Credentialing 101: What new dentists need to know

How to avoid delays, payment problems, common pitfalls

For many new dentists, provider credentialing is not only one of the first administrative hurdles they face after graduation, but also one of the most frustrating. Delays in credentialing can postpone start dates, slow onboarding and even prevent dentists from getting paid for patient care.

In a recent survey conducted for the ADA New Dentist Committee, 85% of respondents responded that they are either not enrolled, or not sure if they are enrolled, in the ADA’s free credentialing service powered by the Council for Affordable Quality Healthcare, the healthcare industry alliance better known as CAQH. Nearly 43% of respondents said they did not know the service existed, and at the same time, nearly 72% said an ADA-supported credentialing platform would be either valuable or somewhat valuable to them.

“So many dentists didn’t know about the ADA’s credentialing services, and that actually surprised me,” said Sara Ehsani, D.D.S., a board-certified pediatric dentist, past new dentist representative to the ADA Council on Dental Benefit Programs and a 2025 ADA 10 Under 10 Award recipient. “The biggest challenge with credentialing, people said, was time, emails and paperwork.”

Credentialing is the process of verifying a dentist’s qualifications so they can participate with insurance plans and receive reimbursement. According to Dr. Ehsani, preparation is key.

“My biggest advice to new dentists is before they start applying for jobs or changing offices, it’s good to have all the documents ready,” she said. “If something is missing or expired, it’s going to take way longer.”

Dr. Ehsani recommends creating a dedicated credentialing folder with essential documents, including:

• Dental license
• Drug Enforcement Administration registration, if applicable
• National Provider Identifier number
• CAQH login information
• Current CV
• Dental school diploma and residency certificates, if applicable
• Specialty board certification documents, if applicable
• Malpractice insurance information
• Government-issued identification
• Immunization records
• Professional references

“A lot of delays happen because something is missing or expired,” she said. “If you have everything ready, it just makes everything way simpler.”

The ADA credentialing service is designed to streamline that process by allowing dentists to maintain one centralized profile that can be shared with multiple payers. Dr. Ehsani said the ADA’s credentialing checklist is a strong starting point for new dentists navigating the process for the first time.

“Everything is in one place, so it makes it easier,” she said. “Otherwise, some people don’t know where to start, so they pay companies to do it for them, and I want to be like, ‘ADA has it for free!’ These are the things we’re not taught in dental school.”

Credentialing timelines vary by payer and state, but Medicaid enrollment in particular can take months, Dr. Ehsani said. She recalled one instance when credentialing delays pushed her own start date back by nearly three months. Another common misconception, she added, is that credentialing happens automatically.

“Some people think the office handles everything,” Dr. Ehsani said. “But often the practice is waiting on something from the dentist, and the dentist doesn’t realize it. You have to be proactive.”

That means regularly checking in with office managers, monitoring CAQH profiles and reattesting information every 120 days when required.

Eddie Ramirez, D.M.D., another 2025 ADA 10 Under 10 Award recipient and member of the ADA Council on Dental Benefit Programs, said one of the most confusing parts of credentialing is how much redundancy exists across plans.

“You’re like, ‘I’ve already filled out this information. Why do I need to refill it out again?’” Dr. Ramirez said. “And then the requirements are sometimes different depending on the insurance.”

Dr. Ramirez began his career in public health before transitioning to private practice and eventually purchasing his own office earlier this year. Along the way, he learned that credentialing becomes even more complicated when changing jobs, locations or ownership structures. It’s important to understand what it means to work under a different tax ID, he said, because it’s not always spelled out clearly.

“Your credentialing is you as an individual, but your in-network or out-of-network status is connected to a tax ID or the business you are working with,” he said.

He encouraged new dentists to understand exactly what contracts they are entering into and whether those agreements will follow them into future practice settings, as well as recognize the significance of following up.  

Survey respondents echoed that need for support. Dentists said the most helpful resources would include step-by-step onboarding guides, live or recorded walk-throughs, reminders for CAQH re-attestation and tools that allow credentialing tasks to be securely delegated to staff members.

For new dentists balancing clinical responsibilities with the realities of practice management, Dr. Ehsani said understanding credentialing early can prevent major headaches later.

“The main advice is basically to be proactive,” she said. “Don’t assume it’s automatic. Ask questions, follow up and keep everything updated.”

For more information on the ADA’s credentialing service, visit ADA.org/credentialing.