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MyDental Membership Plan

No Insurance? We’ve got you covered with our membership program. Get access to all of your preventive/ maintenance dental care for one low annual fee. Our membership plan also gives you 10-25% discount on all other dental treatment!

Effective: 7-1-2026

** This Dental Membership Plan is not dental insurance—it is a dental maintenance program for prepaid dental services offered only at MyDental in Lutz, FL. It does not cover procedures performed outside our practice. If periodontal disease or gingivitis is present, additional treatment will be necessary before your cleaning, and a periodontal maintenance plan may be available for those who qualify.

Annual enrollment fee is non-refundable and non-transferable; no rollover benefits. Patient fees are due in full at the time of service including no-show/cancellation fee (for less than 48 hours’ notice).

Dental Codes: D1110, D1120, D0150, D0120, D0272, D0274, D0330, D0140, D0220, D1208, D4910

BASIC ADULT WELLNESS PLAN

$175/Year

ADULT WELLNESS PLAN

$350/Year

Child Wellness Plan (12 & under)

$300 per year

Perio (Gum Disease) Maintenance Plan

$1000/Year

How Do I sign up for MyDental Membership Plan?

Existing patients: just ask us at your next visit.

New patients: schedule your initial evaluation, and Dr. Shurova will recommend the plan that best fits your needs.

JOIN OUR MEMBERSHIP TODAY

Please, provide your details in the form to the right to proceed with booking. Let us know which membership you are interested in.

***I understand the information disclosed in this form may be subject to re- disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.