Call for free sedation or implant consultation: 402.397.7827
Text Message us now 402.740.9235 or email Dr. Starkey--

Anesthesia Surgery Center

Pain? Broken or lost teeth? Call us in AM we can usually get you in the same day. 402.397.7827

Referral  Request Form

For IV/ N20-02 Anesthesia Dentistrhy

Patient Name_________________________________________Date_________

Referring Doctor______________________________________Phone___________

Reason(s) for referral?

  • Gag reflex
  • Difficulty getting numb
  • Anxiety
  • Phobia
  • Needs both teeth and implants in one visit
  • Neurological ( Palsey, Tremors, Huntington's, Parkinsons, other)
  • Physical-e.g. neck, back, difficulty opening mouth
  • Older patient
  • Additional monitoring and IV line in place for safety precaution
  • Cardiovascular, pulmonary
  • Diabetic complications
  • Ambulatory problems
  • Other:

Treatment requests/special instructions:

Michael A. Starkey, DDS

7618 Dodge Street

Omaha, Ne 68114


Email Phone 402.926.4848 Text 402.740.9235


Call us at 402.926.4848 for your next cleaning and check up

      Master, College of Conscious Sedation American Dental Society of Anesthesiology           

The Omaha Dental





Specializing in Comprehensive Dentistry

​ With Dental Sedation that fits your needs.

The Sweet Dreams Dental Team

Michael A. Starkey, DDS And Associates​​​​

Benefits of our Sedation Dental Center
Dental Implants, bone grafting, teeth in a day, mini implants, dentures