Drs. Kyrkos & Chhibber
Diplomates, American Board of Pediatric Dentistry
660 Dover Center Rd #17, Bay Village, OH 44140
Tel: (440) 892-5556
Below you may access our new patient forms. Please complete a packet for each new patient we will be seeing. The Privacy Health Information (PHI) form can be used after your child's first visit to our office and will be valid for 2 years. A parent or legal guardian must be present for new patient appointments. When you arrive for your family’s first appointment with us, we will collect the completed forms and a copy of your dental insurance card. If you don’t have a dental insurance card, please provide a print out from your employers HR or the insurance’s website. To submit a claim on your behalf, we will need, the insurance name, claims address, eligibility phone number, ID and group number. If your insurance does not provide an ID number, the policyholder's social security number will be necessary to bill your insurance.
We provide emergency phone consultation services after working hours and on weekends. Call us at our office (440) 892-5556