Re-credentialing

Helping ensure our networks' quality through re-credentialing.

Recently receive a First Dental Health^® re-credentialing request?

To maintain the quality of our network, we periodically review our providers' credentials. If you recently received a re-credentialing request via email and/or mail, simply complete and return the re-credentialing form with copies of the following requirements:

All sections of the form are filled out completely

A clear and legible copy of your Professional Liability Insurance (not general) declaration page(s), showing name and address of carrier, individual covered, effective date, expiration date, and liability limits

Nevada providers: The Nevada Department of Insurance requires use of the Uniform Credentialing Form NDOI 901 Rev. 02/2025 or the Uniform Credentialing Addendum NDOI 901A Rev.10/24. If there have been any changes to the information on the Uniform Credentialing Form since it was originally filled out, you will use the Uniform Credentialing Form NDOI 901. If there have not been any changes, you only need to complete the Uniform Credentialing Addendum NDOI 901A. All fields on the Addendum must be filled out

Please complete the Re-credentialing form for your state:

Arizona or California Re-Credentialing Form

Nevada Uniform Credentialing Form

Nevada Uniform Credentialing Addendum - only use if applicable

Recently receive a First Dental Health termination letter?

If you've received a network termination letter due to missing re-credentialing information, you can still rejoin our network. Within 30 days of the effective termination date shown on the letter, simply complete and return the re-credentialing form with copies of the following requirements:

All sections of the form are filled out completely

A clear and legible copy of your Professional Liability Insurance (not general) declaration page(s), showing name and address of carrier, individual covered, effective date, expiration date, and liability limits

Nevada providers: The Nevada Department of Insurance requires use of the Uniform Credentialing Form NDOI 901 Rev. 02/2025 or the Uniform Credentialing Addendum NDOI 901A Rev.10/24. If there have been any changes to the information on the Uniform Credentialing Form since it was originally filled out, you will use the Uniform Credentialing Form NDOI 901. If there have not been any changes, you only need to complete the Uniform Credentialing Addendum NDOI 901A. All fields on the Addendum must be filled out

Please complete the Re-credentialing form for your state:

Arizona or California Re-Credentialing Form

Nevada Uniform Credentialing Form

Nevada Uniform Credentialing Addendum - only use if applicable

You can return all completed forms and documents to us through one of three options:

FDHCredentialing@firstdentalhealth.com

866-613-6381

First Dental Health Attn. Credentialing Department PO BOX 919029 San Diego, CA 92191

Senate Bill 137 and Directory accuracy (California dentists only)

Have you responded to the most recent SB 137 letter yet? If you haven't or need more information, click below:

Learn more

Reach out

Have questions?

Click below to get in touch with us.

Contact us

For more immediate support, call our provider network team at:

800-334-7244

Monday – Friday, 8:00 a.m. to 5:00 p.m. PT