Dentist Plano Appointment Request

Need an appointment with a dentist in Plano? Requesting an appointment at our Plano, TX family and cosmetic dental office is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with Dr. Timothy Icenhower today!


We accept Visa, Mastercard, Discover, and American Express, as well as debit cards and cash.


We file all insurance forms for our patients and accept insurance reimbursement.


If you have a dental emergency, we see all patients the very same day. Call our practice today at (972) 979-3539 if you have any questions. 


Print out the patient forms below and fill them out in the comfort of your own home with no rush. Just don't forget to bring them to your appointment!


Patient Registration

Medical History

HIPAA Consent

Notice of Privacy Practices #1

Notice of Privacy Practices #2

Patient Information (* denotes fields that are required)
Patient Name*
Phone Number*
Email Address
Are you a current patient?
No Yes
Best time(s) to call?
Morning Noon Afternoon Evening
Appointment Information
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments