Search for:

Home
About Us
Products
Provider Network
- Join Our Network
- Find A Provider
Contact Us
- FAQs
Blog

Search for:

Home
About Us
Products
Provider Network
- Join Our Network
- Find A Provider
Contact Us
- FAQs
Blog

Home
About Us
Products
Provider Network
- Join Our Network
- Find A Provider
Contact Us
- FAQs
Blog

Become a Provider: DentalleadwayDev2023-06-06T10:00:15+01:00

Service Provider

Join over 1000 healthcare providers to better serve value to
our teeming customers today.

Get Started Today

Practice Name

Address

State

Local Government

Suburb/Town

Do you have branches?

Branch Address

Suburb/Town

State

Local Government

Add Another branch

Branch Address

Suburb/Town

State

Local Government

Add Another branch

Branch Address

Suburb/Town

State

Local Government

Add Another branch

Branch Address

Suburb/Town

State

Local Government

Add Another branch

Branch Address

Suburb/Town

State

Local Government

Hospital Phone Line 1

Hospital Phone Line 2

Email for portal access

Name of Managing Director

Name of Primary Contact Person

Name of Secondary Person

Email of Managing Director

Mobile No. of Primary Contact Person

Mobile No. of Secondary Person

Facility available days & time

Open From

Bank Account Name

Bank Name

Bank Account Number

Claims Payment Frequency

Number of Dental Surgery Rooms

Dental X-ray

Available Specialists

please select the days that apply

Maxillofacial Surgeon

Monday

Tuesday

Wednesday

Thursday

Friday

Sat/Sun

Orthodontist

Monday

Tuesday

Wednesday

Thursday

Friday

Sat/Sun

Dentist

Monday

Tuesday

Wednesday

Thursday

Friday

Sat/Sun

Copy of CAC registration certificate

Copy of Evidence of Registration with the relevant state accreditation agency

Copy of Certificate of Medical Indemnity Insurance as detailed under section 8 of the agreement

Upload Practice Licenses of Professional Staff

By proceeding, you agree to our data privacy policy and to collection and processing of your personal data

This field should be left blank

Thank you for subscribing

An error occurred when trying to collect your email. Please try again later.

Download the Leadway Health App

Company

Health Plans

Our Advantage

Speak to a Doctor

Quick Find

FAQs

Our Blog

Find a Provider

Join Us

Careers

Pharmacy Benefit

Investor Portal

Legal

Whistle Blower

Privacy Policy

Terms & Conditions

Data Subject Access Request