Patient Forms

Adult Medical History 2015-04-07To save time on the day of your appointment, please fill out these forms and bring them with you:

Pediatric Dental Patient Forms:

Adult DENTAL PATIENT Forms:

Anesthesia PATIENT FORMS:

These files are in PDF format. If you do not have AdobeĀ® ReaderĀ® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.

Scheduling Appointments

To schedule an appointment, please call (516) 487-8110 for our office. A pediatric dentist and general dentist are on-call 24 hours-a-day, 7 days-a-week.

If you have an emergency after office hours, please call (516) 674-5973. Our emergency answering service will contact the appropriate dentist on-call, depending on if the emergency is for an adult or a child. Our dentists will contact you after they are notified of your emergency.

Office Hours

Monday - Thursday
Friday
Saturday*
Sunday
8:00am - 6:00pm
8:00am- 5:00pm
8:00am - 1:00pm
Closed

*July and August 8:00am - 12:00pm

Health Insurance Plans

Filing of insurance forms by the practice is done as a courtesy to our patients. The responsible person shown in our records, not the insurance carrier, is financially liable for payment.

Financial Policy

Just as we are committed to providing excellent dental care, we are concerned with making it affordable to you. By reducing costly billing procedures and requesting payment at the time services are rendered, we can keep our costs down and pass the savings on to our patients. For your convenience, we accept MasterCard, VISA, AMEX, personal checks and cash. For extensive treatment, we are pleased to offer CareCredit, a flexible payment option offered to our patients. Ask us for details.

Meet Our Dentists

Our pediatric dentists, general dentists and anesthesiologists are fully trained and experienced to provide our patients with the highest quality of care.

Board Certified Pediatric Dentists
Dr. Mary George
Dr. Gina Sajnani
Board Certified Dentist Anesthesiologist
Dr. Ralph Epstein

Locate our office

Distinctive Dental Services of New York 173 East Shore Road, Suite 201
Great Neck, New York 11023
Tel: 516.487.8110 Maps & Directions » Contact Us