Kentucky Medicaid – Dental Program
As of October 1, 2011, Avesis Third Party Administrators, Inc. will be the dental program administrator for one of the contracted managed care organizations with the Kentucky Department of Medicaid Services. Avesis will be administering services for eligible Kentucky Medicaid members enrolled in CoventryCares of Kentucky, a Medicaid product of Coventry Health and Life Insurance Company.
If you are interested in participating in the Kentucky Medicaid program please complete the Credentialing and Contracting paperwork by following the link below. If you have any questions please contact one of our Provider Services Representatives at 855-214-6776.
Please click here to access KY Medicaid Dental Care Program Provider Forms.
Providers wanting to participate in the Kentucky Medicaid program administered by Avesis must have a NPI, current Medicaid ID number and fill out a Kentucky State Application. To apply for a NPI number click here; to apply for a Kentucky Medicaid ID number click here.
Send Completed Materials by mail to Provider Services:
Mail To:
Avesis Third Party Administrators, Inc.Attn: Kentucky Network Development
10324 Soulth Dolfield Road
Owings Mills, MD 21117