Providers Contracting

Thank you for your interest in becoming a Managed Dental Care of Oregon Preferred Provider. Please complete the Prospective Provider Form below and submit it to Provider Services for consideration. You will be notified once we have evaluated the need for additional providers. If Managed Dental Care of Oregon moves forward with contracting, we will begin the credentialing process at that time.

Please email the Prospective Provider Form and any inquiries to [email protected]

Prospective Provider Form

• Completing a Prospective Provider Form does not guarantee network participation.
• If you have treated Managed Dental Care of Oregon members but have not obtained a prior authorization, services may not be reimbursed, and per OAR 410-120-1280, the member may not be billed.
• Until you have contracted with Managed Dental Care of Oregon, all Managed Dental Care of Oregon members should be referred to member services at 1-800-538-9604 or [email protected]