Dentist Connection - Forms & Resources

Do you need to update your practice information or would you like to sign up for direct deposit? Our most commonly used forms can be found below. You can access these forms anytime, providing you with convenient access to the information you need right away.

 

General Dentist Forms

Direct Deposit Enrollment Form

W9 and Other IRS Forms

Dental Claim Form

Re-Credentialing Application

 

Facility Update Forms

New Associate Joining Practice
Adding Additional Service Office Location
Address Change Information Sheet
Closing Facility
Dentist No Longer At Facility
New Participating Facility Profile Form
TIN Change Form

 

Smiles Resources

2017 Provider Session Flyer


Additional Resources

Delta Dental Member Plan Contact Info
Delta Dental Dentist Handbook
Delta Dental National Policies

Dental Office Toolkit Guide

Delta Dental Participation Review Panel Procedures Guide

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