Patient Information

Dr. Siegel and her knowledgeable, caring staff look forward to working with you to ensure your child’s experience with us is positive. Please take a moment to complete the new patient form below prior to your visit. If you have any questions prior to your visit, please call our office and a member of our Special Smiles staff would be happy to assist you.

When confirming your child’s appointment, please let us know if there are special accommodations needed. Remember to bring all insurance documents to your appointment.


For 30 years, CareCredit has been a leader in helping patients move forward with the care they want or need. The CareCredit credit card is accepted at more than 200,000 enrolled providers and select merchant locations nationwide and is designed to help you finance health, beauty and wellness needs for you and your entire family, including your pets.

To streamline your experience with Special Smiles Pediatric Dentistry, please complete our PDF forms prior to your appointment.

Accepted Insurance

As a courtesy, Special Smiles Pediatric Dentistry will file your primary insurance benefits and our staff will provide you with an estimate of any recommended treatment plan. 

Our office accepts most insurance plans and we are in network with Delta Dental (Premier), Cigna, Aetna and most Anthem plans.