Call: (703) 370-3012

Appointment Request

Alexandria Oral Surgery, P.C is open during the following days and times: 

Monday: 8:30AM - 5:00PM
Tuesday:  8:30AM - 5:00PM
Wednesday: 8:30AM - 3:00PM
Thursday:  8:30AM - 5:00PM 
Friday 8:30AM - 3:00PM

We will attempt to schedule your visit at a time that is convenient for you. Emergency situations are bound to arise. We make every effort to make you an appointment that same day. If you need to cancel an appointment please give us at least 24 hours notice. Please inform the office prior to your visit of any pertinent medical conditions. These possible conditions include diabetes, recent surgical procedures, heart conditions, artificial valves and joints (which require premedication) and anticoagulant therapy (coumadin use).
The doctors are available for emergencies after hours and weekends at (703) 370-3012.


  • Patient Photo ID 
  • Insurance cards— medical and dental
  • X-Rays— (You may have your dentist send them to our office or e-mail them to us. If different x-rays are needed, such as a panorex, we will take them at our office.)
  • Referral form— If you have been sent by a dentist to our office, he/she will delineate your treatment plan on this referral form
  • List of all medication
  • Parent or legal guardian— Children under 18 must accompanied by parent or guardian

Please do not use this form to cancel or change an existing appointment.

*Items in bold are required.
Are you a current patient?

Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.


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Office Location

  • Alexandria
  • 4660 Kenmore Ave.
  • Suite 204
  • Alexandria, VA
  • 22304
  • Map & Directions
  • Call: (703) 370-3012