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About Our Office
Meet Dr. Karim Naguib
Meet Dr. Ken Nguyen
Meet Dr. Marina Salib
Meet Dr. Robert Sharobiem
Meet Dr. Neil Tamashiro-Myamoto
Meet Dr. Farrah Yassi
Meet Our Team
Our Lancaster Office
Our Technology
Testimonials
Dental Services
Cosmetic Dentistry
Invisalign
Lumineers
Orthodontics
Porcelain Veneers
Tooth Bonding
Tooth Whitening
General Dentistry
Dental Cleanings
Dental Fillings
Emergency Dentistry
Family Dentistry
Laser Dentistry
Mouthguards
Pediatric Dentistry
Root Canal
Sedation Dentistry
Tooth Extraction
Restorative Dentistry
Dental Bridges
Dental Crowns
Dental Implants
Dentures & Partials
Inlays & Onlays
Periodontal Therapy
TMJ Treatment
Dental Implants
All-On-X
Bone Grafting
Single Tooth Implants
Multiple Dental Implants
Benefits of Dental Implants
Dental Implant Process
Dental Concerns
Bad Breath
Bleeding Gums
Crooked Teeth
Discolored Teeth
Fear of the Dentist
Headaches
Missing Teeth
For Patients
First Visit
Patient Forms
Payment & Insurance
Blog
Contact Us
Specials
Smile Gallery
Smile Reveals
About Our Office
Meet Dr. Karim Naguib
Meet Dr. Ken Nguyen
Meet Dr. Marina Salib
Meet Dr. Robert Sharobiem
Meet Dr. Neil Tamashiro-Myamoto
Meet Dr. Farrah Yassi
Meet Our Team
Our Lancaster Office
Our Technology
Testimonials
Dental Services
Cosmetic Dentistry
Invisalign
Lumineers
Orthodontics
Porcelain Veneers
Tooth Bonding
Tooth Whitening
General Dentistry
Dental Cleanings
Dental Fillings
Emergency Dentistry
Family Dentistry
Laser Dentistry
Mouthguards
Pediatric Dentistry
Root Canal
Sedation Dentistry
Tooth Extraction
Restorative Dentistry
Dental Bridges
Dental Crowns
Dental Implants
Dentures & Partials
Inlays & Onlays
Periodontal Therapy
TMJ Treatment
Dental Implants
All-On-X
Bone Grafting
Single Tooth Implants
Multiple Dental Implants
Benefits of Dental Implants
Dental Implant Process
Dental Concerns
Bad Breath
Bleeding Gums
Crooked Teeth
Discolored Teeth
Fear of the Dentist
Headaches
Missing Teeth
For Patients
First Visit
Patient Forms
Payment & Insurance
Blog
Contact Us
Specials
Smile Gallery
Smile Reveals
Lancaster
(661) 231-7157
Current Patients: (661) 948-6700
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Schedule Appointment
East Palmdale
(661) 231-7031
Current Patients: (661) 273-6565
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Schedule Appointment
West Palmdale
(661) 605-3714
Current Patients: (661) 947- 7777
Leave A Review
Schedule Appointment
About Our Office
Meet Dr. Karim Naguib
Meet Dr. Ken Nguyen
Meet Dr. Marina Salib
Meet Dr. Robert Sharobiem
Meet Dr. Neil Tamashiro-Myamoto
Meet Dr. Farrah Yassi
Meet Our Team
Our Lancaster Office
Our Technology
Testimonials
Dental Services
Cosmetic Dentistry
Invisalign
Lumineers
Orthodontics
Porcelain Veneers
Tooth Bonding
Tooth Whitening
General Dentistry
Dental Cleanings
Dental Fillings
Emergency Dentistry
Family Dentistry
Laser Dentistry
Mouthguards
Pediatric Dentistry
Root Canal
Sedation Dentistry
Tooth Extraction
Restorative Dentistry
Dental Bridges
Dental Crowns
Dental Implants
Dentures & Partials
Inlays & Onlays
Periodontal Therapy
TMJ Treatment
Dental Implants
All-On-X
Bone Grafting
Single Tooth Implants
Multiple Dental Implants
Benefits of Dental Implants
Dental Implant Process
Dental Concerns
Bad Breath
Bleeding Gums
Crooked Teeth
Discolored Teeth
Fear of the Dentist
Headaches
Missing Teeth
For Patients
First Visit
Patient Forms
Payment & Insurance
Blog
Contact Us
Specials
Smile Gallery
Smile Reveals
About Our Office
Meet Dr. Karim Naguib
Meet Dr. Ken Nguyen
Meet Dr. Marina Salib
Meet Dr. Robert Sharobiem
Meet Dr. Neil Tamashiro-Myamoto
Meet Dr. Farrah Yassi
Meet Our Team
Our Lancaster Office
Our Technology
Testimonials
Dental Services
Cosmetic Dentistry
Invisalign
Lumineers
Orthodontics
Porcelain Veneers
Tooth Bonding
Tooth Whitening
General Dentistry
Dental Cleanings
Dental Fillings
Emergency Dentistry
Family Dentistry
Laser Dentistry
Mouthguards
Pediatric Dentistry
Root Canal
Sedation Dentistry
Tooth Extraction
Restorative Dentistry
Dental Bridges
Dental Crowns
Dental Implants
Dentures & Partials
Inlays & Onlays
Periodontal Therapy
TMJ Treatment
Dental Implants
All-On-X
Bone Grafting
Single Tooth Implants
Multiple Dental Implants
Benefits of Dental Implants
Dental Implant Process
Dental Concerns
Bad Breath
Bleeding Gums
Crooked Teeth
Discolored Teeth
Fear of the Dentist
Headaches
Missing Teeth
For Patients
First Visit
Patient Forms
Payment & Insurance
Blog
Contact Us
Specials
Smile Gallery
Smile Reveals
Request a consultation
Language
Dr Naguib Form
Dr Naguib Form
What best describes your current dental condition?
Missing teeth
Cracked, loose, or failing teeth
Struggling with dentures or partials
Gum disease
Most of my teeth are in bad condition
None of the above
Where are the missing or failing teeth located?
Upper teeth
Lower teeth
Both upper and lower
Which best describes your situation?
I’m missing 1 tooth
I’m missing multiple teeth
I’m missing most or all of my teeth
I still have my teeth, but many are failing or need to be pulled
How long have you been dealing with this issue?
Less than 3 months
3–6 months
6–12 months
More than 1 year
More than 5 years
Do you currently have any dental solutions?
Dentures or partial dentures
Bridge or crowns
Dental implants
None of the above
Which of the following best describes your experience eating or chewing?
I chew mostly on one side
I experience pain while chewing
I avoid certain foods
I can eat comfortably
Has your smile or dental condition affected your confidence socially?
Yes
No
What is your primary goal for treatment?
Restore my smile/confidence
Improve chewing and comfort
Eliminate pain or infection
Replace failing teeth
Both appearance and function
What has prevented you from getting treatment sooner?
Cost
Fear/anxiety
Time/scheduling
Couldn’t find the right dentist
Still researching my options
How soon are you looking to begin treatment?
ASAP — I’m ready now
Within 1–3 months
Just researching for now
What matters most to you when choosing an implant dentist?
Affordable pricing
Monthly payment options
Flexible appointment availability
Comfortable patient experience
Experience and expertise with implants
Are you interested in monthly payment options or financing?
Yes
No, I plan to self-pay
Which best describes your estimated credit score?
740+
700–739
660–699
620–659
Under 620
I don’t know / prefer not to answer
I plan to self-pay
If financing is needed, would you have a co-signer available?
Yes
No
Not sure
Do you currently have a source of income?
Yes
No
First Name
Last Name
Phone Number
Email
Street Address
City
State
Zip Code
Submit
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