Notice
Happy Thanksgiving! Our offices will be operating during normal call center hours from 8:00 AM to 5:00 PM ET on Wednesday, November 27th. We will be closed on Thursday, November 28th and Friday, November 29th to allow our associates time to spend with their families and loved ones. We wish you a wonderful holiday filled with gratitude and joy!
We apologize for any inconvenience this may cause. Please self-service by signing into your account or using our Interactive Voice Response System (IVR) 24/7 at 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.
Delta Dental of New Jersey is a part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.
