Are you a current Cypress Provider and need to submit a change? Download the form you need below!
Keeping your profile up to date is easy! Find the form you need to submit your provider office’s changes or updates.
- Additional Location Form: Use this form to add a new office location.
- Change in Tax ID # Form: Download this document to inform us of a recent change in Tax ID #.
- Location Change Form: Use this form to notify us of a recent change of provider location address.
Join the Cypress Dental Network!
Provider Enrollment Application: This form is to apply to become a Cypress Participating Provider and allow Cypress members to access your dental services in-network.
Are you a patient that wants to nominate your dentist’s office to become a Cypress Participating Provider?
Provider Nomination Form: Complete this form to request that we reach out to your provider’s office to become in-network with Cypress Dental.