Update Your Information

Let us know in writing when you change your address; sell, buy, open or close an office; add a dentist, change your name or specialty and/or change your Tax Identification Number (TIN).

Download Forms

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Important note: If you change your TIN, you will need to re-register for Online Services with your new TIN.

How to Submit

Mail or fax completed forms to your local Delta Dental:

Delta Dental of California

Delta Dental of California
Attention: Dentist Network Administration and Contracting Department
P.O. Box 537010
SacramentoCA  95853-9926

Or fax to: 916-852-8995

Delta Dental Insurance Company

For the states of Alabama, Florida, Georgia, Louisiana, Mississippi, Montana, Nevada, Texas and Utah

Delta Dental Insurance Company
Attention: Dentist Network Administration and Contracting Department
P.O. Box 1809
AlpharettaGA  30023-1809

Or fax to: 770-641-5395

Mid-Atlantic Region

Includes Delta Dental of Pennsylvania (Pennsylvania and Maryland), Delta Dental of Delaware, Inc., Delta Dental of the District of Columbia, Delta Dental of New York, Inc., and Delta Dental of West Virginia, Inc.

Delta Dental
Attention: Dentist Network Administration and Contracting Department
One Delta Drive
MechanicsburgPA  17055-6999

Or fax to: 717-774-1770

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