652-7370	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
1740606243	BRITTANY MCCROREY (Individual)	1775 GRAND CONCOURSE 6TH FLOOR BRONX LEBANON HOSPITAL CENTER DEPT OF DENTISTRY BRONX, NY 10453 (919) 358-0734	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1740718204	DANIELE MICHELLE ORELLANA (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1740771153	ANNICK M FOMETE (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8158	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1740804541	CITIBRITES DENTAL BAYCHESTER LLC (Organization)	4000 BAYCHESTER AVE BRONX, NY 10466 (646) 828-2566		Non-Participating Provider	NO
1740848225	JULIAN ALEXANDER (Individual)	3670 PALMER AVE FL 2 BRONX, NY 10466 (954) 842-0799		Non-Participating Provider	YES
1750437935	AMRENDRA PRATAP SINGH (Individual)	120 BENCHLEY PL BRONX, NY 10475 (718) 379-4800	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1750460390	ISABEL GARCIA (Individual)	423 E 138TH ST 2ND FLOOR BRONX, NY 10454 (718) 292-3800	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1750473278	JERROLD WASSERMAN (Individual)	6011 RIVERDALE AVE BRONX, NY 10471 (718) 548-6900		Non-Participating Provider	NO
1750776928	JORGE L PANTOJA (Individual)	86 W 183RD ST DENTAL OFFICE BRONX, NY 10453 (718) 367-4222	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma 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 Delta Dental PPO EMI Health Florida Combined Life Humana TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1750962056	LEEDA BASSAM (Individual)	111 E 210TH ST BRONX, NY 10467 (888) 700-6623	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1760011035	MOJDEH SALEHI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 515-5419	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1760112700	KYLE KENECHUKWU NWANKWO (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 590-1800	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1760442412	ROBYN JO BURCHMAN (Individual)	3836 E TREMONT AVE BRONX, NY 10465 (718) 892-2035	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 Florida Combined Life Humana	Non-Participating Provider	YES
1760484331	CECELIA ACOSTA-LAKE (Individual)	1894 WALTON AVE BRONX, NY 10453 (718) 583-3060		Non-Participating Provider	NO
1760488043	BHARAT MANKAD (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1760488787	LESLIE FRANCES SMITHEY (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1760529838	MELANIA SECAREANU (Individual)	2737 3RD AVE BRONX, NY 10451 (718) 838-1092		Non-Participating Provider	NO
1760530885	MARIA TERESA ATANACIO MANALAD (Individual)	330 E 204TH ST BRONX, NY 10467 (718) 652-0290	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1760682314	DENNIS MICHAEL QUINN (Individual)	1332 METROPOLITAN AVE BRONX, NY 10462 (718) 892-1676		Non-Participating Provider	NO
1760733570	SCHIMMEL ORTHODONTIC ASSOCIATES (Organization)	3265 JOHNSON AVE SUITE 104 BRONX, NY 10463 (718) 548-4768		Non-Participating Provider	NO
1760734800	JACK ROBERT MEYER (Individual)	1934 YATES AVE BRONX, NY 10461 (718) 824-5540		Non-Participating Provider	NO
1760753941	THIRD AVENUE DENTAL P.C. (Organization)	3055 THIRD AVENUE, SUITE B BRONX, NY 10451 (718) 665-1000		Non-Participating Provider	NO
1760757512	CHEONG EUN LEE (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400	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 Humana Paramount Paramount Dental	Non-Participating Provider	YES
1760828552	HARRY GOLNAZARIAN (Individual)	111 E 210TH ST BRONX, NY 10467 (818) 640-7770	Anthem Blue Cross and Blue Sheld 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1760883805	FARHAD MIRABRISHAMI (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5690		Non-Participating Provider	NO
1760900690	NY FAMILY ORTHODONTICS P.C. (Organization)	5795 TYNDALL AVE FL 1 BRONX, NY 10471 (718) 884-7700		Non-Participating Provider	NO
1760973796	ROZANA KARIM (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1770014011	ALEKSANDER KHASIDOV (Individual)	1575 BLONDELL AVE STE 150 BRONX, NY 10461 (888) 700-6623	Aetna CVS Health 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 Dominion National Guardian Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1770237554	AFSHIN EGHTEDARI SHAHSAVAN (Individual)	1543 INWOOD AVE BRONX, NY 10452 (844) 400-1975		Non-Participating Provider	NO
1770506123	MARIO JAMES ABATI (Individual)	2130 WILLIAMSBRIDGE RD 1H BRONX, NY 10461 (718) 792-1000		Non-Participating Provider	NO
1770657306	BRONX QUEENS DENTAL CARE PC (Organization)	780 E TREMONT AVE BRONX, NY 10460 (718) 731-6176	UnitedHealthcare	Non-Participating Provider	NO
1770699878	THE TOWNSEND DENTAL PRACTICE P.C. (Organization)	1606 TOWNSEND AVE BRONX, NY 10452 (718) 299-1724		Non-Participating Provider	NO
1770705634	SHEREE MORGAN (Individual)	1276 FULTON AVE ROOM 208 BRONX, NY 10456 (718) 901-8918	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1770710147	KRISTA JUSTINE MCKENZIE (Individual)	3370 BAYCHESTER AVE BRONX, NY 10475 (718) 671-2826	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1770718504	BRONX PARK DENTAL PC (Organization)	2016 BRONXDALE AVE #303 BRONX, NY 10462 (718) 792-7972	UnitedHealthcare	Non-Participating Provider	NO
1770746786	PRINCE N. MORGAN (Individual)	1775 GRAND CONCOURSE BRONX, NY 10453 (718) 992-7669	Renaissance Dental	Non-Participating Provider	YES
1770759961	YOON J. KWON (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	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
1770877524	JEAN PIERRE RWIGEMA (Individual)	1770 GRAND CONCOURSE APT 2F BRONX, NY 10457 (718) 901-8110	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma 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 Delta Dental PPO Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1780042150	ROBERT P ANG (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (718) 589-2440	UnitedHealthcare	Non-Participating Provider	NO
1780313627	MONTASIR RAHMAN (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5000		Non-Participating Provider	NO
1780655365	CARMEN MIREYA RIJOS (Individual)	2420 DAVIDSON AVE 1FL BRONX, NY 10468 (718) 563-0303	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1780684373	BARTLEY R. LABINER (Individual)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347		Non-Participating Provider	NO
1780763300	JAIRO BASTIDAS (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167	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 Florida Combined Life Humana UnitedHealthcare	Maybe Accepts Medicare	YES
1780946558	ANTONIO J MARQUES (Individual)	951 PROSPECT AVE BRONX, NY 10459 (718) 860-8440	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	Non-Participating Provider	NO
1780977926	LIA DATIKASHVILI (Individual)	293 E 149TH ST BRONX, NY 10451 (646) 404-5005	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1790036010	SEUNG B LIM (Individual)	570 MELROSE AVE BRONX, NY 10455 (718) 585-9200	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1790041523	EMIL BAILEY (Individual)	555 E FORDHAM RD BRONX, NY 10458 (347) 801-8888	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1790123941	YUVIKA CHOUDHARY (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-7920	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1790175677	NATALIE HEATHER BAKER (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (188) 635-0777	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 Guardian Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1790178606	ZACHARY BERMAN (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1790242683	NINA ABRAHAM (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039		Non-Participating Provider	NO
1790325884	BONITA SONRISA DENTAL MSO BONITA SONRISA DENTAL MSO (Organization)	1624 DR MARTIN L KING JR BLVD BRONX, NY 10453 (845) 793-4469		Non-Participating Provider	NO
1790418903	BELAL ASSAEDI (Individual)	857 MORRIS PARK AVE BRONX, NY 10462 (347) 264-1000	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	NO
1790421212	MERIAM HANNA (Individual)	11 E 210TH ST BRONX, NY 10467 (718) 741-2426	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1790774271	DAVID MARK FRAENKEL (Individual)	2374 GRAND CONCOURSE BRONX, NY 10458 (718) 365-6000	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1790779635	PARESH I PATEL (Individual)	2722 WHITE PLAINS RD BRONX, NY 10467 (718) 655-2813	Humana	Non-Participating Provider	NO
1790825297	DEBRA D SPERLING (Individual)	100 W MOSHOLU PKWY S BRONX, NY 10468 (718) 549-8022		Non-Participating Provider	NO
1790827392	LOUIS ANNUNZIATA (Individual)	3060 ROBERTS AVE BRONX, NY 10461 (718) 824-6330	Anthem Blue Cross and Blue Shield Humana	Non-Participating Provider	YES
1790831212	SOLAFA SEDKI FATOUH (Individual)	1537 WESTCHESTER AVE BRONX, NY 10472 (718) 617-0624		Non-Participating Provider	NO
1790843035	PELHAM PARKWAY DENTAL ASSOCIATES PC (Organization)	1088 MORRIS PARK AVENUE BRONX, NY 10461 (718) 823-8830		Non-Participating Provider	NO
1790847408	MOHAMMAD F HAQUE (Individual)	188 E 167TH ST BRONX, NY 10456 (718) 588-8000		Non-Participating Provider	NO
1790867646	RAJESHWERRAO KOKKIRALA (Individual)	1418 WYTHE PLACE GROUND FLOOR BRONX, NY 10452 (718) 681-8901	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 Humana UnitedHealthcare	Non-Participating Provider	YES
1790949329	GENTLEDENTAL GENERAL DENTISTRY P.C. (Organization)	586 MORRIS AVE BRONX, NY 10451 (646) 220-0083		Non-Participating Provider	NO
1790965648	STEPHEN BARRE HARRISON (Individual)	1668 WILLIAMSBRIDGE RD BRONX, NY 10461 (718) 828-9006		Non-Participating Provider	YES
1801059811	EDWARD C.S. CHIO (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110		Maybe Accepts Medicare	YES
1801092341	MONTEFIORE DENTAL DEPARTMENT MONTE PARK ORTHODONTICS (Organization)	1625 POPLAR ST BRONX, NY 10461 (888) 700-6623		Non-Participating Provider	NO
1801183736	JIGMEY LHAZE DORJEE (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	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
1801199815	CHRISTOPHER DILLON DDS PLLC PARKCHESTER FAMILY DENTAL (Organization)	64 METROPOLITAN OVAL SUITE 9 BRONX, NY 10462 (718) 863-0200		Non-Participating Provider	NO
1801237953	DENTAL ACCESS SERVICES PLLC (Organization)	814 E 149TH ST BRONX, NY 10455 (718) 665-5500		Non-Participating Provider	NO
1801370143	ROGER LEE (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400	Humana	Non-Participating Provider	YES
1801423058	AVIVA IZMAILOV (Individual)	1400 PELHAM PKWY S STE 3NE1 BRONX, NY 10461 (718) 918-3419	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 Florida Combined Life Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1801811807	ROBERT STUTTS (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1801864848	VARSHA DIVECHA SHAH (Individual)	3005 GRAND CONCOURSE PEDIATRIC DENTIST BRONX, NY 10468 (718) 933-0998		Non-Participating Provider	NO
1801886742	AZIM HIRJI (Individual)	424 E 138TH ST BRONX, NY 10454 (718) 585-3311	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 Paramount Paramount Dental	Non-Participating Provider	NO
1801906904	ROGER CHEHOVA (Individual)	1865 WILLIAMSBRIDGE ROAD BRONX, NY 10461 (718) 892-2042	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1811102239	ELENA M HOLTZMAN (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 863-5077	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
1811210560	SUSAN R SIEGEL (Individual)	3515 HENRY HUDSON PKWY BRONX, NY 10463 (718) 796-2500		Non-Participating Provider	YES
1811236987	AREUMBYUL HONG (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6039	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 Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY	Opted out of Medicare	YES
1811275449	DENIZ ANAR SALIERNO (Individual)	5500 BROADWAY BRONX, NY 10463 (917) 750-4500	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1811327620	ROBERT BOGAN DDS PC (Organization)	5606 BROADWAY BRONX, NY 10463 (718) 549-5544		Non-Participating Provider	NO
1811356033	MARYANN VLAHOS (Individual)	2194 WHITE PLAINS RD BRONX, NY 10462 (929) 388-4488	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1811581176	KIRRAN CLIFFORD TIWARI (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	NO
1811671928	EAST TREMONT DENTAL ARTS PLLC (Organization)	3875 E TREMONT AVE BRONX, NY 10465 (718) 823-3000		Non-Participating Provider	NO
1811986151	ROBERT S. RATKEWITCH (Individual)	1225 GERARD AVE BRONX, NY 10452 (718) 960-2812		Non-Participating Provider	YES
1811991185	SOLOMON NADLER (Individual)	130 W KINGSBRIDGE RD BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1811994924	EVELYN TEJEDA (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1821002064	ANDRES MIRANDA (Individual)	375 E FORDHAM RD 2ND FLOOR BRONX, NY 10458 (718) 584-3826	Humana	Non-Participating Provider	NO
1821062100	ALEKSANDR KHAYKIN (Individual)	761 LYDIG AVE GROUND FLOOR BRONX, NY 10462 (718) 792-4782	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1821102252	HARI OM AGARWAL (Individual)	4039 BARNES AVE BRONX, NY 10466 (718) 515-3315	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1821122888	RAJENDRA C RASTOGI (Individual)	103 E BURNSIDE AVE BRONX, NY 10453 (718) 367-1113		Non-Participating Provider	NO
1821130329	YELENA SHABALA (Individual)	1537 WESTCHESTER AVE BRONX, NY 10472 (718) 617-0624	Ambetter Health Ambetter Health of Delaware 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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1821172909	MOHAMMAD ABUL KALAM AZAD (Individual)	57E MOUNT EDEN AVE BRONX, NY 10452 (718) 583-7588		Non-Participating Provider	NO
1821250598	MICHAEL KHANIN (Individual)	1400 PELHAM PKWY S BUILDING #5, 3RD FLOOR BRONX, NY 10461 (718) 918-3419	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	Non-Participating Provider	NO
1821260456	ADVANCED MOBILE DENTAL PLLC CASTLE HILL DENTAL (Organization)	616 CASTLE HILL AVE BRONX, NY 10473 (917) 386-4738		Non-Participating Provider	NO
1821260712	BRONX DENTAL CENTER INC (Organization)	2420 DAVIDSON AVE 1 FL BRONX, NY 10468 (718) 563-0303		Non-Participating Provider	NO
1821264904	ALI SADEGHI (Individual)	234 E 149TH ST BRONX, NY 10451 (718) 579-5692		Non-Participating Provider	NO
1821317751	NADIA MAJEED (Individual)	4422 3RD AVE BRONX, NY 10457 (201) 681-5652		Non-Participating Provider	NO
1831189356	STEVEN DAVID KANTOR (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Humana Paramount Paramount Dental	Non-Participating Provider	YES
1831245059	OTTO GONZALEZ (Individual)	64 METROPOLITAN OVAL SUITE 2 BRONX, NY 10462 (718) 239-7200	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1831283852	BETH BOGUSLAW (Individual)	1770 GRAND CONCOURSE STE 2F BRONX, NY 10457 (718) 901-8110	Renaissance Dental	Non-Participating Provider	YES
1831302728	NARESH CHANDRA RASTOGI (Individual)	230 E 161ST ST BRONX, NY 10451 (718) 992-8200	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1831321934	ABIGAIL SCHWARTZ (Individual)	505 CLAREMONT PKWY BRONX, NY 10457 (718) 299-3600		Non-Participating Provider	NO
1831361674	DR.SHAKUNTALA J MARKALE (Organization)	1171 GRAND CONCOURSE BRONX, NY 10452 (718) 588-7878		Non-Participating Provider	NO
1831364744	NEILLE RICKS (Individual)	3725 HENRY HUDSON PARKWAY W RIVERDALE FAMILY DENTAL BRONX, NY 10463 (718) 601-0100		Non-Participating Provider	NO
1831387422	MORRIS SASSON (Individual)	100 BENCHLEY PL BRONX, NY 10475 (718) 379-3000		Non-Participating Provider	NO
1831440833	AHMED ORTHODONTICS PC (Organization)	918 PELHAM PKWY S 3 BRONX, NY 10462 (718) 684-3131		Non-Participating Provider	NO
1831444355	SOUTH BRONX ORTHODONTICS (Organization)	2825 3RD AVE SUITE 406 (4TH FLOOR) BRONX, NY 10455 (718) 292-4700	UnitedHealthcare	Non-Participating Provider	NO
1831503754	NEGAR DOLATABADI (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4167		Non-Participating Provider	NO
1831534510	ROBERT COSTISEVSCHI (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1831783976	JIMMY LIU (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-5731		Non-Participating Provider	NO
1841278694	HEMANTIKA SHAH (Individual)	747 MELROSE AVENUE C O MELROSE DENTAL OFFICE BRONX, NY 10451 (718) 585-5124		Non-Participating Provider	NO
1841279783	LAURA T MARTIN (Individual)	3240 CORLEAR AVE BRONX, NY 10463 (718) 601-3910	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 Paramount Paramount Dental	Non-Participating Provider	NO
1841316528	SHELDON HENRY KUPFERMAN (Individual)	545 W 236TH ST BRONX, NY 10463 (718) 548-1148		Non-Participating Provider	NO
1841339991	ROBERT ERIC BAYEWITCH (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1841645819	RIVERDALE COMPREHENSIVE DENTISTRY PLLC (Organization)	2600 NETHERLAND AVE SUITE 117 BRONX, NY 10463 (718) 549-3910	UnitedHealthcare	Non-Participating Provider	NO
1841666377	CIRCLE FAMILY DENTAL PC (Organization)	7 HUGH J GRANT CIR BRONX, NY 10462 (718) 792-0137		Non-Participating Provider	NO
1841680329	LEWIS LAMPERT (Individual)	2769 MORGAN AVE BRONX, NY 10469 (212) 998-9386		Non-Participating Provider	NO
1841689205	PERFECT SMILE BRACES, P.C. PERFECT SMILE BRACES (Organization)	555 E FORDHAM RD BRONX, NY 10458 (347) 801-8888		Non-Participating Provider	NO
1841727567	MICHAEL AGHELIAN (Individual)	2005 NEREID AVE BRONX, NY 10466 (718) 994-8282	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1841762838	TRENT GABRIEL (Individual)	4487 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1841867983	ABDULRAHMAN ESSAEDI (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	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 Delta Dental PPO Highmark Blue Cross Blue Shield West Virginia Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1851480883	FAISAL UPPAL (Individual)	5634 RIVERDALE AVE STE A1 BRONX, NY 10471 (718) 884-4168	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 Paramount Paramount Dental	Non-Participating Provider	YES
1851506505	BARTLEY R. LABINER,DDS DR.BARTLEY R. LABINER (Organization)	1940 GRAND CONCOURSE BRONX, NY 10457 (718) 583-6347		Non-Participating Provider	NO
1851524516	VAIRAGI SHAH (Individual)	747 MELROSE AVE BRONX, NY 10451 (718) 585-5124	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 Delta Dental of North Carolina Dominion National Guardian Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1851587570	MARGARET ROMAO (Individual)	391 E 149TH ST RM 214 BRONX, NY 10455 (718) 993-5454	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 Florida Combined Life UnitedHealthcare	Non-Participating Provider	NO
1851591184	ERIDANIA BAEZ (Individual)	1411 MERRY AVE BRONX, NY 10461 (212) 866-1313	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1851612790	KAREY PATRICE MATTHEWS (Individual)	1770 GRAND CONCOURSE APT 2F BRONX, NY 10457 (718) 901-8110	Ambetter Health Ambetter Health of Delaware 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 UnitedHealthcare	Non-Participating Provider	YES
1851667604	ROSE JOCELYN AMABLE (Individual)	961 EAST 174TH STREET SUITE B150 BRONX, NY 10460 (718) 861-8060	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1851926513	MIANG CHNEH C TEO (Individual)	1100 PELHAM PKWY S BRONX, NY 10461 (718) 684-3131	Anthem Blue Cross and Blue Shield Humana	Non-Participating Provider	NO
1851987622	RI DENTAL CARE PC UNIVERSITY DENTAL ASSOCIATES (Organization)	2505 UNIVERSITY AVE FRNT 1 BRONX, NY 10468 (718) 733-6600	UnitedHealthcare	Non-Participating Provider	NO
1861442311	IRMA D TORRES (Individual)	3201 GRAND CONCOURSE SUITE 2K BRONX, NY 10468 (718) 584-9777	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1861473399	CLIFFORD N SALOSHIN (Individual)	2277 WESTCHESTER AVE BRONX, NY 10462 (718) 829-4646	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1861541690	DARRYL ERIK LIEBERMAN (Individual)	790 CONCOURSE VLG W BRONX, NY 10451 (718) 538-6060	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 UnitedHealthcare	Non-Participating Provider	YES
1861550626	FARAH M ALAM (Individual)	1225 MORRIS PARK AVE BRONX, NY 10461 (718) 839-7085	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 Humana	Non-Participating Provider	YES
1861667917	MOHAMED DAMJI/SHIRAZ DAMJI PARTNERS (Organization)	1250 SHAKESPEARE AVE BRONX, NY 10452 (718) 992-3900		Non-Participating Provider	NO
1861706467	EDWARD WOODBINE (Individual)	4133 WHITE PLAINS RD BRONX, NY 10466 (347) 328-4169	Anthem Blue Cross and Blue Shield Humana	Non-Participating Provider	NO
1861733743	CONCETTA ELIZABETH PERRETTA (Individual)	1933 WILLIAMSBRIDGE RD BRONX, NY 10461 (718) 823-4719	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1861994394	RICHARD CHEVERIE HEINL (Individual)	1575 BLONDELL AVE BRONX, NY 10461 (888) 700-6623	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 Cigna Healthcare Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1871026435	JOY KAY ARTHUR (Individual)	1775 GRAND CONCOURSE, 6TH FLOOR BRONX- LEBANON HOSPITAL CENTER, DEPT OF DENTISTRY BRONX, NY 10453 (718) 901-8110	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. 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 CareSource Delta Dental of Ohio Guardian MedMutual Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1871291179	ERIC LIN (Individual)	3585 E TREMONT AVE BRONX, NY 10465 (408) 838-8609		Non-Participating Provider	NO
1871519462	ALVIN I. EDELMAN, D.D.S., P.C. (Organization)	910 THIERIOT AVE SUITE 1C BRONX, NY 10473 (718) 589-3131		Non-Participating Provider	NO
1871638684	MICHAEL VYACHESLAV ALUF (Individual)	289 E 149TH ST 2ND FLOOR BRONX, NY 10451 (718) 742-7400	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1871639880	DAVID JOSEPH STEVENS (Individual)	1228 PELHAM PKWY S BRONX, NY 10461 (718) 597-2722	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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1871735589	LYDIG DENTAL LYDIG DENTAL (Organization)	2120 MATTHEWS AVE 1 FLOOR BRONX, NY 10462 (718) 863-4777		Non-Participating Provider	NO
1871738302	149 DENTAL, P.C. (Organization)	385 E 149 ST BRONX, NY 10455 (718) 402-2240		Non-Participating Provider	NO
1871813063	GEOFFREY A DUVINER (Individual)	3332 ROCHAMBEAU AVE BRONX, NY 10467 (718) 920-5993		Non-Participating Provider	NO
1871917799	DANIIL PAYZIYEV (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	NO
1881273928	ELNAZ HALABIAN (Individual)	1543 INWOOD AVE BRONX, NY 10452 (855) 681-8700		Non-Participating Provider	YES
1881382711	YEO JOO CHOI (Individual)	4422 3RD AVE BRONX, NY 10457 (718) 960-9000		Non-Participating Provider	YES
1881397958	SWETHA ALUGUBELLI (Individual)	1002 WESTCHESTER AVE BRONX, NY 10459 (718) 320-4466		Non-Participating Provider	NO
1881749182	DAVID BARNETT (Individual)	1645 GRAND CONCOURSE BRONX, NY 10452 (718) 299-7012	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1881754380	OFER A COHEN (Individual)	183 WEST 231ST 2ND FLOOR BRONX, NY 10463 (718) 543-1123	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1881787158	MITA SHARAD PATEL (Individual)	679 E 138TH ST BRONX, NY 10454 (718) 665-6065	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 Paramount Paramount Dental	Non-Participating Provider	NO
1881795094	JOHN M RINAUDO (Individual)	3975 SEDGWICK AVE SUITE 1-H BRONX, NY 10463 (718) 796-4600	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 Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	YES
1891141297	TOVA D NADLER (Individual)	3333 HENRY HUDSON PKWY BRONX, NY 10463 (718) 796-4100	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 Humana	Non-Participating Provider	NO
1891226619	BO YOON (Individual)	432 E 149TH ST BRONX, NY 10455 (718) 618-7564	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1891499745	SMILE DENTAL CARE P.C (Organization)	2344 EASTCHESTER RD BRONX, NY 10469 (646) 401-7878	UnitedHealthcare	Non-Participating Provider	NO
1891755682	RONALD G. MCLEAN (Individual)	3575 EASTCHESTER RD BRONX, NY 10469 (718) 515-9010	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 UnitedHealthcare	Non-Participating Provider	NO
1891845848	JOHN THOMAS MORROW (Individual)	545 E 142ND ST BRONX, NY 10454 (718) 579-1723		Non-Participating Provider	YES
1891916730	MITESH P PARIKH (Individual)	1002 CASTLE HILL AVE BRONX, NY 10472 (718) 319-1570		Non-Participating Provider	NO
1891962809	EUNICE J. LEE (Individual)	1770 GRAND CONCOURSE 2F BRONX, NY 10457 (718) 901-8110	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
1902020670	RHONA STANLEY (Individual)	2488 GRAND CONCOURSE 318 BRONX, NY 10458 (718) 367-7072		Non-Participating Provider	NO
1902080872	JASMIN A STERLING (Individual)	1530 UNIONPORT RD BRONX, NY 10462 (718) 892-2200	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1902119704	DORADO DENTAL P.C. (Organization)	3055 THIRD AVE BRONX, NY 10455 (917) 597-1123		Non-Participating Provider	NO
1902127897	COHENS GENERAL DENTAL COHENS GENTLE DENTAL (Organization)	183 W 231ST ST 2ND FLOOR BRONX, NY 10463 (718) 365-0990		Non-Participating Provider	NO
1902147911	CONCOURSE WEST DENTAL PLLC (Organization)	880 RIVER AVENUE BRONX, NY 10452 (718) 992-0410		Non-Participating Provider	NO
1902155062	BRONX KIDS PEDIATRIC DENTISTRY (Organization)	1610 WILLIAMSBRIDGE RD BRONX, NY 10461 (914) 715-9932		Non-Participating Provider	NO
1902157910	PERFECT SMILE BRACES, P.C. PERFECT SMILE BRACES (Organization)	555 E FORDHAM RD BRONX, NY 10458 (347) 801-8888		Non-Participating Provider	NO
1902226368	SHANNON ALICIA WILLIAMS DASH (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8410	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma 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 Delta Dental PPO DentaQuest USA Insurance Company Inc. EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1902292311	EMILY ANN SCHADT (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1902296593	RACHEL LIN (Individual)	586 MORRIS AVE BRONX, NY 10451 (203) 554-9827	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 Paramount Paramount Dental	Opted out of Medicare	YES
1902299027	BLAIR SITTMANN (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	NO
1902533342	SPORE TEST INC (Organization)	1624 UNIVERSITY AVE APT 2B BRONX, NY 10453 (718) 294-3725		Non-Participating Provider	NO
1902538424	MICHAEL PARK (Individual)	55 E MOSHOLU PKWY N BRONX, NY 10467 (718) 652-7370		Non-Participating Provider	NO
1902896426	DAVID AARON BASKAS (Individual)	MONTEFIORE MEDICAL CENTER DEPT. OF DENTISTRY 1575 BLONDELL AVE. SUITE 150 BRONX, NY 10461 (718) 405-8190	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1902898570	VIJAYKUMAR C SHAH (Individual)	3250 THIRD AVE BRONX, NY 10456 (718) 842-6960	Florida Combined Life	Non-Participating Provider	NO
1902916000	VINCENT M CEFOLA (Individual)	1865 WILLIAMSBRIDGE ROAD BRONX, NY 10461 (718) 892-2042	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	YES
1902933609	FAMILY PRACTICE DENTISTRY FAMILY PRACTICE DENTISTRY & LASER DENTAL CARE LLC (Organization)	1725 EDISON AVE LOBBY C BRONX, NY 10461 (718) 892-7114		Non-Participating Provider	NO
1902989858	DAVID K MAGID (Individual)	880 RIVER AVE BRONX, NY 10452 (718) 992-0410		Non-Participating Provider	NO
1912040528	DAVID S PINKHASOV (Individual)	2665 GRAND CONCOURSE BRONX, NY 10468 (718) 365-8660	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1912142936	ANTHONY JOSHUA GALIANI (Individual)	1732 BOGART AVE BRONX, NY 10462 (718) 824-9222	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
1912386301	AMBAR MIER (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-4321		Non-Participating Provider	YES
1912508458	STERLING SMILES LLC (Organization)	1022 E163RD ST BRONX, NY 10459 (718) 542-2088		Non-Participating Provider	NO
1912699851	EGLI HAJDARMATAJ (Individual)	1376 MERRY AVE BRONX, NY 10461 (929) 369-4615	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1912946500	BERNARD SPENCER LICHTENSTEIN (Individual)	64 METROPOLITAN OVAL SUITE 8 BRONX, NY 10462 (718) 829-8990		Non-Participating Provider	NO
1912971490	ROGER GUPTA (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400		Non-Participating Provider	NO
1922020072	PETER GROSS (Individual)	2967 MORGAN AVE BRONX, NY 10469 (718) 655-1972	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1922027309	LOUIS JOSEPH GRECO (Individual)	1635 CROSBY AVE BRONX, NY 10461 (718) 792-1888		Non-Participating Provider	YES
1922052455	VINCENT D'APPOLONIA (Individual)	860 GRAND CONCOURSE SUITE 1M BRONX, NY 10451 (718) 993-4343	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1922098698	ANDREW F. GOLD (Individual)	505 CLAREMONT PKWY BRONX, NY 10457 (718) 299-3600		Non-Participating Provider	NO
1922138304	OLGA WERCHOLA (Individual)	2503 SAINT RAYMONDS AVE BRONX, NY 10461 (718) 823-1415		Non-Participating Provider	NO
1922180306	NUNTIYA KAKANANTADILOK (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-6266	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 Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1922196054	ERIC M GOLDFARB (Individual)	466 EAST FORDHAM ROAD BRONX, NY 10458 (718) 365-4300	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1922211408	APTIN GHODS-DJURABCHI, DDS, PC (Organization)	2505 UNIVERSITY AVE BRONX, NY 10468 (718) 733-6600		Non-Participating Provider	NO
1922262625	MARAL SIEGEL (Individual)	2967 MORGAN AVE BRONX, NY 10469 (718) 655-1972		Non-Participating Provider	NO
1922395896	LAUREN ALENA ATWELL-OGLESBY (Individual)	3444 KOSSUTH AVE BRONX, NY 10467 (352) 359-3286	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1922536432	YAKOV MASHEYEV (Individual)	1200 WATERS PL STE M107 BRONX, NY 10461 (718) 822-8787	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1922556414	PROBITY DENTAL PLLC COVENANT DENTAL (Organization)	815 HUTCHINSON RIVER PKWY BRONX, NY 10465 (646) 578-8378		Non-Participating Provider	NO
1922668961	SUZANA AHMED (Individual)	2181 STARLING AVE BRONX, NY 10462 (718) 823-4444	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 Humana UnitedHealthcare	Non-Participating Provider	NO
1922714906	RACHEL BRESSLER (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-5000	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 Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1922881358	AUSTIN LE (Individual)	960 MORRIS PARK AVE BRONX, NY 10462 (718) 377-6453	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1932304730	ZVI KAHANE (Individual)	3333 HENRY HUDSON PKWY BRONX, NY 10463 (718) 796-4100		Non-Participating Provider	NO
1932328382	DIMITRI PAPADOPOULOS (Individual)	2169 WHITE PLAINS RD BRONX, NY 10462 (718) 597-6314	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 Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1932389939	REBECCA KIM (Individual)	2505 UNIVERSITY AVE BRONX, NY 10468 (718) 733-6600		Non-Participating Provider	NO
1932396645	GENARO J TAVERAS (Individual)	2002 GRAND AVE BRONX, NY 10453 (718) 299-1340		Non-Participating Provider	NO
1932579596	505 DENTAL ASSOCIATES PLLC (Organization)	505 CLAREMONT PKWY BRONX, NY 10457 (914) 830-4804	UnitedHealthcare	Non-Participating Provider	NO
1932591633	YINA YOON (Individual)	111 E 210TH ST BRONX, NY 10467 (917) 580-2316	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 Paramount Paramount Dental	Non-Participating Provider	NO
1932780848	DORIT BASIRATMAND (Individual)	1725 EDISON AVE BRONX, NY 10461 (718) 892-7114		Non-Participating Provider	NO
1942210331	THOMAS V CHOLANKERIL (Individual)	4303 BYRON AVE BRONX, NY 10466 (718) 994-6200	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 UnitedHealthcare	Non-Participating Provider	NO
1942263785	OILIM LEUNG (Individual)	85 W BURNSIDE AVE BRONX, NY 10453 (718) 716-4400		Non-Participating Provider	NO
1942281829	GABRIEL A ISIOYE (Individual)	3024 KINGSBRIDGE AVE BRONX, NY 10463 (718) 543-4747	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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1942291190	JEFFREY JOEL GRANT (Individual)	2202 GRAND CONCOURSE BRONX, NY 10457 (718) 365-6389	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1942342746	ALVAREZ DENTAL PC (Organization)	2400 HUGHES AVE BRONX, NY 10458 (718) 295-1615		Non-Participating Provider	NO
1942349691	ELI HANONO (Individual)	2685 UNIVERSITY AVE BRONX, NY 10468 (718) 543-7283	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
1942366489	LILA NIKKHAH (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3060		Non-Participating Provider	NO
1942393970	CLAUDIA LAWRENCE (Individual)	1473 WEST AVE BRONX, NY 10462 (718) 824-5444	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 Paramount Paramount Dental	Non-Participating Provider	NO
1942412218	SYED MONZURUL ALI (Individual)	1197 RIVER AVENUE BRONX, NY 10452 (718) 681-0020		Non-Participating Provider	YES
1942525985	OPEN DENTAL, P.C. (Organization)	432 E 149TH ST BRONX, NY 10455 (267) 266-5366		Non-Participating Provider	NO
1942576434	ALLA GIZERSKAYA (Individual)	2336 GRAND CONCOURSE BRONX, NY 10458 (718) 220-0439	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 Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1952366973	MODERN ORTHODONTICS, PC KENNETH COOPERMAN, DMD, PC (Organization)	391 E 149TH ST RM 214 BRONX, NY 10455 (718) 993-5454		Non-Participating Provider	NO
1952386120	CHRISTINE HENG (Individual)	1400 PELHAM PKWY S JACOBI MEDICAL CENTER BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	YES
1952393100	AMRITBHAI PATEL (Individual)	1706 WATSON AVE BRONX, NY 10472 (718) 542-1840		Non-Participating Provider	NO
1952419327	QASIM RAZA GARDEZI (Individual)	1042 SOUTHERN BLVD BRONX, NY 10459 (718) 617-2257	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1952467334	WALI KHAN (Individual)	1221 WHITE PLAINS RD SUITE 106 BRONX, NY 10472 (718) 792-6991	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1952513327	PAUL MARTIN HERTZ (Individual)	6011 RIVERDALE AVE BRONX, NY 10471 (718) 548-6900		Non-Participating Provider	NO
1952528549	MARTIN RICHARD KRAUSS (Individual)	3425 BOSTON RD BRONX, NY 10469 (718) 654-4704		Non-Participating Provider	NO
1952561219	JOEL C GREEN (Individual)	918 PELHAM PKWY S BRONX, NY 10462 (718) 823-7312		Non-Participating Provider	YES
1952567570	MIROSLAVA KAUTSIS (Individual)	86 W 183RD ST DENTAL OFFICE BRONX, NY 10453 (718) 367-4222	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 UnitedHealthcare	Non-Participating Provider	NO
1952573594	BOYNTON DENTAL,PC (Organization)	1537 WESTCHESTER AVE BRONX, NY 10472 (718) 617-0624		Non-Participating Provider	NO
1952603110	OLATUNJI RAFIU ALMAROOF (Individual)	2181 STARLING AVE BRONX, NY 10462 (347) 520-2194		Non-Participating Provider	NO
1952760282	PETER J HEALY DDS (Organization)	1725 EDISON AVE BRONX, NY 10461 (718) 892-7114		Non-Participating Provider	NO
1952765992	KATERINA LEVY (Individual)	140 DE KRUIF PL BRONX, NY 10475 (718) 379-1700	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1962434266	MARVIN LEVINE (Individual)	1837 EDISON AVE BRONX, NY 10461 (718) 654-2500		Non-Participating Provider	NO
1962492181	GRACE ENCARNACION CHIN (Individual)	111 E 210TH ST MONTEFIORE MEDICAL CENTER- PEDIATRIC DENTISTRY BRONX, NY 10467 (347) 577-4950	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1962492728	SUBODH GOPALDAS PATEL (Individual)	902 HUNTS POINT AVE BRONX, NY 10474 (718) 328-2570	Ambetter Health Ambetter Health of Delaware 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 Florida Combined Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1962651836	CHRISTIAN J OCONNOR (Individual)	466 E FORDHAM RD BRONX, NY 10458 (718) 365-4300	Ambetter from Meridian Ambetter Health 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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1962667576	KAVI SAGUNARTHY (Individual)	266 E 167TH ST BRONX, NY 10456 (718) 991-8668	Humana	Non-Participating Provider	NO
1962694901	JESSICA MYAE LEE (Individual)	1959A WESTCHESTER AVE BRONX, NY 10462 (718) 822-6086	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1962996389	DANIEL CHOI (Individual)	2466 ARTHUR AVE BRONX, NY 10458 (718) 329-1000	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1972009959	LEILA HAZAVEI (Individual)	111 EAST 210TH STREET BRONX, NY 10467 (718) 920-4321	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1972509313	JAMES H GANEY (Individual)	1770 GRAND CONCOURSE BRONX, NY 10457 (718) 901-8110	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1972649762	VAIBHAVI PRADHAN (Individual)	3950 WHITE PLAINS RD BRONX, NY 10466 (718) 652-6622	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	Non-Participating Provider	NO
1972717122	CARLOS J OCASIO (Individual)	2278 GRAND CONCOURSE BRONX, NY 10457 (718) 584-2274	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1972760296	M M ABDUR ROB (Individual)	780 E TREMONT AVE BRONX, NY 10460 (718) 731-6176	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1972947349	PATRICIA M IZQUIERDO (Individual)	183RD STREET THIRD AVENUE BRONX, NY 10457 (718) 960-6628	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1972997245	PERI LOREN WEINGARTEN (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3230	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 Renaissance Dental	Non-Participating Provider	NO
1982107405	CHELSEA FOSSE (Individual)	1400 PELHAM PKWY S BRONX, NY 10461 (718) 918-3419		Non-Participating Provider	NO
1982167698	SARA WEINGARTEN (Individual)	1808 CROTONA PKWY BRONX, NY 10460 (728) 484-3338	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	Non-Participating Provider	YES
1982180790	HEATHER STEPHANIE KUNEN (Individual)	555 E FORDHAM RD BRONX, NY 10458 (347) 801-8888	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 Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1982632204	MONROE WARREN KORNFELD (Individual)	7 HUGH J GRANT CIR BRONX, NY 10462 (718) 792-0137		Non-Participating Provider	NO
1982761607	PETER J. HEALY (Individual)	1725 EDISON AVE LOBBY C BRONX, NY 10461 (718) 892-7114	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 Paramount Paramount Dental	Non-Participating Provider	NO
1982773149	MUKESH H AJMERA (Individual)	1561 WESTCHESTER AVE BRONX, NY 10472 (718) 542-6272	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 Florida Combined Life Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	YES
1982791919	JORDAN FREEMAN (Individual)	VA MED CENTER, DENTAL BRONX, NY 10468 (718) 584-9000		Non-Participating Provider	NO
1982992574	BIANCA CLARK (Individual)	3317 BAINBRIDGE AVE BRONX, NY 10467 (718) 547-2833	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
1992165377	TESSA MILLER (Individual)	1775 GRAND CONCOURSE FL 6 BRONX, NY 10453 (718) 901-8110	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 Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1992386056	CHELSEA CAMILO (Individual)	111 E 210TH ST BRONX, NY 10467 (718) 920-2418	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 Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1992757538	AYELET C YOLES (Individual)	1065 SOUTHERN BLVD BRONX, NY 10459 (917) 699-3349		Non-Participating Provider	YES
1992779458	SAUL S MEDNICK (Individual)	493 E 138TH ST BRONX, NY 10454 (718) 665-6010	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 Humana Paramount Paramount Dental	Non-Participating Provider	NO
1992843544	SUSAN LUNARDI (Individual)	2152 MULINER AVE BRONX, NY 10462 (718) 829-3050	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	Non-Participating Provider	YES
1992932727	VIOLETA SKEVAS (Individual)	2665 GRAND CONCOURSE BRONX, NY 10468 (718) 365-8660		Non-Participating Provider	NO
1992968598	DHVANIT PATEL (Individual)	1225 MORRIS PARK AVE BRONX, NY 10461 (718) 431-5150	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 Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1992972806	BRACE YOURSELF P.C. (Organization)	565 E 184TH ST BRONX, NY 10458 (718) 220-8800		Non-Participating Provider	NO
1992974323	KIGON SONG (Individual)	3744 3RD AVE BRONX, NY 10456 (718) 590-5090	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

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