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Emergency Dentistry is Available
To set up an appointment with one of our doctors, please call our office or communicate with us using the live chat system on our website.
Your dental health is important, and our patients' safety is our top priority. Please read through our COVID-19 Office Protocols and see our Oral Hygiene Tips

Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:

How do you prefer to be contacted? *

Phone Text Email  

Appointment Preference *

Morning appointment Afternoon appointment  

If applicable, Name of Insurance Co.

Insurance Type

PPO HMO  

Confirmation

 
 

It may take a moment to submit your information. Please wait for a confirmation message.

 
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Request an Appointment Online | Irvine Dentistry
At Irvine Dentistry, we make it easy to schedule your appointment online. Simply visit our website to access the secure form, and we'll contact you to confirm.
Irvine Dentistry, 5394 Walnut Ave Suite E, Irvine, California 92604 ~ (949) 656-2933 ~ irvinedentistry.com ~ 9/25/2023 ~ Page Phrases: Dentist Irvine CA ~