Become a Participating Dentist with Dominion National
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Join Our Network

Please complete the appropriate application and provider agreement(s) below based on your state of business and the network(s) you are interested in joining.

If you are interested in learning more about becoming a participating dentist, please contact our Professional Services Department directly at 888.471.3631.

Provider Applications

Select State

Select Plan (DHMO) Provider Agreement

DC

DE

MD

NJ

PA

VA

PPO Provider Agreement

Select State

Third-Party Access

Dominion enters into agreements that grant certain third parties access to Dominion’s network dentists, in accordance with Dominion’s agreements with its network dentists.

Network dentists who do not want to participate in such third-party access should notify Dominion at ProviderApps@dominionnational.com or 888.518.5338.

The following third parties have access to Dominion’s network dentists:

  • BlueKC (Missouri)
  • Capital Blue Cross (Pennsylvania)
  • CarePartners of Connecticut (Connecticut)
  • CommunityCare (Oklahoma)
  • Cox Health Plan (Missouri)
  • Humana (Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania, Virginia)
  • Independence Blue Cross (Pennsylvania)
  • AmeriHealth (New Jersey)
  • Providence Health Plan (Oregon, Washington)
  • Tufts Health Plan (Massachusetts)

Last Updated January 19, 2024