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Contact 21st Century Dental Centre

Call or email us to schedule a visit or inquire about our services. To learn more about 21st Century Dental Centre and our services — which include Invisalign, oral sedation, and family dentistry — or to schedule an appointment, please fill out our contact form or call us at 604-543-2600.

Contact Us

21st Century Dental Centre

139-12101 72nd Avenue

Surrey, British Columbia V3W 2M1

Phone: 604-543-2600
Fax: 604-543-2603
Email: 21dental@shawbiz.ca

Office Hours

Monday 11:00 AM - 07:00 PM

Tuesday 09:00 AM - 05:00 PM

Wednesday 09:00 AM - 05:00 PM

Thursday 11:00 AM - 07:00 PM

Friday Closed

Saturday 09:00 AM - 05:00 PM

Sunday Closed

Note: We are open two Saturdays per month. Please call to schedule an appointment!

Send Us a Message

Feel free to send us your questions and we’ll get back to you as soon as possible.

New Patient Form

We are accepting new patients. Fill the new patient form below and we’ll get back to you shortly.

Patient Information

Mr.
Mrs.
Ms.
Miss.
Child

Name:

Male
Female

Whom may we thank for referring you to us?

Internet
Advertising
Walk-in

Insurance Information

Additional Insurance Information

Dental History

Yes
No

Medical History

Rheumatic fever
Stroke
AIDS
Psychiatric care
Heart murmur
High blood pressure
HIV positive
Epilepsy
Congenital heart condition
Lung/Breathing problems
Venereal disease
Thyroid disease
Heart attack
Tuberculosis (TB)
Diabetes
Cortisone/Steroid therapy
Heart surgery
Kidney problem
Hemophilia
Asthma
Pacemaker/Artificial valves
Liver disease
Anemia
Stomach ulcer
Angina
Hepatitis/Jaundice
Cancer
Joint replacement

Authorization and Release

To the best of my knowledge, the above information is complete and correct. I understand that it is my responsibility to inform my doctor if I, or my minor child, ever have a change in health. I also understand it is my responsibility to inform the office of any changes to my contact information or any changes in my dental insurance. It has been explained to me that although the staff at Dr. Parveen Atwal’s office will bill my insurance company directly when possible, any balances not paid by my insurance are my responsibility. I also consent to my personal physician being contacted if necessary.

Download and Print

Patient Update Form

Mr.
Mrs.
Ms.
Miss.
Child
Male
Female

Would you like appointment reminders sent to your phone by text or email?

Rheumatic fever
Stroke
AIDS
Psychiatric care
Heart murmur
High blood pressure
HIV positive
Epilepsy
Congenital heart condition
Lung/Breathing problems
Venereal disease
Thyroid disease
Heart attack
Tuberculosis (TB)
Diabetes
Cortisone/Steroid therapy
Heart surgery
Kidney problem
Hemophilia
Asthma
Pacemaker/Artificial valves
Liver disease
Anemia
Stomach ulcer
Angina
Hepatitis/Jaundice
Cancer
Joint replacement

Authorization and Release

To the best of my knowledge, the above information is complete and correct. I understand that it is my responsibility to inform my doctor if I, or my minor child, ever have a change in health.

I also understand it is my responsibility to inform the office of any changes to my contact information or any changes in my dental insurance. It has been explained to me that although the staff at 21st Century Dental Centre will bill my insurance company directly when possible, any balances not paid by my insurance are my responsibility.

I also consent to my personal physician being contacted if necessary.

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COVID-19 Policy 

Our Safety Protocols

At 21st Century Dental Centre, we have changed some of our office protocols to help keep everyone safe.

  • * Upon arrival during your appointment, you will be asked to read and sign a COVID-19 screening/waiver.
  • * We ask that you please not arrive more than 10 minutes prior to your scheduled appointment time.
  • * Once you reach the office, you will be asked to sanitize your hands with the dispenser located nearest the front entrance.
  • * Please ensure you wear a mask. If you have forgotten one, we can supply you with one.
  • * We have installed a plexiglass barrier at the front desk
  • * There are 4 air purifiers located in the office.
  • * You will be temperature checked prior to entering the clinical area for treatment.
  • * Increased sanitization of the reception area/waiting room and washroom.
  • * Our team members are screened every morning prior to their shift.
  • * Staff PPE has been increased during clinical appointments, and masks are mandatory throughout the day.
  • * Contactless payment.

COVID-19 Waiver 

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Directions to our Surrey dental practice.

Cancellation Policy and Insurance Policies

Cancellation Policy

We have reserved your dental appointment especially for you. Please provide us with two business days' notice to cancel or reschedule this appointment to avoid a fee. Please note, we are closed every Friday.

Insurance Policies

We happily accept most insurance and direct bills. Please note that if there are fees not covered by insurance, you are responsible for this payment. (For example, if your insurance is 80%, you will be liable to pay the remaining 20%.)

 

It is possible that you may be referred to a specialist or have used your benefits at another office. Please notify our administrators if this is the case for us to help you keep track of the insurance limits used in the year. 

 

Predeterminations or authorizations: most insurance companies will not send a copy to the dental office due to the Privacy Act. Please forward these to the dental office at least one week before your dental appointment for the administrators to accurately quote your costs. 

Contact Us

Address

21st Century Dental Centre

139-12101 72nd Avenue

Surrey, British Columbia V3W 2M1

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Office Hours 

Monday 11:00 AM - 07:00 PM

Tuesday 09:00 AM - 05:00 PM

Wednesday 09:00 AM - 05:00 PM

Thursday 11:00 AM - 07:00 PM

Friday Closed

Saturday 09:00 AM - 05:00 PM

Sunday Closed

* Note: We are open only two Saturdays per month. Please call to schedule an appointment!

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