National Provider Identifier (NPI)
Federal law (HIPAA) requires all healthcare providers and organizations to use a standard identifier—called the National Provider Identifier (NPI)—on electronic transmissions involving patient health information.
All electronic claims submitted to Delta Dental must include:
- The treating dentist’s Type 1 NPI
- The treating dentist’s state license number
- The Tax Identification Number (TIN) of the billing dentist or practice
- Optionally, the Type 2 NPI to identify the billing provider (e.g., group practice)
Applying for an NPI
You can apply in one of three ways:
- Online.
- By mail using Form CMS-10114. Call 800-465-3203 or TTY 800-692-2326 to request a copy.
- Through a vendor or clearinghouse using electronic file interchange.
Registering your NPI with Delta Dental
Send a copy of your NPI assignment document to:
By mail
Delta Dental
Attn: Provider Records
PO Box 30416
Lansing, MI 48909-7916
By fax
517-706-3618
| Practice Type | Required NPI(s) |
|---|---|
| Sole proprietor/solo practitioner | Type 1 only |
| Incorporated individual | Type 1 for dentist, Type 2 for practice |
| Group practice | Type 1 for each dentist, Type 2 for practice |
| Multi-location clinics | Type 1 for each dentist, Type 2 for each location |
If your practice bills under a business TIN, you’ll need a Type 2 NPI in addition to your Type 1 NPI.