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Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:

Confirmation

How do you prefer to be contacted? *

  Email   Phone  

 
 

It may take a moment to submit your information. Please wait for a confirmation message.

 

Office hours

Mon–Thurs 8:00 a.m.–5:00 p.m.
Fri 7:00 a.m.–2:00 p.m.

Location

3933 N Maize Rd Suite 200
Wichita, KS 67101-9619

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Contact

Office (316) 202-9629
Fax (316) 202-0141

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Request an Appointment Online - Wichita, KS • Tiny Teeth
At Tiny Teeth Pediatric Dentistry, we make it easy to schedule your appointment online. Visit our website to access our secure form, and we'll contact you to confirm.
Tiny Teeth Pediatric Dentistry, 3933 N. Maize Road, Suite 200 Wichita, KS 67101 / (316) 202-9629 / tinyteethwichita.com / 12/6/2024 / Related Terms: Pediatric Dentist Wichita KS /