If you’re a member of a HumanaDental® Network, you can save on your out-of-pocket costs by visiting a dentist who participates in the HumanaDental Network.

Is your dentist missing from our network?

We don’t want you to have to choose between continuing to see your dentist and receiving the best possible value from your dental benefit plan. You can help us get your dentist on our participation list.

Simply complete the information below. We’ll invite your dentist to participate in the HumanaDental network.

Please note: If the dentist you would like to refer is in Georgia, please access the nomination form.

Required fields

1. Dentist information

Dentist name
Dentist speciality Select General Dentistry Endodontics Orthodontics Pedodontics Periodontics Surgery - Oral and Maxillofacial Plan type Select PPO DHMO Advantage Medicare >
Street address 1 Street address 2
City State Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington DC Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming ZIP code This is not a valid ZIP code.
Business phone

2. Your information

Your name Email address Enter a valid email
Phone number Your employer's name
Your employer's city Your employer's state Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington DC Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
My name can be used when contacting my dentist.