Join Our Network!

If you are a licensed dentist in Colorado, you are eligible to join our network. Participation means you’ll be considered an in-network provider for Delta Dental patients nationwide.

Network Options:

1. Delta Dental Premier Only (cannot see EPO or CHP+ patients)
2. Delta Dental Premier and PPO (includes EPO and CHP+)
3. Child Health Plan Plus (CHP+) Only (an otherwise non-participating dentist may join only the CHP+ network)

To join Delta Dental’s network(s) as a new dentist, select the Provider Agreement for the network you wish to join. Premier participation is required to for those who join the PPO network.

• Delta Dental Premier Participating Dentist Agreement
• Delta Dental PPO Participating Dentist Agreement
• CHP+ Participating Dentist Agreement

Once you’ve selected a network, your participating agreement(s) must be returned with the following completed forms and information:

• Participating Dentist Agreement Summary Disclosure Form
• Substitute Form W-9
• Provider Credentialing Form
• A copy of your Colorado Dental License
• A copy of your dental diploma
• A copy of your D.E.A. registration
• A copy of your current malpractice insurance declaration page
• Basic life support certification
• Specialty certification, if applicable
• National Provider Identifier (NPI) Official Notification

Return your completed forms to Delta Dental using one of the methods below.

Mail
Delta Dental of Colorado
Attention: Provider Records
P.O. Box 5468
Denver, CO 80127-5468

Fax
303-741-2230
Attention: Provider Records

E-mail
profservices677@ddpco.com

Already participating, but want to join another Delta Dental network?
If you already participate but want to join another network, it’s simple! Just complete the PPO Dentist Agreement or the CHP+ Agreement and fax it to 303-741-2230 or e-mail it to profservices677@ddpco.com.

Questions?
Contact Professional Services Monday through Friday, 8:00 a.m. to 4:30 p.m. by calling 303-889-8677 or toll free 1-800-233-0860, extension 677. You may also send an e-mail to profservices677@ddpco.com.