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P.O. Box 327 Seattle, WA 98111-0327 DENTAL PROVIDER CREDENTIALING APPLICATION This application is not a contract. The information provided in this application is used to determine whether a practitioner

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What is dental provider credentialing application?

Dental provider credentialing application is a form that healthcare professionals, specifically dentists, must submit to obtain credentialing from insurance companies or healthcare organizations.

Who is required to file dental provider credentialing application?

Any dentist who wishes to become an in-network provider with insurance companies or join a specific healthcare organization's network is required to file a dental provider credentialing application.

How to fill out dental provider credentialing application?

To fill out a dental provider credentialing application, dentists need to provide their personal and professional information, including their educational background, licensing information, employment history, malpractice insurance details, and references. The application form can usually be obtained from the insurance company or healthcare organization's website.

What is the purpose of dental provider credentialing application?

The purpose of dental provider credentialing application is to verify the qualifications, experience, and professional background of dentists who want to become in-network providers or join a specific healthcare organization's network. It ensures that only competent and qualified dental providers are approved to provide services to patients who are covered by dental insurance.

What information must be reported on dental provider credentialing application?

The information required on a dental provider credentialing application typically includes personal information, such as name, contact details, and social security number, as well as professional details like educational background, licenses held, employment history, malpractice insurance information, references, and any disciplinary actions taken against the dentist.

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