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Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member, please register here.

If you are a Medicare Advantage or Medicare Supplement member, please register here.

Contracting Dentist

  1. Contact your Provider Relations Representative to order your contract. (See DPAP100)
  2. Submit the following items. Any missing items may result in the return of incomplete documents or a delay in processing.
    • Current state license (attach a copy)
    • Malpractice/liability insurance - minimum amounts of $1 million per occurrence, $3 million aggregate (attach a copy)
    • Dentist Profile Form
    • W-9
    • Attachment A
    • DEA Certificate (attach a copy)
    • Provider tax ID or ownership update (This is only required when a new contract on an existing provider is required due to a tax ID or ownership updated.)



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Fax: 208-387-6818


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