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New Patient Forms

Please print and complete the new patient forms and bring them to your dental visit, along with your ID and insurance card.

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Per our office policy, missed initial appointments will not be rescheduled.

 

We look forward to meeting you soon!

Coffee Mug of Fresh Smiles

Insurances Accepted

Our office accepts most major PPO dental insurances, as well as Medicaid for kids only (up to age 18).

Aetna
GEHA
Guardian
Principal
Delta Dental
Dental Network of America
Connection
Cigna
BlueCross BlueShield
Metlife
UnitedHealthCare
UnitedConcordia Dental

No Insurance?  No Problem.

We offer an in-office savings plan customized to provide dental care at an affordable price for our patients (adults and kids) who have no insurance.

Cost: Adult Plan- $350/year; Child Plan- $250/year​​

Annual FSD Membership includes: 

  • 20% off services (based on UCR fee schedule, limitations/ exclusions apply)

  • 2 basic cleanings

  • 2 check-up examinations

  • 2 fluoride applications 

  • 2 emergency exams

  • X-rays (recommended once per year and as needed)

Contact Us

(708) 468 - 8571

15127 73rd Ave, Unit H1
Orland Park, IL 60462

Office Hours:

Mondays

Wednesdays

Fridays                12pm – 5pm

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Saturdays

10am – 5pm

10am – 5pm

  9am – 3pm

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©Copyright 2023 Fresh Smiles Dental. All rights reserved.

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