At J Street Dental Group
We have always advocated for your oral wellness and now have a better way to guide your overall dental care.
Our Wellness Membership Program allows you to choose the plan that’s best for you and your family.
Your membership plan is between our practice and you. You unfortunately cannot transfer it to another dentist.
Please call our office at the number listed below and we would be happy to set up an appointment for you.
Just login to our simple Member Portal and click “Billing” to update any information.
We accept credit and debit cards including Visa, Discover, American Express, and Mastercard.
Yes! You can easily add dependents to your membership account.
If you are a patient at our practice and do not have dental insurance, a membership plan is a perfect fit for you. Plans include preventive care and discounts on other procedures.
Our Practice
Plan: Perio
Effective Dates: 9/24/2023 – 9/24/2023
Renewal Date: 9/24/2024
Renewal: Annual
Price: $720 / year or $60 / month
Annual Value: $1290 (Save $570 compared to our standard fees)
Description | CDT Code | Qty/Yr | Value | |
---|---|---|---|---|
Periodontal Maintenance | D4910 | 3 | $576 | |
Periodic Oral Evaluation - Established Patient | D0120 | 2 | $144 | |
FMX | Varies | 1 | $199 | |
Emergency Exam- Problem Focused | D0140 | 1 | $182 | |
Topical Application Of Fluoride Varnish | D1206 | 2 | $189 | |
Total | $1290 |
The following highlights the discounts provided for each dental procedure category as part of this membership plan:
Procedure Category | Discount | |
---|---|---|
Diagnostic | 20% | |
Preventive | 20% | |
Restorative | 20% | |
Endodontics | 20% | |
Prosthodontics Removable | 20% | |
Maxillofacial Prosthetics | 20% | |
Implant Services | 20% | |
Prosthodontics Fixed | 20% | |
Oral And Maxillofacial Surgery | 20% | |
Adjunctive General Services | 20% | |
Orthodontics | 10% |
This Dental Services Membership Agreement (the “Agreement”) is entered into on the Commencement Date (as defined below) by and between Practice (as defined in Exhibit A), and the Patient as listed below; and with the Practice and the Patient also each referenced herein as a “Party” and collectively as the “Parties”.
WHEREAS, the Practice is a subscriber to TruBlu Plan For Health, LLC Oral Wellness Membership Program software as a service platform (“TruBlu Software”)
WHEREAS, the Practice utilizing the TruBlu Software has created specific oral wellness membership programs to offer its patients (“Programs”);
WHEREAS, the Patient desires to participate in one of the Programs and engage the Practice to provide dental services for the Patient under the terms of this Agreement;
WHEREAS, the Patient has selected the Program that includes the dental services and/or benefits which he/she will be provided by the Practice (the “Dental Services”) from the Programs offered in the Practice’s instance of the TruBlu Software Platform included in this online enrollment process;
WHEREAS, based on the Patient’s Program selection(s) the TruBlu Software has calculated the Membership Fee (as defined below), and the Patient has completed the payment requirements as required through the secure portal on this website; and
WHEREAS, the Patient desires to enter into this Agreement as the terms and conditions under which the Dental Services will be provided by the Practice through the Program;
The Practice has established certain rules as its standard operating procedures (e.g.; cancellation and rescheduling of appointments; timing, and method of payment for any treatments/services not included in the Dental Services; emergency protocols; and COVID-19 infection control measures). These procedures are included on this website, and a paper copy of them will be provide to the Patient upon his/her first appointment. The Patient must comply with them as a condition of continued enrollment in the Program.
The various treatments\services which the Practice provides through the Program, as listed in the menu, may be altered, changed, added - to, subtracted- from, or deleted at any time, including but not limited to, at the time of any renewal of this Agreement, without prior notice to the Patient.
If during the Enrollment Period the Patient requests that the Practice provide any treatments/services which are not include in the Dental Services, and the Practice does provide them, they will be charged according to its usual, customary, and reasonable fee schedule then in effect.
Dental Services which are begun but are not completed as of the Termination Date will be continued under the Program after the Termination Date; but only if the Patient renews this Agreement for another Enrollment Period. If the Patient does not renew, then the completion of these Dental Services will be according to the Practice’s usual, customary, and reasonable fee schedule then in effect.
Dental Services which the Patient does not utilize by the Termination Date cannot be carried over with any renewal of this Agreement for a successor Membership Period. The Patient will not receive a refund of any portion of the Membership Fee for any Dental Services which the Patient does not utilize prior to the Termination Date.
I have read, understand, and knowingly agree to, and will comply with, all the terms and conditions of this Agreement. I acknowledge that my participation in the Program is strictly voluntary.
Plan: Adult Complete
Effective Dates: 9/24/2023 – 9/24/2023
Renewal Date: 9/24/2024
Renewal: Annual
Price: $492 / year or $41 / month
Annual Value: $951 (Save $459 compared to our standard fees)
Description | CDT Code | Qty/Yr | Value | |
---|---|---|---|---|
Prophylaxis - Adult | D1110 | 2 | $300 | |
Periodic Oral Evaluation - Established Patient | D0120 | 2 | $144 | |
FMX | Varies | 1 | $199 | |
Emergency Exam- Problem Focused | Varies | 1 | $182 | |
Topical Application Of Fluoride Varnish | D1206 | 2 | $126 | |
Total | $951 |
The following highlights the discounts provided for each dental procedure category as part of this membership plan:
Procedure Category | Discount | |
---|---|---|
Diagnostic | 20% | |
Preventive | 20% | |
Restorative | 20% | |
Endodontics | 20% | |
Prosthodontics Removable | 20% | |
Maxillofacial Prosthetics | 20% | |
Implant Services | 20% | |
Prosthodontics Fixed | 20% | |
Oral And Maxillofacial Surgery | 20% | |
Adjunctive General Services | 20% | |
Orthodontics | 10% |
This Dental Services Membership Agreement (the “Agreement”) is entered into on the Commencement Date (as defined below) by and between Practice (as defined in Exhibit A), and the Patient as listed below; and with the Practice and the Patient also each referenced herein as a “Party” and collectively as the “Parties”.
WHEREAS, the Practice is a subscriber to TruBlu Plan For Health, LLC Oral Wellness Membership Program software as a service platform (“TruBlu Software”)
WHEREAS, the Practice utilizing the TruBlu Software has created specific oral wellness membership programs to offer its patients (“Programs”);
WHEREAS, the Patient desires to participate in one of the Programs and engage the Practice to provide dental services for the Patient under the terms of this Agreement;
WHEREAS, the Patient has selected the Program that includes the dental services and/or benefits which he/she will be provided by the Practice (the “Dental Services”) from the Programs offered in the Practice’s instance of the TruBlu Software Platform included in this online enrollment process;
WHEREAS, based on the Patient’s Program selection(s) the TruBlu Software has calculated the Membership Fee (as defined below), and the Patient has completed the payment requirements as required through the secure portal on this website; and
WHEREAS, the Patient desires to enter into this Agreement as the terms and conditions under which the Dental Services will be provided by the Practice through the Program;
The Practice has established certain rules as its standard operating procedures (e.g.; cancellation and rescheduling of appointments; timing, and method of payment for any treatments/services not included in the Dental Services; emergency protocols; and COVID-19 infection control measures). These procedures are included on this website, and a paper copy of them will be provide to the Patient upon his/her first appointment. The Patient must comply with them as a condition of continued enrollment in the Program.
The various treatments\services which the Practice provides through the Program, as listed in the menu, may be altered, changed, added - to, subtracted- from, or deleted at any time, including but not limited to, at the time of any renewal of this Agreement, without prior notice to the Patient.
If during the Enrollment Period the Patient requests that the Practice provide any treatments/services which are not include in the Dental Services, and the Practice does provide them, they will be charged according to its usual, customary, and reasonable fee schedule then in effect.
Dental Services which are begun but are not completed as of the Termination Date will be continued under the Program after the Termination Date; but only if the Patient renews this Agreement for another Enrollment Period. If the Patient does not renew, then the completion of these Dental Services will be according to the Practice’s usual, customary, and reasonable fee schedule then in effect.
Dental Services which the Patient does not utilize by the Termination Date cannot be carried over with any renewal of this Agreement for a successor Membership Period. The Patient will not receive a refund of any portion of the Membership Fee for any Dental Services which the Patient does not utilize prior to the Termination Date.
I have read, understand, and knowingly agree to, and will comply with, all the terms and conditions of this Agreement. I acknowledge that my participation in the Program is strictly voluntary.
Plan: Child Complete
Effective Dates: 9/24/2023 – 9/24/2023
Renewal Date: 9/24/2024
Renewal: Annual
Price: $396 / year or $33 / month
Annual Value: $817 (Save $421 compared to our standard fees)
Description | CDT Code | Qty/Yr | Value | |
---|---|---|---|---|
Prophylaxis - Child | D1120 | 2 | $272 | |
Periodic Oral Evaluation - Established Patient | D0120 | 2 | $144 | |
Emergency Exam- Problem Focused | Varies | 1 | $182 | |
Bitewings - Radiographic Images | Varies | 1 | $93 | |
Topical Application Of Fluoride Varnish | D1206 | 2 | $126 | |
Total | $817 |
The following highlights the discounts provided for each dental procedure category as part of this membership plan:
Procedure Category | Discount | |
---|---|---|
Diagnostic | 20% | |
Preventive | 20% | |
Restorative | 20% | |
Endodontics | 20% | |
Prosthodontics Removable | 20% | |
Maxillofacial Prosthetics | 20% | |
Implant Services | 20% | |
Prosthodontics Fixed | 20% | |
Oral And Maxillofacial Surgery | 20% | |
Adjunctive General Services | 20% | |
Orthodontics | 10% |
This Dental Services Membership Agreement (the “Agreement”) is entered into on the Commencement Date (as defined below) by and between Practice (as defined in Exhibit A), and the Patient as listed below; and with the Practice and the Patient also each referenced herein as a “Party” and collectively as the “Parties”.
WHEREAS, the Practice is a subscriber to TruBlu Plan For Health, LLC Oral Wellness Membership Program software as a service platform (“TruBlu Software”)
WHEREAS, the Practice utilizing the TruBlu Software has created specific oral wellness membership programs to offer its patients (“Programs”);
WHEREAS, the Patient desires to participate in one of the Programs and engage the Practice to provide dental services for the Patient under the terms of this Agreement;
WHEREAS, the Patient has selected the Program that includes the dental services and/or benefits which he/she will be provided by the Practice (the “Dental Services”) from the Programs offered in the Practice’s instance of the TruBlu Software Platform included in this online enrollment process;
WHEREAS, based on the Patient’s Program selection(s) the TruBlu Software has calculated the Membership Fee (as defined below), and the Patient has completed the payment requirements as required through the secure portal on this website; and
WHEREAS, the Patient desires to enter into this Agreement as the terms and conditions under which the Dental Services will be provided by the Practice through the Program;
The Practice has established certain rules as its standard operating procedures (e.g.; cancellation and rescheduling of appointments; timing, and method of payment for any treatments/services not included in the Dental Services; emergency protocols; and COVID-19 infection control measures). These procedures are included on this website, and a paper copy of them will be provide to the Patient upon his/her first appointment. The Patient must comply with them as a condition of continued enrollment in the Program.
The various treatments\services which the Practice provides through the Program, as listed in the menu, may be altered, changed, added - to, subtracted- from, or deleted at any time, including but not limited to, at the time of any renewal of this Agreement, without prior notice to the Patient.
If during the Enrollment Period the Patient requests that the Practice provide any treatments/services which are not include in the Dental Services, and the Practice does provide them, they will be charged according to its usual, customary, and reasonable fee schedule then in effect.
Dental Services which are begun but are not completed as of the Termination Date will be continued under the Program after the Termination Date; but only if the Patient renews this Agreement for another Enrollment Period. If the Patient does not renew, then the completion of these Dental Services will be according to the Practice’s usual, customary, and reasonable fee schedule then in effect.
Dental Services which the Patient does not utilize by the Termination Date cannot be carried over with any renewal of this Agreement for a successor Membership Period. The Patient will not receive a refund of any portion of the Membership Fee for any Dental Services which the Patient does not utilize prior to the Termination Date.
I have read, understand, and knowingly agree to, and will comply with, all the terms and conditions of this Agreement. I acknowledge that my participation in the Program is strictly voluntary.
9/24/2024
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American (Not Hispanic or Latino)
A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Two or More Races (Not Hispanic or Latino)
Persons who identify with two or more race/ethnic categories named above.
J Street Dental Group is committed to respecting your online privacy and recognizes your need for appropriate protection and management of any personally identifiable information (“Personal Information”) you share with us.
J Street Dental Group is a “data controller”. This means that we are responsible for deciding how we hold and use personal information about you. This privacy notice makes you aware of how and why your personal data will be used, namely for the purposes of the J Street Dental Group employment recruitment process, and how long it will usually be retained.
Data protection principles
We will comply with data protection law and principles, which means that your data will be:
The kind of information we hold about you
In connection with your application for work with us, we will collect, store, and use the following categories of personal information about you:
How is your personal information collected?
We collect personal information about candidates from the following sources:
How we will use information about you?
We will use the personal information we collect about you to:
Having received your CV, cover letter, and/or your application form, we will then process that information to decide whether you meet the basic requirements to be screened by our in-house recruitment team for the role. If you do, we will decide whether your application is strong enough to invite you for an interview, be it by telephone, in person, or by other electronic means. If we decide to engage you for an interview, we will use the information you provide to us at the interview to decide whether to offer you the role. If we decide to offer you the role, we will then take up references before confirming your appointment.
If you fail to provide personal information
If you fail to provide information when requested, which is necessary for us to consider your application (such as evidence of qualifications or work history), we will not be able to process your application successfully and we will not be able to take your application further.
Automated decision-making
You will not be subject to decisions that will have a significant impact on you based solely on automated decision-making.
Data sharing With third parties
Data security
We have put in place appropriate security measures to prevent your personal information from being accidentally lost, used, or accessed in an unauthorized way, altered, or disclosed. In addition, we limit access to your personal information to those employees, agents, contractors, and other third parties who have a business need-to-know. They will only process your personal information on our instructions and they are subject to a duty of confidentiality.
We have put in place procedures to deal with any suspected data security breach and will notify you and any applicable regulator of a suspected breach where we are legally required to do so.
Data retention (how long will you use my information for)
Rights of access, correction, erasure, and restriction
Under certain circumstances, by law, you have the right to:
Right to withdraw consent
When you applied for this role, you provided consent to us processing your personal information for the purposes of the recruitment exercise. You have the right to withdraw your consent for processing for that purpose at any time.
To withdraw your consent, please contact the Recruitment Manager. Once we have received notification that you have withdrawn your consent, we will no longer process your application, and, subject to our policies, we will dispose of your personal data securely.
Data protection officer
We have appointed a data protection officer (DPO) to oversee compliance with this privacy notice. If you have any questions about this privacy notice or how we handle your personal information, please contact the DPO by email, at info@jstreetdentalgroup.com.