How to Apply

Application Process Checklist

DenteMax contracts with quality dentists who are willing to accept the DenteMax fee schedule as full consideration when seeing DenteMax patients. To join the DenteMax network, you must submit all of the following:

• A complete and signed DenteMax Application that includes the Professional Questions and Attestation. Click here to see a sample.
• An explanation to accompany any Professional Question answered with a “yes”
• A copy of your state dental license, specialty and/or board certification (if applicable) and DEA certificate
• A copy of your malpractice insurance certificate or face sheet indicating levels of coverage and current policy date
• Completed W9. Click here to see a sample.

DenteMax has created a quick tutorial for our application process to help explain everything we need from your office. Click here to view the tutorial.

Download Application

Click here to download the application.

If you have any questions or issues before or during the enrollment process, please don’t hesitate to contact our customer service team at 800.752.1547 We strive to make participation as easy as possible but if you need assistance of any kind, please call. We’re here to help!