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Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • Patient Form (Child) PDF | DOC
  • Patient Form (Adult) PDF | DOC

If you’re unable to open PDF files, you can get Adobe Reader® for free.

Contact Us

Start changing your life today.

At every step of your care, you’ll know that you’re more than just a patient file. We’ll strive to provide an environment that accounts for your specific needs. It’s all just part of making a great experience with effective treatment part of every visit.

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Call (408) 226-0323

Ready for an appointment? Schedule online now.

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Call Us

(408) 226-0323
Email

taheridds@gmail.com
Map Us
704 Blossom Hill Rd #104 San Jose, CA 95123
Fill out our form below to contact our office. If you need to see a dentist today, call our office at (408) 226-0323.
Logo - Dentistry for Children & Young Adults
San Jose’s premiere pediatric and general dentistry.
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