Apply With Your CAQH Profile

Apply quickly using the information already in your CAQH profile.

What You'll Need

• Your CAQH information
• A completed W-9
• A completed Disclosure of Ownership (DOO), if applicable
• A signed DEA/CDS waiver, if applicable *

Important: The legal entity name on your W‑9 must match the name on your IRS documentation. All documents must be current and not expire within 30–60 days.

CAQH Authorization

• In CAQH, authorize Envolve Dental.
• Make sure your profile attestation is current (within the past 60 days).

* Medicaid providers: an active DEA license or a completed DEA/CDS waiver is required for network participation.