Join MCNA Today!
MCNA is a leading dental benefit management company committed to providing high quality services to state agencies and managed care organizations for their Medicaid, Children's Health Insurance Program (CHIP), and Medicare members. We invite you to join our network of primary and specialized oral health practitioners. MCNA is a provider-friendly program. The key to our success has been our relationships with our providers in each region.
If you wish to enroll in one of the following states, please visit our dedicated enrollment page for that state:
- Arkansas Medicaid and CHIP
- Florida Medicaid
- Idaho Smiles Medicaid
- Iowa Dental Wellness Plan
- Louisiana Medicaid and CHIP
- Nebraska Medicaid
- Texas Medicaid and CHIP
- Utah Medicaid
- Washington Medicaid
To join our network in any other state, please follow the process below:
Enroll Online
Complete our Online Credentialing Application, which includes all required forms.
Enroll by Fax, Email, or Mail
The Enroll Online option above is recommended for the quickest turnaround, however you may alternatively download, print, and complete the documents below to begin the contracting and credentialing process.
- Step 1: Download and complete all of the following forms (Adobe Reader may be required to view PDF files.):
- New Provider Form (one per dentist)
- New Location Form (one per physical location)
- Dental Provider Agreement
- IRS W-9 Form
- Payment Method Selection Form
- Disclosure of Ownership Form (Florida Providers Only)
- Step 2: Submit the completed documents via one of the following methods:
- Fax to: 1-877-684-5717
- Email to: Network_Development@MCNA.net
- Mail to:
- MCNA Dental
Attn: Network Development
P.O. Box 29008
San Antonio, TX 78229
- MCNA Dental
For More Information or For Questions
If you have questions and would like to speak with a Network Development Representative, please call our Network Development Hotline at 1-844-352-6262. Alternatively, you may complete the form below, and we will contact you shortly to answer all of your questions and assist you in joining our network! Please provide as much information as possible.
Note: This contact form is only for dentists interested in enrolling. If you are an MCNA member, or you or your child are looking to receive dental care, please click here to contact our Member Services Department.
