Delta Dental of New Mexico


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Download Enrollment Form

Please send a completed application and a check for the enrollment fee(s) to:

Delta Dental of New Mexico
100 Sun Avenue NE, Suite 400
Albuquerque, NM 87109

Applications are also available by calling Delta Dental of New Mexico at (505) 883-4777 or toll-free (800) 999-0963. Enrollment fees may be paid with a check (mail-in only).

Enrollment Details

You may enroll your spouse and other family members. The cost per person of Delta Dental Patient Direct is less when more than one per person in a family enrolls.

Dependent children include natural children, stepchildren, and legally adopted or foster children living in the same household, who are younger than age 25. Dependents who do not fall into one of those categories may enroll in Delta Dental Patient Direct as a single adult. To be eligible for one of the family rates, dependent(s) must be enrolled at the time the first person enrolls. Adult dependents who wish to enroll after that may enroll as a single adult.

Enrollment Fees depend on the number of family members being enrolled. Refer to the current Delta Dental Patient Direct Enrollment Fees page for specific price information. Reduced Enrollment Fees apply to enrollees age 60 or over.

Learn more about Delta Dental Patient Direct: