552 Broadway, Suite 505
New York, New York 10012

Online Registration

We offer our patients an online registration system that allows them to provide their medical history and fill in their other new patient paperwork from home, rather than needing to arrive early to their first appointments. Please take the time to complete these forms prior to your first visit. Then when you arrive, you can just to check in with our receptionist and get started.


Under federal law, the confidentiality of your personal information and medical history is fully protected. The law that protects your health information and restricts how that information can be used is called the Health Insurance Portability and Accountability Act (HIPAA). Your responses to these forms are securely transmitted to our staff and nowhere else. This information is only used to ensure we can provide you with the care that improves your dental and overall health. 


Your privacy is very important to us. We take great care to comply with every HIPAA provision so that our patients can feel comfortable sharing their information with us. 


Of course, if you have any questions about these forms, please call us at (212) 878-7646   and we will be happy to help you. 

$150 NEW PATIENT OFFER

Consists Of Comprehensive Dental Exam, X-rays, Cleaning, & Custom Treatment Plan.

NP Offer Online Registration page form

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