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Join Our Provider Network – Dental Providers


This submission is a request for participation only and not the formal credential application.
Please allow up to 10 business days for a response.

Select a provider type:
***Select a provider type:
* Indicates required field

Providers that utilize CAQH must enter their CAQH Provider ID in the space below. UPMC Health Plan will retrieve the provider's CAQH application for credentialing before you can complete the rest of the form. Please ensure CAQH has recently been attested, all documentation is current, and UPMC has authorization to view the application. CRNPs, CNMs, and PAs: Please attach a copy of the collaborative agreement to the CAQH application documentation.