Re-Credentialing
First Dental Health Re-Credentialing Request Received
To maintain the quality of our network we periodically review our providers' credentials. You may have recently received a request but need another copy of the required paperwork. Simply complete and return the Re-Credentialing Forms with copies of the following requirements:
- Copy of your Federal DEA Registration (if applicable)
- Copy of your Board Specialty Certification (if applicable)
- Copy of your Current Professional Liability Insurance declaration page/face sheet
First Dental Health Termination Letter Received
If you've received a Network Termination letter due to missing Re-Credentialing information and would like to rejoin just complete and return, within 30 days of the effective termination date shown on letter, the Re-Credentialing and Reinstatement Forms, with copies of the following requirements:
- Copy of your Federal DEA Registration (if applicable)
- Copy of your Board Specialty Certification (if applicable)
- Copy of your Current Professional Liability Insurance declaration page/face sheet
Re-Credentialing and Reinstatement Form
You can return all completed forms and documents to us through one of three options:
- Email: ProviderRelations@firstdentalhealth.com
- Fax: 866-613-6381
- Mail: First Dental Health Attn. Network Development PO BOX 919029 San Diego, CA 92191
If you have any questions, please contact our Customer Service Team at 1-800-334-7244 Monday to Friday 8:00 a.m. to 5:00 p.m. PST.