Patient Registration

Patient Registration


You may preregister with DFW Oral & Maxillofacial Surgery by filling out our secure online patient registration form

After you have completed the form, please make sure to press the submit button at the bottom to automatically send one of our oral surgeons in Irving, Mesquite, and Ennis, Texas, your information. On your first visit with one of our Doctors, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.


2727 North O’Connor Road
Texas 75062
(972) 594-7414


2101 N Belt Line Rd
Suite B
Mesquite, TX 75150
(972) 270-6617


2200 W. Ennis Blvd,
Suite B
Ennis, TX 75119
(972) 875-7616

First Visit

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any X-rays, if applicable.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit with one of our Doctors.

A preoperative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink eight hours prior to your surgery. You will also need an adult to drive you home.

Please alert our oral and maxillofacial surgeons in Irving, Mesquite, and Ennis, Texas, if you have a medical condition that may be of concern prior to surgery (e.g., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (e.g., heart medications, aspirin, anticoagulant therapy, etc.).

Financial Policy

For your convenience, our oral surgeons in Irving, Mesquite, and Ennis, Texas, accept Visa, MasterCard, American Express and Discover. We are able to help with your financial challenges by providing other financing options, such as CareCredit and Lending Club.

Our Doctors and our team deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered. If you have questions regarding your account, please contact us. Many times, a simple telephone call will clear any misunderstandings.

Please remember that you are fully responsible for all fees charged by DFW Oral & Maxillofacial Surgery regardless of your insurance coverage.

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. If a refund is expected, please allow us 60 to 90 days for processing after your procedure.

Privacy Policy

Click here to download the pdf privacy policy