Forms Reorder Request - Denti-Cal - CA.gov 2026

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The document is a reorder request form for the California Medi-Cal Dental (Denti-Cal) Program, providing instructions for billing providers to request various dental claim forms and envelopes. It includes details on how to submit the request via fax or mail, along with a list of available forms and envelopes for different purposes.

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Click ‘Get Form’ to open the Forms Reorder Request in our editor.
Begin by entering your Billing Provider Name and NPI/Billing Number in the designated fields. This information is crucial for processing your request.
Fill in your Mailing Address, Telephone Number, City, State, and ZIP Code. Ensure all details are accurate to avoid delays.
Select the forms you wish to reorder from the list provided. You can choose multiple items such as TAR/Claim Forms or Envelopes based on your needs.
Once completed, review all entries for accuracy. Use our platform’s editing tools to make any necessary adjustments before submission.
Finally, either fax your completed request to (877) 401-7534 or print it out and mail it to the specified address for Denti-Cal Forms Reorder.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (50 Votes)
2017	4.2 Satisfied (107 Votes)
2014	4.2 Satisfied (26 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Are Medi-Cal and Denti cal the same?

Medi-Cal gives dental coverage for qualified patients and families within California. Previously in California dental benefits program was called Denti-Cal, and you may still hear people say Denti-Cal. Today there is many similar terms related to the same coverage (Denti-cal, Medi-cal, Cal-Optima).

How do I talk to a real person at Medi-Cal?

Phone numbers: Medi-Cal Managed Care: 1-800-430-4263 (TTY 1-800-430-7077)

How do I contact Medi-Cal Dental?

If you have any questions or need assistance finding a dental provider, call the Medi-Cal Dental Customer Service Line at (800) 322-6384, or visit Smile, California.

What is the payer ID for Denti Cal?

Medi-Cal Dental Programs Payer ID number is 94146.

What is the denti cal fee for service?

denti-Cal, medi-Cals fee-for-service (ffs) dental program, was the primary public financer of dental care for more than 8 million low-income, elderly, and disabled people in California in 2007. in 2009, most of the medi-Cal adult dental benefits were eliminated due to the states budget deficit.

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How do I change to denti Cal?

To change your dental plan, call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) Or you can complete a Medi-Cal Dental Choice form. You can find the form on the Download forms page. Call Medi-Cal Dental at 1-800-322-6384 to find a dentist who takes Medi-Cal. Mail the completed choice form.

How do I contact Denti Cal?

Please have the operator call the Toll-Free Member Line at 1-800-322-6384. To contact the Medi-Cal Dental Program, please call the Member Telephone Service Center at (800) 322-6384. The call is free. Medi-Cal dental program representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday to assist you.

What is the phone number for Denti Cal referral?

If you have questions when submitting the referral, please contact the Customer Service Center (CSC) at (800) 423-0507. All referrals are evaluated to determine eligibility based on case management criteria.

Forms Reorder Request - Denti-Cal - CA.gov 2026

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How to use or fill out Forms Reorder Request - Denti-Cal - CA.gov with DocHub

See more Forms Reorder Request - Denti-Cal - CA.gov versions

Complete this form in 5 minutes or less

Got questions?

Are Medi-Cal and Denti cal the same?

How do I talk to a real person at Medi-Cal?

How do I contact Medi-Cal Dental?

What is the payer ID for Denti Cal?

What is the denti cal fee for service?

Security and compliance

Complete this form in 5 minutes or less

People also ask

How do I change to denti Cal?

How do I contact Denti Cal?

What is the phone number for Denti Cal referral?

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