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Knox Public Health | Mount Vernon, Ohio

Dental Clinic

Details
Published: 20 October 2017

Dental cover

The Dental Clinic at the Knox County Community Health Center provides routine dental care for children and adults including:

  • Fillings
  • SealantsState of the Art Panoramic X Ray Unit thank you 07022020
  • X-Rays
  • Cleanings
  • Extractions (including Wisdom Teeth!)
  • Child Dentistry

 

We have a full-time dentist, oral surgeon,

dental assistants and dental hygienists!

 

   

Payment Policy

  • Payment is due at time of service.
  • Minimum payment for self-pay patients is $20 for Dental.
  • If patients do not have health insurance, a sliding fee schedule at 200% above federal poverty guidelines is offered to all patients who are eligible. Need help getting coverage? Visit HealthCare.gov for easy steps to get health insurance. 
  • Health Center staff can also assist patients with enrolling in health insurance or Medicaid if they qualify.
  • We accept Cigna Dental, Delta Dental, CareSource, Molina and All Ohio Medicaid Plans.
  • Patients are expected to pay the full sliding-fee-scale amount at the time of their appointment.
  • KCCHC protects its patients from surprise medical bills for services and items provided by KCCHC through a combination of:
    • compliance with requirements established under Section 330 of the Public Health Service Act and
    • provision of Good Faith Estimates as outlined in Section 27966B-6 of the Federal No Surprises Act.  

 

Knox County Community Health Center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

 

Notice of Privacy Practices - HIPAA  

Sliding Fee Scale Chart

Visit Our Health Center

 

Paperwork

*NOTICE: By signing your name electronically and submitting the form(s), you acknowledge your electronic signature has the same legal validity as your manual signature.

Intake Packets

Intake Packet: Intake Packet 

Spanish Intake Packet - Versión en Español 

Other Forms

Sliding Fee Scale: SFS Application   Versión en español - Solicitud de escala móvil de tarifas

Records Release: Release Form TO  Release Form FROM  Versión en español - Publicación de registros

Unaccompanied Minor: Parent Consent to Treat  Versión en español - Consentimiento para tratar

Sports Physical: OHSAA Pre-Participation Physical Exam Forms  *If athlete is coming unaccompanied, PARENT/GUARDIAN needs to SIGN form before appointment

Special Clinic Forms

Please bring your completed Special Clinics form(s) - Additional intake forms are NOT needed.

COVID-19 Vaccine: COVID-19 Consent Form

Flu Shot:  Flu Shot Consent Form

School Vaccines: School Immunization Clinic Consent & Demographics

 

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Public Health: prevent. promote. protect

Our Mission
Promote a healthy community through education, innovation, and equitable care.

Our Vision
Inspire and empower healthy lifestyles for generations to come.

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Contact Us

Health Department 

Hours: Monday- Friday 8:00am - 4:30pm

Phone: 740-392-2200  Fax: 740-392-9613

11660 Upper Gilchrist Road, Mount Vernon

 KnoxHealth.com 

 

Health Center

Hours: Monday - Friday, 8:00am - 4:30pm 

Phone: 740-399-8008  Fax: 740-399-8012

11660 Upper Gilchrist Road, Mount Vernon (inside KPH) - Dental Services

202 West Vine Street, Mount Vernon - Medical Services 

207 West High Street, Mount Vernon (inside Foster's Pharmacy) - Medical Services

206 South Mulberry Street, Mount Vernon - Behavioral Health Services

12 East Main Street, Danville - Behavioral Health & Medical Services

706 South Market Street, Danville - Dental Services 

 

For Health Center service during non-business hours, call 740-399-8008 and choose the "After Hours Service" option. 

For Public Health emergencies during non-business hours, call 740-397-3333 Option 1.

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