Dental

How to Get Credentialed with Delta Dental in Idaho

Network: Open
90-120 Days

Quick Overview

Timeline

90 - 120 days

CAQH

Not Required

Re-credentialing

Every 3 year(s)

Delegated

No

Idaho-Specific Requirements

Delta Dental: Premier and PPO networks available (separate fee schedules apply). Apply online via state Delta Dental affiliate provider portal. CAQH ProView accepted by most affiliates. Processing typically 30-60 days from complete application. State licensing: Idaho State Board of Dentistry issues DDS/DMD licenses. Dental hygienists (RDH) may credential separately. State affiliate: Delta Dental of Idaho. State note: Accepts WREB clinical exam. Extended access dental hygiene permit available for underserved areas. Delta Dental is a federation of 39 independent companies. The state affiliate handles local credentialing and network management. Premier and PPO are separate networks; providers may participate in one or both.

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Idaho.

2

Prepare Your Application

Complete Delta Dental's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Delta Dental.

4

Track & Follow Up

Credentialing typically takes 90-120 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

CV/Resume

Work history and education

DEA License

Conditional

Required if performing sedation or prescribing controlled substances

Malpractice Insurance

Current malpractice insurance certificate

Medical License

Active dental license required

NPI Certificate

Active NPI number required

Enrollment Forms

Delta Dental Provider Application

Provider application to join the Delta Dental Premier or PPO network.

Required
Online Open →

Contact Information

Delta Dental Credentialing

National

1-800-765-6003

Delta Dental General

National

1-800-765-6003

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