Temporary Reservationappointment

Schedule an Appointment

At Akasaka Hiro Dental, we provide a temporary reservation system for you to make an appointment.

Please use the contact form below and enter your desired date and time (up to three requests). We will contact you on our next working day after your submission, and confirm your reservation.

Please be advised that appointments will be confirmed only after you have received a phone call or email from us.

In case of urgency, please feel free to contact us by phone.

Make your temporal reservation here

Call us here

03-6230-9575

Working Hours

Mon, Tue, Thu, Fri/9:30 – 18:30
Sat/9:30 – 14:30

  • Closed on Wednesday, Sundays and Holidays
  • In order not to keep our patients waiting, we have made a complete reservation system. Please make a reservation in advance by phone or reservation form.
  • Please arrive ten minutes before the appointment for a smooth reception to treatment.

Temporary Reservation Form

Please fill in the following form and click the “Send” button.
This reservation is TEMPORARY.
Your Appointment will be confirmed by a phone call or Email from us.

    First timeSecond time or moreI don’t know(Mandatory)
    Check-upScalingProfessional Dental CleaningCaries TreatmentPeriodontal treatmentDenturesPediatricsOrthodonticsWisdom Tooth ExtractionCosmetic Dentistry(White Fillings or Crowns)Dental ImplantsBruxismTMD, TMJ TreatmentsOther
    ex:Bruxism treatment,Whitening etc.
    ex:Right molar is hurting for three days etc
    1.Date : yy/mm/dd,Time ex : 10:00~12:00,Afternoon etc. (Mandatory)
    2.Date : yy/mm/dd,Time ex : 10:00~12:00,Afternoon etc. (Mandatory)
    3.Date : yy/mm/dd,Time ex : 10:00~12:00,Afternoon etc. (Mandatory)
    ex:Taro Yamada (Mandatory)
    ex:03-0000-0000 (Mandatory)
    ex:sample@yamadahp.jp (Mandatory)
    ex : Chiyoda-ku,Otemachi1-1-1
    MaleFemale(Mandatory)
    Age
    ex : 32 years old、in the Fifties (Mandatory)
    記事監修医師
    西原 宗信 院長

    西原 宗信 院長

    赤坂ひろデンタル

    〒107-0052
    東京都港区赤坂2-14-31 ウィンド赤坂2F 03-6230-9575

    診療時間
    9:30~13:00 / /
    14:00~18:30 / / /

    ★9:30~14:30まで
    ※不定期に、木曜日が休診日となる場合があります。

    • 休診日:水曜日・日曜・祝日
    • 患者さまをお待たせしないため、予約制を採用しております。あらかじめ、お電話かネット予約にて予約をおとりください。なお、急患は受付可能です。
    • 受付から診療までスムーズにお進みいただけるよう、初診時は予約時間の10分前までにご来院ください。
    TEL:03-6230-9575
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