Membership Plan
Reflection Dental Membership Plan
Child Plan $365.00
Children 12 & younger
$1.00/Day Includes:
Annual fluoride up to twice in 12 months
Professional cleanings twice in 12 months
Periodic exam twice in 12 months
Oral cancer screening twice in 12 months
Digital imaging up to twice in 12 months
Emergency Exam-Once annually
15% off all other dental procedures
Teens and Adult Plan $456
Healthy Adults/Teens 13 & older
$1.25/Day Includes:
Professional cleanings twice in 12 months
-in absence of gum disease/bone loss
Annual fluoride up to twice in 12 months
Periodic exam twice in 12 months
Oral cancer screening twice in 12 months
Digital imaging up to twice in 12 months
Emergency Exam-Once annually
15% off all other dental procedures
Periodontally Involved Adults & Teens $730
with gum disease/bone loss
$2.00/Day Includes:
Professional cleanings three times in 12 months
Annual fluoride up to twice in 12 months
Periodic exam twice in 12 months
Oral cancer screening twice in 12 months
Digital imaging up to twice in 12 months
Emergency Exam-Once annually
15% off all other dental procedures
**Additional Deep Cleaning Set Fee of $995.00
to treat all four quadrants (irrigation included)
American Dental Association (ADA) CDT Coding Information:
Fluoride: D1206/D1208
Exams: D0150/D0180/D0120
Emergency: D0140/D0220/D0230/D0270/D0272
Imaging: D0350/D0330/D0210/D0220/D0230/D0272/D0274
Cleaning: D1110/D1120/D4910/D4346/D4355/D4341/D4342
Enhance your smile, health, and wellness with an exclusive 12-Month Reflection Dental Membership. Memberships start as low as $1.00 a day depending on your age and periodontal condition.
*Memberships run for 12 months. Prescheduling of annual visits are encouraged to take full advantage of procedures offered during 12-month membership. Missed or Changed Visits within 24 hours of a scheduled appointment is waived on first occurrence only.
**D4341/D4342: Represents a scaling & root planning procedure, which is essential for treating gum disease by cleaning below the gumline when bone loss, gum infection, &/or inflammation are present. A periodontal screening/evaluation which reveals periodontal disease prevents a healthy mouth cleaning from being performed due to the Standard of Care in regards to the ADA & AAP coding requirements.
*Non-Refundable Club Membership: The purchase of this 12-month membership plan is final and non-refundable. Once the member has been activated, no refunds, partial or full, will be issued for any reason, including but not limited to early cancellation, non-usage, or dissatisfaction with dental services. Annual fee is collected upon membership activation.