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Location

(408) 268-2550

New Patient Forms

New Patient Forms and Online Forms

Smile Dentistry offers our patient form(s) online so they can be completed it in the convenience of your own home or office. Follow these easy three steps:

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • To complete the necessary form(s), Click Here and fill in the required information.

New Dental Patient Form - Required

This lets us know the history and current state of your dental health. What questions, concerns, goals, regarding dental care can we help you with? Let us know!

Business Information

Contact


Smile Dentistry
6501 Crown Blvd. Suite 104
San Jose, CA 95120
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  • Phone: (408) 268-2550
  • Fax: (408) 268-2552
  • Email Us

Office Hours

Monday:

10:00 am-7:00 pm

Tuesday:

10:00 am-7:00 pm

Wednesday:

7:30 am-5:00 pm

Thursday:

7:30 am-5:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Newsletter

Featured Articles

Read about helpful topics

  • Your Rights and Responsibilities as a Patient

    Patient Rights You have a right to choose your own dentist and schedule an appointment in a timely manner. You have a right to know the education and training of your dentist and the dental care team. You have a right to arrange to see the dentist every time you receive dental treatment, subject to ...

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  • Crowns and Bridges

    Bridges Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.Bridges are sometimes referred ...

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  • Veneers

    Teeth that are badly stained, shaped, or crooked may be improved by a veneer placed on the surface of the affected teeth.Veneers are thin pieces of porcelain or plastic cemented over the front of your teeth to change their color or shape. Veneers are used on teeth with uneven surfaces or that are chipped, ...

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  • Invisalign®

    Invisalign's® invisible, removable, and comfortable aligners will give you the beautiful straight teeth you've always wanted. And best of all, no one can tell you're wearing them. Invisalign® is great for adults and teenagers. What is Invisalign®? Invisalign® is the invisible way to straighten your ...

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  • April 2022 Dental Newsletter

    The Importance of Preventive Care: Maintaining Good Oral Health Preventative dental care is a significant part of overall dental health, but it's often an afterthought. Our dedicated dentist sees many patients who don’t keep up with consistent preventative oral care and then must fix the problems ...

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  • Fillings

    Fillings How Teeth Are Restored After diagnosing the problem and devising a treatment plan, the next step to restore a tooth to health is to make you comfortable. We will give you a local anesthetic so that you do not feel any discomfort. After the decay is removed, the tooth is ready to receive ...

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  • Wisdom Teeth

    Wisdom Teeth Wisdom teeth, or third molars, usually appear around age 18. Eruption may be straight, crooked, or impacted. Even if these molars come in straight, they may need to be extracted due to a lack of space and an inability to keep them cleaned and maintained. Please read and view the images ...

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  • Vizilite Plus

    ViziLite® Plus oral lesion identification and marking system The newest tool in the fight against oral disease is the ViziLite Plus oral lesion identification and marking system. ViziLite Plus, from Zila Pharmaceuticals, combines the oral screening technology of ViziLite, an advanced chemiluminescent ...

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  • XDR Digital X Ray

    XDR Digital X-ray System Our practice is committed to bringing the safest and highest quality of care to our patients. The installation of our new digital X-ray system continues that commitment. The state-of-the-art XDR system enables us to provide greatly improved diagnostic capabilities to our ...

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  • Zoom Chairside

    Zoom!® Chairside Whitening System Do you want to zoom in one hour? The Zoom! In-Office Whitening System is a revolutionary tooth whitening procedure. It's safe, effective, and fast - very fast. In just over an hour, your teeth will be dramatically whiter. Zoom! Whitening is ideal for anyone looking ...

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