This page collects the Delta Dental of Pennsylvania numbers, portal, payer IDs, mailing addresses and filing rules a dental front desk needs, taken from the payer's own provider materials and last checked on September 25, 2026.
Plan types: Delta Dental PPO, Delta Dental Premier, DeltaCare USA (DHMO), Individual and Family Plans · States: PA, MD
Delta Dental of Pennsylvania phone numbers for dental offices
Department | Phone | Hours |
|---|---|---|
Provider services: eligibility, benefits and claims | Mon-Fri 8am-8pm ET | |
Credentialing (CAQH DataSpring Solutions Center) | Weekdays 8am-8pm ET | |
Individual insurance sales (Pennsylvania) |
Delta Dental of Pennsylvania provider portal
The provider portal is Provider Tools: https://www.deltadentalins.com/ciam/login.
Submit claims and pre-treatment estimates with attachments
Check claim status
File claim adjustments and Provider Disputes
Enroll in EFT and view ERAs
Review contracted fees
Check DeltaCare USA eligibility and benefits
Delta Dental of Pennsylvania payer IDs for electronic claims
Payer ID | Use for | Notes |
|---|---|---|
23166 | Delta Dental of Pennsylvania claims (PA and MD) | Listed on Delta Dental's national claims lookup tool. Confirmed by the Delta member-company directory (rev. 10/24). |
Delta Dental of Pennsylvania claims and appeals mailing addresses
Send | Address |
|---|---|
Claims | Delta Dental of Pennsylvania, P.O. Box 2105, Mechanicsburg, PA 17055-6999 |
Timely filing limits
Original claims: 12 months from date of treatment (some programs shorter)
EFT and ERA enrollment
Sign in to Provider Tools and select the EFT and ERA icon; a voided check verifies banking details. Enroll each location under a TIN separately. Enrollment takes 2 to 4 weeks. From January 1, 2027, paper checks carry a $15 weekly fee where state law allows.
Credentialing and network enrollment
Contact: 888-599-1771 (DataSpring Solutions Center, weekdays 8am-8pm ET); https://www1.deltadentalins.com/dentists/caqh-credentialing.html
Credentialing and re-credentialing are free through DataSpring, powered by CAQH. Register or sign in and grant Delta Dental global authorization to access your CAQH profile.
Plan clauses to check during verification
Missing tooth clause
Whether a missing tooth clause applies depends on the group plan. Ask whether the plan excludes replacing teeth lost before coverage began, and note the answer before you present a bridge or implant. See how to spot the missing tooth clause.
Waiting periods
Waiting periods are set by the group plan. Confirm the waiting period for basic and major services and the patient's effective date.
Downgrades (alternate benefit)
Ask whether posterior composites are paid at the amalgam rate and whether crowns downgrade to a base-metal benefit, so the patient estimate is right the first time.
Frequency limits
Set per plan. Once a frequency limit or annual maximum is reached the patient owes the charges, but contracted dentists cannot bill above the patient portion Delta Dental determines.
Verification checklist for Delta Dental of Pennsylvania
Use Provider Tools for real-time eligibility, benefits and claim status; one login covers PA, MD and the DE, DC, NY and WV affiliates.
Confirm the underwriting company before filing; PA shares its P.O. Box with DE, DC, NY and WV, which keep their own payer IDs.
File a claim adjustment in Provider Tools within 90 days before escalating to a Provider Dispute with the Provider Inquiry Form.
For DeltaCare USA (DHMO) patients, use the separate eligibility and benefits flow in Provider Tools.
From January 1, 2027, practices that keep paper checks pay a $15 weekly fee where state law allows.
Record the representative's name, the call reference number and the date for every phone verification.
Related guides
Delaware, DC, New York and West Virginia affiliates share PA's claims address and 800-932-0783 but keep payer IDs 51022, 52147, 11198 and 31096.
Shares Provider Tools, EFT and CAQH credentialing with Delta Dental of California and Delta Dental Insurance Company on deltadentalins.com.
The Delta directory lists Maryland as administered directly by Delta Dental of Pennsylvania.
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Sources
Every number and address above comes from Delta Dental of Pennsylvania's own website or provider documents, checked on September 25, 2026. Payers change phone trees and PO boxes, so confirm with the payer before you mail anything time-sensitive.
Dental Insurance Claims Resources: Get Dental Claim Support | Delta Dental
Credentialing and re-credentialing process with DataSpring | Delta Dental
Shop Individual Delta Dental Insurance in Pennsylvania | Delta Dental
Contact information for Delta Dental member companies (rev. 10/24)
Delta Dental Claims Submission Payer ID and Address Lookup Tool