How to Become a Participating Provider

Access Dental Plan provides dental services for members of the Healthy Families Program, Geographic Managed Care and Los Angeles Prepaid Health Plan . Under each of these plans, members are assigned to a Primary Care Dentist in our network for receiving general dental services and have access to a complete array of specialists. If you are a dental provider in a county covered by these plans, you can become a participating provider in Access Dental Plan's network.

To become a participating provider, please print and complete the Provider Agreement, Provider Credential Information and the Internal Revenue Services W-9 Form. The completed material, including the copy of the additional items listed below should be mailed to our Provider Relations Department. Reimbursement levels for each of our programs are also available through our Provider Relations Department.

Copies of the following items should be mailed along with completed forms:

1. Wallet-size dental license

2. Malpractice Insurance Declarations page

Mail to:

Access Dental Plan
Attn: Provider Relations
P.O. BOX 659005
Sacramento, CA 95865-9005

For more information about becoming a participating provider, please Contact Us.