DEPARTMENT OF INSURANCE

Name	Delta Dental of Kentucky, Inc. (TPA)	DOIID	578336	NAIC NPN	6264

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Resident	Administrator	Not Applicable	10/10/2003		3/31/2027

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Administrator	01/15/2025	03/31/2025	01/15/2025	01/15/2025	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	10100 Linn Station Road Louisville, KY 40223
Mailing	10100 Linn Station Road Louisville, KY 40223

Internet Information

Type	Address
Business Email	danielle.jackson@deltadentalky.com

Phone Information

Type	Phone
Business / Home Office	(502) 736-4647