Type 2 NPI Numbers & Delta Dental of WA
Over the past few months, the WSDA has received numerous calls and emails from members who were confused about recent communications they received from Delta Dental of Washington. These communications demanded that providers obtain a Type 2 NPI number even if they were sole proprietors who currently had a Type 1 NPI number. One email from a Delta Dental representative read “If you are a sole practitioner, you will still need to apply for this Type 2 NPI number,” claiming that this was a requirement requested of Delta from the Office of the Insurance Commissioner (OIC). In another email, a representative told a WSDA member that “many Deltas are already denying claims when the Type 2 NPI is not included in box 49 (while the Type 1 individual NPI is in box 54).” Neither WSDA nor ADA were able to verify this statement.
On behalf of our members, the WSDA contacted both Delta Dental and OIC and was able to determine that this requirement was in fact not valid. Providers that are sole proprietors with Type 1 NPI numbers do not need to apply for Type 2 NPI numbers.
Delta Dental of Washington has since updated their communications around this issue on their provider portal, explaining the actual purpose for collecting Type 2 NPI numbers: “We are actively collecting Type 2 NPI numbers from dentists who have them. Please know a Type 2 NPI is not a requirement of membership nor will it impact how we process claims. We are collecting Type 2 NPIs as part of a monthly reporting requirement that we have with the State of Washington.”
Thank you to those who contacted the Association regarding this matter, allowing us to investigate and resolve this issue on your behalf.