FORM AND INSTRUCTION FOR PATIENTS:


PATIENT: ORAL SURGERY INSTRUCTIONS


Oral Surgery Post Operative Instructions - Advanced Dental Scarsdale

Instrucciones Para Despues de una Extraccion Dental (DEBE/NO DEBE)

Oral Surgery DO'S and DONT'S - Advanced Dental Scarsdale

Oral Surgery: Care After Bone Grafting

Oral Surgery: Care After Dental Implant


PATIENT: ORTHODONTICS/BRACES INSTRUCTIONS


Instructions for Orthodontic opatients (Life with Braces) - Scarsdale Advanced Dental

Preventing problems with your braces - Scarsdale Advanced Dental


FOR OFFICE USE ONLY : ORTHODONTIC FORMS


Welcome Advanced Dental Orthodontic

Ortho consultation TX form

Ortho start/bonding TX form

Ortho adjustment/repair TX form

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Informed Consent Orthodontics Patient - Advanced Dental

Release of Liability Early Removal of Orthodontic Appliances

Informed Consent Braces Removal and Retainer Consent Form

Warning letter due to non-compliance (ortho)

Transfer Patient in-Active Treatment ortho

Healthplex Orthodontic HLD Form

Denta Quest Orthodontic HLD Form

Payment arrangement 12 months comprehensive orthodontic treatment

Payment arrangement 24 months comprehensive orthodontic treatment

Payment arrangement orthodontic treatment government


Payment consent Delta Dental/32BJ ortho 2018

Payment consent DC37 ortho 2019

Payment consent Healthplex Local 237/Local100 ortho

Payment consent GHI ortho 2018


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 : ENDODONTIC FORMS


Informed Consent for Endodontic Treatment

Dentist/Doctor Exuse Letter

Disclosure sheet for cosmetic or uncovered treatment


FOR OFFICE USE ONLY: OTHER FORMS


Financial Policy Advanced Dental 2018

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

HIPAA form for release health information


FOR OFFICE USE ONLY: INFORMED CONSENT FORMS


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


FEE SCHEDULE


Aetna dental PPO plans fee schedule

Denta Quest Emblem | Child medicaid | Child health plus (CHP) |Essential plans | Medicare advantage |Exchange QHP

Denta Quest healthfirst hfic

Denta Quest Fidelis Exchange | Affinity Exchange | Healthfirst Exchange

DC37 fee schedule for ortho, pedo, endo 2018

Liberty dental plan New York Medicaid CHIP

UFT dental fee schedule



INSURANCE PHONE NUMBERS


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

HIP Carrington
800-477-8255  
Liberty Dental Plan 888-352-7924 www.libertydentalplan.com
Medicaid 800-343-9000 www.emedny.org/epaces/Login.aspx
AETNA 800-451-7715 www.aetna.com/provweb/index.html
BCBS 800-722-8879  
BCBS federal 800-522-5566  
Cigna 800-342-5234 www.cignaforhcp.cigna.com
Daniel H Cook (212) 505-5050
Fax: (212) 7141455
www.dhclaims.com
DC37 212-815-1600 www.inmediata.com/us/index.php
Delta Dental 800-932-0783 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 www.guardiananytime.com
GHI Emblem Health (1199) 646-473-7160
212-501-4444
www.emblemhealth.com
Local 371 212-777-9000
(ext. 3069, 3059, 3070)
Fax: 212-260-7908
 
Local 1180 212-505-5050  
Loclal 94 (Seledent) 800-520-3368  
MetLife 800-275-4638 www.metdental.com/prov/execute/home
PBA 212-349-7560  
United Concordia   www.unitedconcordia.com
Seledent 516-887-7566  
SIDS 718-204-7172 www.asonet.com/dentist.aspx
     
UFT 800-577-0576  

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


To schedule an appointment with dental specialist please contact Advanced Dental Scarsdale :
Call Us: (914) 874-5757
130 Garth Road Scarsdale, NY 10583