Alert

i
Attention Delta Dental providers: Protect your practice and patient data with multi-factor authentication. As of October 20, 2025, all users will need their password and an additional way to confirm their identity to log in to their Delta Dental of New Jersey account. See how MFA works.
i
Customer Service Summer Hours (through Friday, 8/29/2025): Monday through Thursday 8:00 AM – 6:30 PM ET and Friday 8:00 AM - 1:00 PM ET. To view benefit information and claim status at any time, please sign into your account or use our Interactive Voice Response System 24/7 at 1-800-452-9310.

Dental Forms Library for Employers

Find the application or form that relates to your needs and easily download and print, or submit online.

Authorization Form Granting Access to PHI (PDF, 1 page, 52kb)

Eligibility Enrollment Change Form (PDF, 2 pages, 22kb)
Use this form to submit new adds, changes, and terminations. 


Disabled Dependent Verification Certification
 
(PDF, 1 page, 13kb)
This form officially certifies the dependency status of a disabled dependent. To be signed by the child's physician.