Dentist Resources

As you scroll down the page, the sections will appear in the following order:

1. DENTIST HANDBOOKS & New 2027 CDT Changes —visit the dentist portal to view the following items:

Participating Dentists’ Handbook—Delta Dental of Virginia
2027 CDT Code Changes - NEW

2. CREDENTIALING FORMS

Delta Dental Participation Packet — for new dentists, view this document on the dentist portal
Delta Dental Recredentialing Packet — for existing dentists
DEA Waiver

3. CONTRACTS/AGREEMENTS — login to the dentist portal to view the following items:

Delta Dental Participating Dentist Agreement, Effective 1/1/2027 – NEW
Delta Dental Participating PPO Dentist Agreement , Effective 1/1/2027 – NEW
Delta Dental Participating Medicare Advantage Dentist Agreement , Effective 1/1/2027 – NEW
Summary of Material Updates to the Delta Dental Participating Dentist Agreements, Effective 1/1/2027 – NEW
Contract Amendment (Virginia Ethics and Fairness in Carrier Business Practices Act) Effective 1/1/2026

4. OFFICE UPDATES FORMS

Address Change Packet — For office location changes under the same Tax ID
Addition of Dentist — Add a participating or non-participating dentist to an existing location
Additional Office Packet — Add a location for an existing Tax ID
Facility Update — To update office information (phone number, email, office hours, etc.)
Inactive practitioner — When a dentist is no longer practicing at a particular location
New Office Packet — Add location to a new Tax ID
Tax ID Change Packet — To transfer locations from one Tax ID to another Tax ID
W-9

5. DIRECT DEPOSIT (EFT)

Direct Deposit (EFT) Enrollment Form
Direct Deposit (EFT) Informational Flyer
Video: How to access Electronic Remittance Advices (ERAs) on DeltaDental.com
Video: How to access Electronic Remittance Advices (ERAs) on DeltaDentalVA.com

6. MEDICARE ADVANTAGE RESOURCES — login to the dentist portal to view the following items:

Delta Dental of Virginia Medicare Advantage Compliance Plan
Delta Dental Medicare Advantage Attestation
Fraud, Waste and Abuse Training
Offshore Subcontracting Attestation Form
Participating Dentists’ Handbook—Medicare Advantage

7. INDIVIDUAL PLAN RESOURCES

2025 Individual Dental Plans Summary — view this document on the dentist portal
Delta Dental of Virginia — Basic Plan Policy Document — view this document on the dentist portal
Delta Dental of Virginia — Classic Plan Policy Document — view this document on the dentist portal
Delta Dental of Virginia — ClearPlus Plan Policy Document — view this document on the dentist portal
Delta Dental of Virginia — Enhanced Plan Policy Document — view this document on the dentist portal
Delta Dental of Virginia — Million Dollar Smile Plan Policy Document and Flyer — view these documents on the dentist portal
Delta Dental of Virginia — Premium Plan Policy Document — view this document on the dentist portal
Delta Dental of Virginia — Progressive Plan Policy Document — view this document on the dentist portal
Order Form: Individual and Family Plan™ brochures