Dental

How to Get Credentialed with DentaQuest in Texas

Network: Open
30-60 Days

Quick Overview

Timeline

30 - 60 days

CAQH

Not Required

Re-credentialing

Every 3 year(s)

Delegated

No

Texas-Specific Requirements

DentaQuest: Medicaid managed dental and commercial networks. DentaQuest administers Medicaid dental benefits in this state. Providers must be enrolled in state Medicaid before applying to DentaQuest. State Medicaid dental fee schedule applies. Apply via DentaQuest provider portal (dentaquest.com/providers). Uses CAQH ProView in most states. Processing typically 30-60 days. State licensing: Texas State Board of Dental Examiners issues DDS/DMD licenses. Dental hygienists (RDH) may credential separately. State note: Requires TSBDE jurisprudence exam. Accepts CDCA, ADEX, or WREB clinical exam. Opioid and human trafficking CE required. Primary Medicaid dental benefits administrator. Operates in 30+ states. Providers must first be enrolled in their state Medicaid program before applying to DentaQuest network. Now part of Sun Life. State-specific Medicaid dental requirements and fee schedules apply.

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 Texas.

2

Prepare Your Application

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

3

Submit Your Application

Submit your completed enrollment package to DentaQuest.

4

Track & Follow Up

Credentialing typically takes 30-60 days. Monitor your application status and respond promptly to requests for additional information.

Free Consultation

Need help enrolling with DentaQuest?

Our specialists handle the entire DentaQuest enrollment process: applications, follow-ups, and approvals in Texas.

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

DentaQuest Provider Enrollment Form

Provider enrollment form for DentaQuest Medicaid and managed dental programs.

Required
Online Open →

Key Credentialing Terms

CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Fee Schedule
A complete listing of fees and reimbursement rates that an insurance payer will pay for specific medical services and pr...
Network Status
A provider's participation status with a specific insurance payer, indicating whether they are in-network (contracted) o...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Participating Provider
A healthcare provider who has signed a contract with an insurance payer to provide services to the plan's members at neg...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to DentaQuest.

View Dentist Credentialing Checklist →

Contact Information

Provider Credentialing

National

1-888-468-5509

Mon-Fri 8am-5pm

Provider Services

National

1-888-468-5509

Claims & Billing

National

1-888-468-5509

Need Help?

Let PayerReady handle your DentaQuest enrollment in Texas.

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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