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01. Edit your dentaquest provider change online
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02. Sign it in a few clicks
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Send dentaquest provider change form via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out Dental Home Change Form - DentaQuest with DocHub
- Click ‘Get Form’ to open it in the editor.
- Begin by filling in your personal information. Enter your first and last name, Medicaid ID (if known), date of birth in the format dd/mm/yyyy, contact phone number, and email address. Ensure all required fields marked with an asterisk (*) are completed.
- Next, provide details about your preferred dentist. Fill in the dentist's name, city, address, zip code, and phone number. Additionally, include the date of your last visit to this dentist.
- Once all fields are filled out accurately, review your entries for any errors before finalizing the form.
- After confirming that all information is correct, you can save or print the form directly from our platform for mailing or faxing to DentaQuest.
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Got questions?
We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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What does existing dental home mean?
DentaQuest Chosen to Administer Dental Benefits for Californias Medicaid DMC Program.
How do I change the main dentist in DentaQuest?
To choose a new Main Dentist or Dental Home, click on the Set as Main Dentist button. Then follow the instructions to complete the change. You will need the Member or Medicaid ID, the Member phone or last four numbers of the Members SSN, and Member DOB ready.
How do you switch dental offices?
Switching Dentists in Five Easy Steps 1.) Find a new dentist. 2.) Notify your previous dentist. 3.) Transfer your dental records. 4.) Attend your first appointment. 5.) Enjoy a healthier mouth. Consider Dansville Dental Professionals. We are accepting new patients!
Whats the number for DentaQuest?
We hope our dental plan serves you well. If you have a problem, talk with your primary care dentist (PCD), call Member Services at 1-833-479-0687 or write to PO Box 2906 Milwaukee, WI 53201.
Can I switch dentists with DentaQuest Medicaid?
What if I want to change dentists? Yes, you may choose from DentaQuests extensive Personal Dental Plan network of qualified dentists and dental clinics. You are free to change your dentist at any time.
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