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  • Delta Dental Of Arkansas Claims Address

Get Delta Dental Of Arkansas Claims Address

FOR D. D. USE ONLY ATTENDING DELTA DENTAL OF ARKANSAS P. O. Box 15965 North Little Rock Arkansas 72231 800 462-5410 Fax Claims to 888-900-1373 501 835-3400 DENTIST S STATEMENT CHECK ONE FOR PREDETERMINATION FOR PAYMENT 1. PROCEDURE NUMBER FEE HOW 31. IS TREATMENT FOR ORTHODONTICS MANY IF NO REASON FOR REPLACEMENT IF SERVICES ALREADY COMMENCED ENTER 30. DATE OF PRIOR DATE APPLIANCE PLACED MOS. TREATMENT REMAINING G 32. REMARKS FOR UNUSUAL SERVICES WARNING ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE DEFRAUD OR DECEIVE ANY INSURER MAKES ANY CLAIM FOR THE PROCEEDS OF AN INSURANCE POLICY CONTAINING ANY FALSE INCOMPLETE OR MISLEADING INFORMATION IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN PRISON. IDENTIFY MISSING TEETH WITH X FACIAL I HEREBY CERTIFY THAT THE PROCEDURES AS INDICATED BY DATE ABOVE HAVE BEEN PERFORMED ACCORDING TO THE PROVISIONS OF THE DENTAL CARE PLAN NAMED ABOVE. ALSO THAT THE FEES SUBMITTED ARE THE ACTUAL FEES I HAVE CHARGED AND INTEND TO COLLE....

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Our claims processing center (and corporate office) is located at 9000 Northpark Drive, Johnston, IA 50131. Claims should be mailed to Delta Dental of Iowa, PO Box 9000, Johnston, IA 50131-9000.

If you prefer to write Delta Dental with your question(s), you can do so via email to customer.care@deltadentalma.com or by mail: 465 Medford Street, Boston MA 02129.

Our payer ID # for Delta Dental Premier, PPO and Delta Dental Smiles is CDAR1.

MAIL ORIGINAL TO PLAN OR FAX TO 888-900-1373 RETAIN COPY FOR YOUR FILE.

Electronic claims submission tips: Call DASI at 800-462-7283 to check the status of all claims, including electronically submitted claims.

Delta Dental of New Jersey, Inc. Coordination of Benefits Form P.O. Box 16354, Little Rock AR 72231 Phone: 1-800-452-9310; Fax: 973-285-4141 Email: service@deltadentalnj.com Dear Member: If your family has another dental insurance or medical coverage, Delta Dental of New Jersey may be the secondary payer.

If you are enrolled in an Allwell Medicare Advantage plan and have questions about your benefits or a claim, please call our Customer Service Center at (855) 253-4706.

What is the correct mailing address for Delta Dental? All paper claims should be mailed to P.O. Box 8690, St. Louis, MO 63126-0690.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232