DENNIS P. DONE, DMD, PC   |   128 EAST JEFFERSON AVE. KIRKWOOD MO, 63122   |   314.965.7220
Dental InsuranceOffice PoliciesPatient Forms

Office Information

Dental Insurance

Our office accepts most dental insurance plans. We are preferred providers in the Advantica, Aetna, Delta Dental and United Health Care networks. Even if we are not "in network" in your particular plan, you may still have some coverage with our office. Our fees are such that many insurance plans provide the same benefit as if we were an "in network" provider.

When you call our office for an appointment, please have your dental insurance information ready. Your insurance carrier should have provided you with an identification card. You may also need to provide us with the date of birth and/or social security number of the policyholder. We can then verify your coverage with your insurance carrier, and also give you an idea of the level of coverage your insurance company will provide. Without verifying your insurance information prior to your appointment, you may be responsible for the charges incurred at your visit.

At your first visit it is very important for you to have your dental insurance card with you, as well as a photo ID. This enables us to verify your identity and prevent fraudulent use of your dental insurance

Office Policies

Our office strives to provide quality service to all our patients. We see patients by appointment only and we schedule our appointments with the right amount of time to provide high quality care. Therefore, we ask all our patients to be as considerate of our time as we are of their time. We try to confirm our appointments 48 hours before they are scheduled, and if a patient needs to change or cancel an appointment, we appreciate at least the same 48 hours notice. A charge of $50 may be made for broken appointments. Patients who break or cancel appointments with inadequate notice on a regular basis may be dismissed from the practice. Furthermore, we take pride in the fact that we run on schedule over 95% of the time, and our patients routinely compliment us about this. Any patient that will be over 10 minutes late to any appointment may be rescheduled. Please call ahead to let us know if you are running late. It is not fair for patients that arrive on time to have to wait because another patient is late.

A parent or guardian must remain in the reception area while any child under 18 is being treated.

For payment, we accept cash, check, MasterCard, Visa, and Discover cards, as well as debit cards. There is a $25 service charge on all returned checks. We also work with CareCredit financing for larger treatment plans. And in some situations we will offer an "in house" financing option.

If you have dental insurance, we will gladly file the claim when the treatment is completed. We will then bill you for any balance that your insurance did not cover. Payment on the billed balance due is expected within 30 days. If your insurance carrier does not pay within 45 days, the account holder will be billed. If the insurance company does eventually pay the claim, we will then issue a prompt refund directly to you. Regardless of insurance coverage, the patient is ultimately responsible for all balances.

If you do not have insurance, payment is expected at time of service unless previous arrangements have been made.

Overdue balances may be subject to late payment penalties. Payments that are over 90 days past due are subject to referral to a collection firm; patient is responsible for all fees involved in collection on delinquent accounts.

Patient Forms

Below are the office Registration/Health History form; the Privacy Policy for our practice; and the Receipt of Privacy Policy form.

Discrimination is Against the Law

DENNIS P DONE, DMD, PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex DENNIS P DONE, DMD, PC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

If you need these services, contact Dr. Dennis Done.

If you believe that DENNIS P DONE, DMD, PC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

800-537-7697 (TDD)

Complaint forms are available at

Tomaremos acciones razonables para proporcionar servicios de asistencia lingüística gratuitos a aquellas personas cuyo lenguaje escuchemos frecuentemente en nuestro consultorio y que no hablen un inglés lo suficientemente bueno como para hablar con nosotros sobre el servicio odontológico que suministramos.


Chúng tôi sẽ thực hiện các bước cần thiết để cung cấp dịch vụ hỗ trợ ngôn ngữ miễn phí cho những người giao tiếp bằng những ngôn ngữ mà chúng tôi có thể nghe thấy tại phòng khám của mình và cho những người không có đủ trình độ tiếng Anh để thảo luận về dịch vụ chăm sóc nha khoa mà chúng tôi đang cung cấp.