This article is for dentists and oral surgeons caring for our members
We’d like to remind you of the importance of using the correct fields for Type 1 and Type 2 NPIs. Please review the table below to determine which type of NPI to include in each field of the claim form.
If you have this type of NPI: | Submit your paper claim using: | Submit your electronic claim using: |
---|---|---|
Type 1 NPI — for dentists contracted as individual or sole proprietor | The Type 1 NPI in Box 49 & 54 of the 2012 ADA Claim Form | The Type 1 NPI in the billing provider information section. |
Type 2 NPI — for dentists contracted as a:
|
The Type 2 NPI in Box 49 of the 2012 ADA claim form and
The individual provider’s NPI (Type 1) in Box 54. |
The Type 2 NPI in the Billing Dentist or Dental Entity provider information section and
The individual provider’s (Type 1) NPI in the Treating Dentist and Treatment Location Information section. |
To make any changes to your NPIs, please be sure to:
Note: Out-of-state providers should check with your local Plan about how to make updates to your NPI.
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