Credentialing

Thank you for your interest in becoming a Credentialed Provider with Valleygate Dental Surgery Centers, or our affiliate center, Carolinas Center for Ambulatory Dentistry.  You may complete your application below by clicking on the provided link. 

 

 Dental Assistant Application

Periodonist Credentialing Privilege Application

Pediatric Dentist Credentialing Privilege Application

Oral Surgeon Credentialing Privilege Application

General Dentist Credentialing Privilege Application

Endodontist Credentialing Privilege Application

CRNA Credentialing Privilege Application

Anesthesiologist Credentialing Privilege Application

Anesthesiologist Assistant Credentialing Privilege Application

  • Upon completion of the application, our Credentialing Specialist will be in contact with you for any missing documents. 
  • The Application will then be reviewed by the Credentialing Committee for recommendations of privileges.
  • Upon recommendation from the Credentialing Committee, the application will be presented to the governing board for approval to send to Credential America for full credentialing.  The governing board will issue temporary privileges.

For any questions, please contact our office or email: [email protected]