Request and Appointment with Sundberg Center for Dentistry View and complete Sundberg Center for Dentistry's new patient forms
(503) 928-5903
511 Sw. 10th Ave. Suite 1101 Portland, OR 97205
ADA Accessibility Information
Check Out Our New Location
511 SW 10th Ave, Suite 1101
Portland, OR 97205

Request an Appointment

Please fill out the form below and we will contact you with an appointment time. Required fields are marked with asterisks (*).

Patient Information

Name: *

Phone: *

Email address: *

Have you visited our office before? *

Yes No  

What is the reason for the appointment? *

  Regular Exam / Cleaning
  Specific Concern / Procedure

What concerns, if any, would you like to speak to the doctor about:



How do you prefer to be contacted? *

  Email   Phone  


It may take a moment to submit your information. Please wait for a confirmation message.


Request Your Viseh Sundberg, DDS
Download new patient paperwork.
Refer a friend to Sundberg Center for Dentistry
Viseh Sundberg, DDS

Sundberg Center for Dentistry

(503) 928-5903
Portland OR 97205
Sundberg Center for Dentistry | | (503) 928-5903
222 NW 10th Ave, Portland, OR 97209
Copyright © 2016-2018 Sundberg Center for Dentistry and WEO MEDIA. All rights reserved.  Sitemap | Links