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.

Milpitas Office Hours:

Monday - Saturday
Alternating Sundays 


Fremont Office Hours:

Monday - Friday 
Alternating Saturdays and Sundays 

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

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

Which office location(s) would you prefer for your appointment?

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.):

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


View More

Office Locations

  • Milpitas
  • 995 Montague Expy #110
  • Milpitas, CA
  • 95035-6827
  • Map & Directions
  • Call: (408) 946-0902
  • Fremont
  • 1895 Mowry Ave, Suite 101C
  • Fremont, CA
  • 94538
  • Map & Directions
  • Call: (510) 793-7938