Forms

Download frequently requested forms and documents.

Claim Form
DASI Assist Form
DASI Shortcuts Guide
Identity Theft—Protect Your Practice from Patient Fraud
X-Ray Procedure Codes
Credentialing Forms

Please Note: Delta Dental of North Carolina accepts standard ADA claim forms. 

For claim submissions, please remember to use your patient's new alternate ID or Social Security number. Your patient can access their alternate ID on the ID card issued in September 2011 or later, or via the Consumer Toolkit. For questions, please contact us at (800) 662-8856.