For Providers

Credentialing Overview

Credentialing is a process every dentist must go through at least once during his or her professional life in order to practice dentistry. In the United States, credentialing requirements vary from state to state and all dentists must have below credentials. Please use below links in finding initial licensure information by state. The information in this section is a brief summary of important facts to help dentists and dental students become more familiar with terms used and more informed about the licensure process.

Step 1: Obtain National Provider Identifier (NPI)

The federal Health Insurance Portability and Accountability Act (HIPAA) requires you to obtain an NPI if you submit claims electronically or if you check claims status or access patient eligibility and benefits information online. However, some health plans may choose to require NPIs on all transactions.

How to Apply

Visit https://nppes.cms.hhs.gov
Complete the application and follow instructions to submit either online or by mail.
After confirmation of the receipt of your application, you should receive your NPI via e-mail within one to five business days if you submitted the application online. Mailed applications may take longer.

Type 1 or Type 2

There are two types of NPIs: Type 1, for individual health care providers, such as dentists and hygienists, and Type 2 for incorporated businesses, such as group practices and clinics.

Type 1 is for the provider. This is the only type of NPI you will need if you receive payments in your name or under your social security number as a solo practitioner. For practices with multiple dentists, obtain a Type 1 NPI for each dentist.
Type 2 is for group practices, incorporated dental practices or other business entities paid under their business or corporate name, or under their employer identification number (EIN).

*If any data related to your NPI changes (name, address, practice location etc.), you are responsible for submitting an update to the NPPES within 30 days of the change.

Step 2: Obtain State License

Though requirements vary from state to state, all applicants for dental licensure must meet three basic requirements; an education requirement, a written examination requirement and a clinical examination requirement.

How to Apply

IllinoisIllinois Board of Dentistry217-785-0800https://www.idfpr.com/profs/Boards/dentist.asp
IndianaIndiana State Board of Dentistry317-234-2054https://www.in.gov/pla/dental.htm
MarylandMaryland State Board of Dental Examiners410-402-8501https://health.maryland.gov/dental/
North CarolinaNorth Carolina State Board of Dental Examiners919-678-8223http://www.ncdentalboard.org

Credentialing Intake Form

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