All new patients in our clinic will require an exam and radiographs (x-rays) to be taken* as part of the standard of care. Dental radiographs may be prescribed every 3-5 years or as needed to provide accurate and best treatment care outcomes. *A current full set of x-rays can be brought from the patient's dental office.
D1110 | Adult Prophylaxis (12 teeth or less, $10.00 discount) | $30.00 |
D4346 | Adult Prophylaxis Class II (Generalized moderate to severe gingivitis) | $35.00 |
D1120 | Child Prophylaxis (up to 12 years) | $20.00 |
D1208 | Fluoride Treatment | $7.00 |
D1206 | Fluoride Varnish | $7.00 |
D1351 | Pit and Fissure Sealant (per tooth) | $6.00 |
D4355 | Full Mouth Debridement with Prophylaxis | $35.00 |
D4341 | Scaling and Root Planing ($10 per quadrant) | $40.00 |
D4910 | Periodontal Maintenance | $35.00 |
D0150 | Comprehensive Oral Exam | $15.00 |
D0120 | Periodic Oral Exam | $10.00 |
D0210 | Complete Radiograph Survey (Child or Adult) | $30.00 |
D0330 | Panoramic Radiograph (Child or Adult) | $30.00 |
D0220 | Periapical- Single, first film | $6.00 |
D0230 | Periapical- Each additional film | $6.00 |
D0272 | Bite-wings- 2 films | $12.00 |
D0274 | Bite-wings- 4 films | $17.00 |
D0277 | Vertical Bite-wing Survey (7 films) | $20.00 |
Film Duplicating- Each survey | $15.00 |
We accept Cash, Check, Visa, Mastercard, Discover, American Express, and JCB for dental services.
The IU Northwest Dental Education Clinic does NOT provide restorative services like fillings or extractions.
