Step 1: Collect the Necessary Information, Go to DDS Enroll, and Complete the Enrollment Online
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. All of the linked forms below are available on DDS Enroll. Please have the following documents and/or information prepared to upload into DDS Enroll:
- Applicable Network Participating Dentist Agreement
- Participating Dentist Agreement Summary Disclosure Form
- Substitute Form W-9 (This is not a required document, but if you are opening a new business, we need this for your tax ID number.)
- 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
- In order to participate in the Delta Dental of Colorado PPO CHP+ Network, you must revalidate with the State of Colorado by following the steps on their website www.colorado.gov/hcpf/provider-enrollment. After completing your application with the state, and receiving Enrollment Approval, please provide Delta Dental of Colorado with the (ATN) Application Tracking Number, that reflects the state approval. You are required to receive approval from the state prior to participating in Delta Dental of Colorado’s PPO CHP+ Network.
Step 2: Choose a Network
- Delta Dental PPO
A network for dentists who want access to all Delta Dental members nationwide.
- Delta Dental Premier
A network with access to only a portion of Delta Dental members.
- Child Health Plan Plus (CHP+)
A network for Premier and non-participating dentists who wish to treat CHP+ members at the CHP+ rate.
- NEW: Participating Independent Dental Hygienists
A licensed hygienist in the state of Colorado who is not working under the employment of a dentist. See the Frequently Asked Questions for more information about this new participating provider category.
Step 3: Submit all Required Information Online at DDS Enroll
If you have any questions or need help with this new credentialing process, please contact DDS Enroll at:
- Website: www.dentalxchange.com/contact/Contact
- Phone: 1-800-576-6412, ext. 471
If you already participate, but want to join another network, or have questions about your participation status, please contact Delta Dental of Colorado’s network management team at 303-889-8677.
If you have questions about your credentialing status, please refer to DDS Enroll or contact Delta Dental of Colorado’s credentialing team via phone at 720-489-4704 or via email at firstname.lastname@example.org.