Verify your TIN to ensure prompt and accurate payment
Avoid 28 percent IRS withholding – check your TIN today
The Tax Identification Number (TIN) we use to report your Delta Dental payments to the IRS must match exactly with the TIN that the IRS has on file for you. If it does not, we are required to withhold 28 percent from the payments we send you until the issue is resolved.
Here is what you can do to make sure we are using your correct TIN:
- Review the payment document you receive from us. The TIN (or the last four digits of the TIN) we use for you appears on the first page.
- Notify us immediately if this number does not match exactly with your name or business name and associated TIN on file with the IRS. Complete and mail a TIN Enrollment form.
- If the TIN number is correct, you do not need to take any action.
TIN tips:
- If two or more names are used (such as Chris Jones, DDS, dba Main Street Dental), report to Delta Dental the first name as it appears on the IRS records.
- If you are unsure of how your practice name and the associated TIN are recorded with the IRS:
- Check what is printed on the mailing labels that are supplied by the IRS for quarterly tax payments, or
- Contact the IRS to request a letter (#147C) that will confirm its record of your name and TIN. The IRS phone number is 800-829-1040.
- A new TIN Enrollment form is required when you:
- Add a new practice location
- Make any change to your TIN
- Make any change to the type of business entity (for example, if you change to a partnership or corporation)
Mail or fax the completed TIN form to your local Delta Dental:
Attention: Dentist Network Administration & Contracting Department
Delta Dental of California
100 First Street, MS 5E
San Francisco, CA 94105
Or fax to: 415-543-6326
Attention: Dentist Network Administration & Contracting Department
Delta Dental Insurance Company
PO Box 1809
Alpharetta, GA 30023
Or fax to: 770-641-5395
Attention: Dentist Network Administration & Contracting Department
Delta Dental of Pennsylvania
One Delta Drive
Mechanicsburg, PA 17055
Or fax to: 717-774-1770 |
