ADVANCED DENTAL
GREENPOINT

Phone: (718) 874-0104

851 Manhattan Ave,
Brooklyn, NY 11222

ADVANCED DENTAL
BRONX

Phone: (718) 292-8988
237 Willis Ave,
Bronx, NY 10454

ADVANCED DENTAL
WESTCHESTER/SCARSDALE

Phone: (914) 874-5757

130 Garth Road,
Scarsdale, NY 10583

ADVANCED DENTAL
MANHATTAN
(ORTHO)
Phone: (212) 427-2237

231 E 106th St,
New York, NY 10029

ADVANCED DENTAL
QUEENS
Phone: (718) 354-8942

81-14 Baxter Ave,
Elmhurst, NY 11373

 

 

 

 

 

 

 

 

 

 

FORM AND INSTRUCTION FOR PATIENTS:

 

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FOR OFFICE USE ONLY:ORTHO FORMS

- Welcome Advanced Dental Orthodontic
- Informed Consent Orthodontics Patient - Advanced Dental
- Informed Consent Braces Removal and Retainer Consent Form
- Healthplex Orthodontic HLD Form
- Denta Quest Orthodontic HLD Form
- Release of Liability Early Removal of Orthodontic Appliances
- Ortho Tx form START/BONDING
- Transfer Patient in-Active Treatment ortho.pdf
- Payment arrangement 12 months comprehensive orthodontic treatment
- Payment arrangement 24 months comprehensive orthodontic treatment
- Payment arrangement orthodontic treatment government.pdf
- Payment consent Delta Dental/32BJ ortho 2018.pdf
- Payment consent GHI ortho 2018.pdf

FOR OFFICE USE ONLY:ORAL SURGERY FORMS

- Welcome package Oral Surgery Procedures
- Welcome Oral Surgery CONSULTATION
- Welcome Oral Surgery Scarsdale
- Advanced Dental Surgery "Tx" Form
- Informed Consent Form for Oral and Maxillofacial Surgery and Anesthesia
- Implant Consent Form
 
- General Anesthesia Record
- Discharge Sheet
 

FOR OFFICE USE ONLY:ENDO FORMS

- Informed Consent for Endodontic Treatment
- Dentist/Doctor Exuse Letter
- Disclosure sheet for cosmetic or uncovered treatment

FOR OFFICE USE ONLY:OTHER FORMS

- Advanced Dental "M" Form
- Advanced Dental "I" Form
- Notice of privacy practices Advanced Dental
- Dentist/Doctor Exuse Letter
- Disclosure sheet for cosmetic or uncovered treatment
- Advanced dental worksheet

FOR OFFICE USE ONLY: INFORMED CONSENT FORM

- Informed Consent Form nitrous oxide sedation
- Informed Consent Form Filling
- Informed Consent Form crown and bridge prosthetics
- Informed Consent Braces Removal and Retainer Consent Form
- Release of Liability Early Removal of Orthodontic Appliances
- Disclosure sheet for cosmetic or uncovered treatment


INSURANCE PHONE NUMBERS

Denta Quest 800-341-8478 https://govservices.dentaquest.com
Denta Quest HIP   https://provider.dentaquest.com/providerlogin
Healthplex 888-468-2183
Fax: 516-542-2614
https://healthplex.com/provider

HIP Carrington
800-477-8255  
Medicaid 800-343-9000 https://www.emedny.org/epaces/Login.aspx
AETNA 800-451-7715 https://www.aetna.com/provweb/index.html
CSEA 800-323-2732  
DC37 212-815-1600 https://www.inmediata.com/us/index.php
Delta Dental 800-932-0783 https://www.deltadentalins.com

DeltaDental Mass

617-886-1234
 
Delta Dental Virginia 800-237-6060  
DDS (MagnaCare) 800-255-5681  
Dental Shop 888-683-3682  
Guardian 800-541-7846 https://www.guardiananytime.com
GHI Emblem Health (1199) 646-473-7160
212-501-4444
https://www.emblemhealth.com
SIDS 718-204-7172 https://www.asonet.com/dentist.aspx

United Health Care (Community plan)
  https://pwp.sciondental.com/PWP/Landing
UHC 877-816-3596  

Daniel H Cook
(212) 505-5050
Fax: (212) 7141455
https://www.dhclaims.com
MetLife 800-275-4638 https://www.metdental.com/prov/execute/home
Local 371 212-777-9000
(ext. 3069, 3059, 3070)
Fax: 212-260-7908
 
Local 1180 212-505-5050  
Loclal 94 (Seledent) 800-520-3368  
Cigna 800-342-5234 https://cignaforhcp.cigna.com
United Concordia   https://www.unitedconcordia.com
Seledent 516-887-7566  
PBA 212-349-7560  
UFT 800-577-0576  
     

   

32BJ 516-394-9485
DeltCare Facility 800-422-4234
DentsCo 201-585-2558




 


The maze

 

 



 


Patient education

Healthplex 

  SCARSDALE ADVANCED DENTAL SPECIALTY REFERRAL FORM

  - Healthplex Referral Form ORTHO-Advanced Dental Scarsdale
  - Healthplex Refferal Form Oral Surgery-Advanced Dental Scarsdale
  - Healthplex Referral Form ENDO - Advanced Dental Scarsdale




Scarsdale Advanced oral surgery and orthodontics: 130 Garth Road, Scarsdale, NY 10583. Phone: (914) 874-5757. email: dmd@lohuddental.com

The information presented on this site is of personal opinion and consequently is slanted and biased and not based on proper scientific research. The information presented is NOT written by a dental expert. Further the information presented has NOT been subjected to peer review by experts to verify accuracy and data integrity.Copyright Dental Arts Press. 2011.
www.dentalartspress.com |
www.mybraces.nyc | www.lohuddental.com

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