Dental Plan - American Dental Offices NEW DENTAL BENEFITS FROM AMERICAN DENTAL OFFICES A PROGRAM DESIGNED ESPECIALLY FOR NEW YORK WOMEN IN FILM & TELEVISION AND THEIR FAMILIES (GROUP #50270) American Dental Offices is pleased to announce that NYWIFT has made arrangements with our company to offer a dental plan for their membership and their families. This dental program is valid at any of the 10 locations of the American Dental Offices (see list below) American Dental Offices entitles you to a special discounted fee schedule that is approximately 50% below NY dentists prevailing fees. In addition, your new membership in this program entitles you to an initial dental examination and oral cancer screening at no charge. Back-to-school child dental assessment and certificate notes will be provided at no cost. The 10 American Dental Offices are conveniently located throughout the five boroughs, Long Island and Westchester This is the largest private dental group practice in NY. They have 300 dentists, specialists, and paraprofessionals to service our membership. The average age of the dentists is 55 and they speak many languages. They have treated over 1 million NY patients in the past 50 years. Your plan includes: No paperwork No pre-existing conditions or exclusions 24 hour emergency dentist Evening and weekend hours 0% financing plan for major work Use of all 10 centers (member may use one office and family members may choose another) Efficient appointment system Electronic private records Our own dental laboratory Your plan will coordinate coverage with any other dental plan that you may have. To make an appointment, call one of the American Dental Offices and indicate that you are a member of NYWIFT Group #50270. For good health we encourage all members to visit the dentist every 6 months for their dental and oral cancer check-up. Sincerely, Phil Hirschhorn, DDS Dr. Phil Hirschhorn ADO Dental Director DISCOUNTED FEE SCHEDULE DENTAL PROCEDURE PATIENT FEE *PREVAILING FEES OF NY DENTISTS PREVENTIVE DENTAL CARE: Examination (initial) NO CHARGE $102.00 X-Rays –Full Series $58.00 $170.00 Cleaning-Prophylaxis $58.00 $135.00 Consultation $58.00 $150.00 Emergency $58.00 $141.00 Sealants (per tooth) $.00 $ 78.00 CORRECTIVE DENTAL SERVICES: Fillings 1 Surface Silver/White $63.00/$67.00 $200.00/$200.00 2 Surfaces Silver/White $97.00/$100.00 $250.00/$265.00 3 surfaces Silver/White $121.00/$124.00 $300.00/$307.00 ORAL SURGERY (Local Anesthesia Only) Surgical Extraction $110.00 $415.00 Soft Tissue Impaction $201.00 $450.00 Partial Bony Impaction $245.00 $600.00 Full Bony Impaction $345.00 $650.00 ROOT CANAL THERAPY 1 Canal (Anterior) $3.00 $975.00 2 Canals (Bicuspid) $389.00 $1,075.00 3 Canals (Molar) $9.00 $1,325.00 PERIODONTICS Gingivectomy (Per Quadrant) $155.00 $695.00 Osseous Surgery (Per Quadrant) $690.00 $1,200.00 Perio Scaling/Root Planing $ 67.00 $250.00 (Per Quadrant) REMOVABLE PROSTHETICS AND REPAIRS Full Upper/Lower Denture $7.00 $1,800.00 Partial Upper/Lower Denture(Cast) $7.00 $1,800.00 Repair Body of Denture $100.00 $200.00 Repair Tooth of Denture $ 67.00 $173.00 Denture Reline $267.00 $500.00 CROWN AND BRIDGE Porcelain Fused to Metal Crown (Individual) Abutment/Pontic (Per Crown) $667.00 $1,400.00 ORTHODONTICS (BRACES) Insertion of Bands and/or Appliances $1,120.00 $2,000.00 Monthly Adjustment Active & Passive $120.00 $230.00 (per month) COSMETIC DENTISTRY Teeth Whitening Pens $ 19.95 $60.00 Full Mouth In Office Teeth Whitening $259.00 $1,200.00 *2006 prevailing national fee schedule 70th percentile AMERICAN DENTAL OFFICES MANHATTAN STATEN ISLAND 241 W. 30th Street 1659 Richmond Avenue (Between 7th & 8th Ave) Corner of Victory Blvd. 917-351-0200 718-983-6300 BROOKLYN NASSAU (HICKSVILLE} 1212 Kings Highway 35 Broadway Between E.12th & E. 13th Streets 1 Block North of L.I.R.R. 718-376-6700 516-433-1800 BROOKLYN NASSAU (HEMPSTEAD) 434 Albee Square West 760 Fulton Avenue Between Fulton & Willoughby Sts 2 Blocks West of Hofstra Univ. 718-858-9211 516-481-9700 BRONX SUFFOLK (COMMACK) 2535 Grand Concourse 6180 Jericho Turnpike Off Fordham Road Btwn. Commack & Larkfield 718-365-4900 631-499-0040 QUEENS (ELMHURST) WESTCHESTER(WHITE PLAINS) 87-10 Grand Avenue 200 Hamilton Avenue At Queens Boulevard White Plains Mall 718-429-8300 914-949-6800Last updated: Feb. 22, 2011