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    Dental

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    Credentialing Forms

    Dental Credentialing

    CAQH Dental Provider Data Sheet
    Dental Billing Authorization Form
    Dental Practice Questionnaire
    Dental Provider Application
    Dental Provider Application Instructions
    Required Documents for Dental Credentialing
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    Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA By: First Care, Inc.). First Care, Inc., CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Names and Symbols are registered trademarks of the Blue Cross and Blue Shield Association.

    CareFirst of Maryland, Inc. and The Dental Network underwrite products in Maryland only.