Patient Resources

Patient Resources

Patient Forms

Prior to your appointment, you will need to complete the form via this link or the button below. Please call our office if you have any difficulty.

Dental Insurance

We accept most PPO insurance plans, contact our office to verify acceptance of your plan. We accept cash or credit cards for payments. We also offer a flexible payment plan. Dental Insurance generally does not cover all dental expenses. It is designed to help reduce out of pocket expense. In addition to being an in-network provider with your insurance company, we will also check your insurance benefits, file your insurance claims, track and follow up on claims as a courtesy. Although we try our best to get accurate benefit information from your insurance company but still it is just estimate, it does not give any guarantee of payment from insurance. Please see our Financial Coordinator for details.

Financing Options

CareCredit is here to help you pay for treatments and procedures your insurance doesn’t cover. We offer No Interest* financing or low minimum monthly payment options so you can get what you want, when you want it. You can even use CareCredit for your family and favorite pet.

With three simple steps, including an instant approval process, it’s easy to apply for CareCredit. After you’re approved, you’re free to use CareCredit for the services you choose including LASIK, veterinary, dentistry, cosmetic, hearing aids and more.

CareCredit is endorsed by some of the most credible organizations specific to each healthcare profession we support. And CareCredit is a GE Money Company, so you know you can count on us. For over 20 years, we’ve been helping over five million cardholders get the healthcare treatments they want and need so there is no need to worry about saving up for any procedures.
With CareCredit, the decision is in your hands to get what you want, when you want it. For more information or to apply online, visit carecredit.com or click the logo below.

Membership Program

This is an annual reduced fee dental plan that allows individuals and families to receive quality dental care from Ivory Dental for a percentage off the office’s usual, customary and reasonable (UCR) fees. This is not an insurance plan, no claims are filed, and no payments are made to any other healthcare providers. Park Street Dental is not a licensed insurer, health maintenance organization, or other underwriter of health services.  This plan may not be combined with any other offers, Care Credit, discounts, insurance, discount plans or advertisements.

Annual Membership fee

  • SINGLE MEMBER: $299
  • EACH ADDITIONAL MEMBER: $250
  • CHILDREN 13 YEARS & UNDER: $200

WHATS INCLUDED & FEES WITH OUT INSURANCE:

  • YEARLY EXAM
  • 2 STANDARD PROFESSIONAL CLEANINGS  ( root scaling & planning not included)
  • 1 LIMITED EXAMS AND 1 XRAYS
  • FULL MOUTH SERIES OF XRAYS

TOTAL VALUE: $523

****20% DISCOUNT ON ALL OTHER DENTAL SERVICES OVER $100****

(Excluding any orthodontic services)

 

More About Us:

Meet Dr. Patel & Staff

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Services Offered:

Braces

Dental Emergency

Root Canal

Tooth Extraction

Dentures

Bridges

Crowns

Fillings

Cleanings & Exams

Scaling & Root Planing

Teeth Whitening

Veneers