Thank You for Trusting Us with Your Referral!

Tooth Fairy Dental Care provides comprehensive pediatric dental services for children across Nevada. We’re proud to accept most insurance, including Medicaid!

We partner with providers to ensure infants, children, and teens – especially those with complex cases or special needs, receive high quality care.

Submit your referral below to get started.
Let’s improve access to care together.

Are you a Patient or Health Care Office/Doctor?*

Health Care Office/Doctor Patient
Your Info:
Your Full Name*

First Name Last Name
Your Phone*
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Your Email*
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Info for Person You are Referring:
Their Full Name *

First Name Last Name
Their Email*
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Their Phone*
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Referral Details / Information*
Doctor or Dentist Name*
Practice Name*
Practice Phone Number*
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Practice Email*
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Patient's Full name*

First Name Last Name
Patient Phone Number*
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Patient Email*
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Preferred Tooth Fairy Dental Care Location*
Reason for Referral*

Medicaid PatientIn Office General Anesthesia Routine Dental Care Requires Specialty Care Full Practice Other (please enter comments in additional details box below)
Additional Details/ Information
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