New to Delta Dental?
If you would like to become a participating dentist with Delta Dental of Rhode Island, just fill out the forms below, sign them and send them to us via fax or regular mail. You can download and print copies of these forms as needed.
If you are already participating with Delta Dental of Rhode Island, this page may be useful to you when you need to add a new dentist to your practice, or to update your office status. You can also view the current and archived Details newsletters here.
The Delta Dental payer ID number is 05029.
Credentialing Committee Meeting Schedule
If you are new to Delta Dental, you must first be credentialed. Delta Dental also re-credentials participating dentists every three years.
This list details all the forms you need to submit your application package.
Fill out your application here. You can type directly on the document then print it out, or print it out and fill it in manually.
We need this form to be able to pay your fees.
Rules & Regulations
This is a list of requirements that dentists must follow to be able to participate with Delta Dental of Rhode Island.
Here is your contract. Please submit two signed copies with your application package.
Participating Dentist Checklist
Use this checklist for credentialing purposes.
Practice Update Forms
Use this form if you retire, or close your office.
Use this form if a dentist has left your practice.
Use this form if a dentist has joined your practice.
Sale of Dental Practice
Use this form to inform us of the sale of a dental practice.
Check Run Schedule
View our check processing dates.
Use this tool to submit documentation electronically.