Appointment Request
The first step towards a beautiful, healthy smile
Call The Office
(801) 280-9595
Office Location
Email Us
Book An Appointment Online
The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.
Please do not use this form to cancel or change an existing appointment.
Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.
First-Time Patient?
Consultation, Exams, and More!
With a little help from you, our pediatric dentist in West Jordan, Utah, can help get your child’s treatment underway. Fill out a patient form and let Jordan Landing Pediatric Dentistry prepare for your child’s visit with Dr. Ryan Johansen.
If you have any questions about how to fill out a form, please give us a call!
Call (801) 280-9595
Patient Forms:
New Patient Form – English
New Patient Form – Spanish
Oral Surgery Form
Insurance Carriers & Plans We Accept
Aetna (PPO, DMO, DHMO- if under 7)
Ameritas/Dental Select (Gold, Platinum)
BlueCross BlueShield (Anthem, Federal, Regence, value care)
Cigna (HMO, PPO, DMO, DHMO-Need referral if over age 7)
Delta Dental (PPO, Premier)
Delta Care
DentaMax
DMBA
EMI
Equitable
GEHA
Guardian
Humana
Medicaid (Utah Medicaid, Premier Access, MCNA, CHIP)
Nevada Medicaid
MetLife
РЕНР
Planstin
Principal
Renaissance
Samara Health
Sunlife
Select Health
TDA
TriCare
UNUM
United HealthCare
United Concordia
Unicare