Forms
Mail completed paper claims to:
Delta Dental of New Mexico
100 Sun Avenue NE, Suite 400
Albuquerque, NM 87109
-
Provider Association Form: Active Delta Dental Participating Providers can use this form to add a new office location without needing to fill out the full Provider Credentialing Profile.
-
Practice Information Update Form: Use this form to notify Delta Dental of New Mexico about changes to practice information, such as the street address or office hours.
-
Provider Termination Form: Use this form to notify Delta Dental of New Mexico about a provider who is no longer working at your practice.
Automated Phone System Reference