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Before submitting information to DenteMax, please be sure that you are a current, participating provider with the DenteMax Network. If you are not a participating provider, but are interested in joining the network, please call customer service at 1.800.752.1547.


To submit your Type 1, Type 2, or both NPI Numbers to DenteMax online, please complete the following form.


Please note:

A Type 1 NPI is an INDIVIDUAL Provider's NPI Number

  and

A Type 2 NPI is an ORGANIZATIONAL or Practice NPI Number.

 
Doctor's Last Name:    
Doctor's First Name:    
Telephone Number (###-###-####):    
Last 5 Digits of Doctor's SSN:    
Last 5 Digits of Doctor's TAX ID (EIN):    
Type 1 - NPI (10 Digits):    
Type 2 - NPI (10 Digits):    
   
 

 



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