Invoice Dentist in United Kingdom Birmingham –Free Word Template Download with AI
123 Colmore Row, Birmingham, B3 2AP, United Kingdom
Tel: +44 (0)121 456 7890
Email: [email protected]
GDC Registration: 123456
Company No: 12345678 | VAT No: GB 123 4567 89
Invoice Number: INV-2024-0892
Date Issued: 15th January 2024
Due Date: 15th February 2024
Payment Terms: Net 30 Days
Bill To:
Patient Name: Mr. James Thompson
Address: 45 Edgbaston Park Road
Birmingham, B15 2RS
United Kingdom
NHS Number: 485 777 222 111
Date of Birth: 12/05/1985
Phone: +44 (0)7700 900123
Email: [email protected]
| Ref | Description of Dental Services | Date of Service | Unit Price (£) | Amount (£) |
|---|---|---|---|---|
| 1 |
Comprehensive Dental Examination Full oral health assessment including periodontal charting, oral cancer screening, and radiographic examination (OPG). Conducted at our Birmingham clinic in accordance with UK dental standards. |
10/01/2024 | 85.00 | 85.00 |
| 2 |
Professional Dental Hygiene Treatment Ultrasonic scaling and hand instrumentation to remove calculus and plaque deposits. Includes polishing and fluoride application. Essential for maintaining optimal oral health in the Birmingham area. |
10/01/2024 | 120.00 | 120.00 |
| 3 |
Composite Resin Filling (Upper Right First Molar) Removal of dental caries and restoration with tooth-coloured composite material. Procedure performed under local anaesthesia following UK dental regulations. |
17/01/2024 | 150.00 | 150.00 |
| 4 |
Root Canal Treatment (Lower Left Second Premolar) - First Visit Endodontic therapy including access preparation, canal negotiation, cleaning, shaping, and temporary dressing. Part of comprehensive dental care provided in Birmingham, United Kingdom. |
24/01/2024 | 275.00 | 275.00 |
| 5 |
Extraction of Upper Left Third Molar (Wisdom Tooth) Surgical removal of impacted wisdom tooth under local anaesthesia. Includes pre-operative assessment and post-operative care instructions. |
31/01/2024 | 220.00 | 220.00 |
| 6 |
Prescription Medication Amoxicillin 500mg (28 tablets) and Ibuprofen 400mg (20 tablets) prescribed following dental procedures. Dispensed at our Birmingham dental practice. |
31/01/2024 | 18.50 | 18.50 |
| 7 |
Dental X-Rays (Bitewing Series) Digital radiographic imaging for diagnostic purposes. Low-radiation digital technology used in compliance with UK radiation protection regulations. |
10/01/2024 | 45.00 | 45.00 |
| 8 |
Follow-up Consultation Post-treatment review appointment to assess healing progress and discuss further dental care recommendations. Conducted at our Birmingham, United Kingdom clinic. |
07/02/2024 | 55.00 | 55.00 |
Payment Instructions
Please make payment within 30 days of the invoice date to avoid late payment charges.
Bank Transfer (Recommended):
Bank Name: Barclays Bank PLC
Account Name: Birmingham Dental Care Centre Ltd
Sort Code: 20-00-00
Account Number: 12345678
Reference: INV-2024-0892
Alternative Payment Methods:
We accept payments by debit/credit card (Visa, Mastercard, Amex) in person at our Birmingham clinic or via our secure online payment portal at www.birminghamdentalcare.co.uk/pay
Insurance Claims:
If you have private dental insurance, please submit this invoice to your provider. We can provide additional documentation if required by your insurance company.
Important Notes:
1. This invoice is issued in accordance with UK dental practice regulations and HMRC requirements.
2. All dental treatments were performed by qualified dentists registered with the General Dental Council (GDC) of the United Kingdom.
3. Our Birmingham clinic operates under strict infection control protocols meeting UK Health Security Agency standards.
4. If you have any queries regarding this invoice, please contact our accounts department at [email protected] or call +44 (0)121 456 7890.
5. Late payments may incur interest charges at 4% above the Bank of England base rate.
6. Please retain this invoice for your records and for any insurance claims.
7. Your next recommended dental check-up is due in 6 months. We encourage regular dental visits to maintain optimal oral health.
8. Birmingham Dental Care Centre is committed to providing high-quality dental services to patients across Birmingham and the West Midlands region of the United Kingdom.
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