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)

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

    LINE初診予約 初診WEB予約 再診WEB予約 03-6230-9575
    TEL:03-6230-9575
    トップに戻る