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Appointment Request

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment. 


M 8:00AM-6:00PM |T 11:00AM-7:00PM |W By Appointments |Th 8:00AM-5:00PM |F  8:00AM-5:00PM |S By Appointments

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

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Office Location

  • Century City
  • 2080 Century Park East
  • Suite #1516
  • Century City, CA
  • 90067
  • Map & Directions
  • Call: (310) 286-3111