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Providers, click here to register We are excited to launch our latest web portal - designed to make vision program management easier than ever for our providers. �I�x�VMx�D��k�_|!XǑ�*ˑ�Z���/���2�֟��lB�����c�i��z�K+�������@�yyI��Q~�W���qRrPl���v�'՜����(�X=e+�q+-�b�w��+J�!v�s;�(��J�z�v,��f/�5ߢ;�7��5�W�Qk�E��j��B�isb���e��͸4$��b�s���1�h߃�@�v=��%�� �J#�Ρ��E�MY�b��M�n\�1�Y�9~W7���]���l��K�����e�-H���S��F�F.*��Gٛ��&1�2�W��T�;ԥ��X�ؤ���ݚ���:�m�尛�,���! There are three easy ways to change your Main Dentist: Online via email: Click here Print Change Main Dentist Form: Click here Call our Member Call Center and request to change Main Dentist: Medicaid Dental Plan: 1-800-516-0165 (toll-free) Children’s Health Insurance Program (CHIP) Dental Plan 1-800-508-6775 (toll-free) 7-1-1 (TDD/TTY toll-free) Session Timed Out Message. We call our approach Preventistry®, and we are so glad you have joined us. Mssu� NT������5���[g�r_p�&�n�u���T~��=��8��u���hI�I�_JԴ�tH�~�tx��kNR��u�d��`�Iw�ͽAZu��� 翩-4��9@�_�m��[��vH�Mge'�Y�Ȝ�bRw�����9��ӱ���53��r����%|���/���}���>��o" endstream endobj startxref %PDF-1.7 %���� Provider Update Form - Provider Operations You may send this form by e-mail to Standardupdates@dentaquest.com or by fax to 262-241-4077 ... Before DentaQuest can change your name in our system, your license must reflect the name change. %PDF-1.7 %���� Sign in to make the most of your day with the new provider portal from DentaQuest. 1300 0 obj <>/Filter/FlateDecode/ID[<481CD1C25EBE64418124613B782A617C><1879346AB6D7034C94A982C6507DA657>]/Index[1270 48]/Info 1269 0 R/Length 132/Prev 267537/Root 1271 0 R/Size 1318/Type/XRef/W[1 3 1]>>stream ��W+Wnq�lYEY�n�����eQ�d��Ԟs��&/��YxլF���u���9o�����G��~��j��,�S+�K�f��c�^�ԧ7*E�ͮ�*�{;��e�q���G�qY���6���a�e-.��G��y7�2g���䫯��'g�GT~�?R)+��b�A�h��w�e�)��e�T����C.���q\��C2u��ؽ�=�8� =U��t��)��TԚt��e᝞۵!��ZYe�2��y[� %%EOF Please enter the following information and fax to (855) 390-6431. 2055 0 obj <>/Filter/FlateDecode/ID[<481CD1C25EBE64418124613B782A617C><696E34795136C34CA949BBE9C5480704>]/Index[1962 156]/Info 1961 0 R/Length 211/Prev 659911/Root 1963 0 R/Size 2118/Type/XRef/W[1 3 1]>>stream