Dentist

Dentist License

Initial Application - Accredited Dental School Graduate

Application for License - ORC 4715.10

Fees for licenses or permits - ORC 4715.13

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

The application will require you to enter a mailing and a public address. The address should be the same for both and should be your main practice address. Only the city and state show on the public look-up. If you do not have a main practice address yet, please use your home address.

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Please list all licenses (current or not) obtained in any jurisdiction in the dental field. Out-of-State certification/verification letters can be emailed or mailed to the Board. Online verifications are also accepted, provided that Board action information is included if applicable.

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Applicants with criminal history will be required to upload: 1. A Personal Statement - A letter in your own words describing the circumstances of the offense, and 2. Provide final disposition/arrest records and completion of probation/parole/sanctions if applicable.

Applicants with disciplinary history will be required to upload: 1. A Personal Statement - A letter in your own words describing the circumstances of the action, and 2. Provide records from the licensing agency regarding the action.

Attachments:

Accredited Dental College Graduate Form - Transcripts or Certification Letter are also accepted - Graduation date and degree received are required. School seals must be visible and legible on a scanned upload. Form or Certification letter must be signed on or after graduation date.

National Board Dental Examination (NBDE/INBDE) Score Card - Screen shot of your score(s) from: https://jcnde.ada.org/, or

You can upload a Word document requesting your scores be pulled - You will need to contact the JCNDE at 1-800-232-1694, and request your scores be made available to the Ohio State Dental Board to pull.

One of the following:

Regional Board Scores (Copy of Scores) - Have taken an examination administered by any of the following regional testing agencies and received a passing score on the examination as determined by the administering agency: CRDTS, NERB, CDCA, SRTA, CITA or WREB; or

Residency - Certificate of Director of Dental Residency Program Attestation and Copy of Certificate of Completion (Diploma) - Completed a dental residency program accredited or approved by the Commission on Dental Accreditation (CODA) and administered by an accredited dental college or hospital. Please note: The online application will still have a required upload for Regional Board Scores - Upload a Word document stating that you completed a residency in lieu of an examination; or

Out-of-State - (See License Verification above for instructions) Possess a license in good standing from another state and have actively engaged in the legal and reputable practice of dentistry in another state or in the armed forces of the United States, the United States public health service, or the United States department of veterans' affairs for five years immediately preceding application.

Jurisprudence Exam - This is an open book exam over the Ohio Dental Practice Act. You must score a 75% or higher to pass. You will be notified via email if you need to retake the exam.
Dental Practice Act
Jurisprudence Exam Questions
Answer Sheet & Notary Page - It is your responsibility to have this document notarized before you upload it to your online application - The notary must use a visible seal.

Medical Report - Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

Criminal Records Check:

Instructions and Information- Both the FBI and BCI are required.
BCI and FBI Fingerprint Cards - If completing out-of-state.

Valid Credit Card (MasterCard or Visa)

Fees for licenses or permits - ORC 4715.13

Even Year Fee $454.00
Odd Year Fee $267.00

Apply online through the portal here: elicense.ohio.gov

Please note: It does not matter when your license was first issued, you will be required to renew by December 31st of the odd year. This is the reason for the even and odd year fees.

Initial Application - Unaccredited Dental School Graduate

Application for licensure of graduates of unaccredited dental colleges located outside the United States - OAC 4715-18-01

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

You are required to enter your dental school information. Most accredited dental schools are listed in the drop down. If your school is not listed, type the word, "Other", and select it to enter your school information. You will need to enter both your unaccredited dental school information and your residency dental school information.

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Attachments:

Unaccredited Dental College Graduate - Transcripts and Diploma (English translation required) - Graduation date and degree received are required. School seals must be visible and legible on a scanned upload.

Certification of Clinical Training and Copy of Certificate of Completion (Diploma) - Successfully completed a minimum of two years of clinical training in general dentistry in one of the following:

A General Practice Residency (GPR) program from an accredited institution; or

An Advanced Education in General Dentistry (AEGD) program from an accredited institution.

Basic Science and Laboratory Examination Attestation Form - Successfully completed a basic science and laboratory examination provided by an accredited institution.

Test of English as a Foreign Language (TOEFL) Scores - A passing score is 75% or higher.

National Board Dental Examination (NBDE/INBDE) Score Card - Screen shot of your score(s) from: https://jcnde.ada.org/ or

One of the following:

Medical Report - Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

Criminal Records Check:

Instructions and Information- Both the FBI and BCI are required.
BCI and FBI Fingerprint Cards - If completing out-of-state.

Valid Credit Card (MasterCard or Visa)

Fees for licenses or permits - ORC 4715.13

Even Year Fee $454.00
Odd Year Fee $267.00

Apply online through the portal here: elicense.ohio.gov

Please note: It does not matter when your license was first issued, you will be required to renew by December 31st of the odd year. This is the reason for the even and odd year fees.

Renewal Application

Registration - notice of change of address - ORC 4715.14

Continuing education - ORC 4715.141

Continuing education requirements - OAC 4715-8-01

Continuing education requirements for renewal or reinstatement - OAC 4715-8-04

Fee waivers available to service members, veterans, or spouses of service members or veterans - OAC 4715-14-02

Renewal Application

Renewal Opens October 2nd

Before you start, make sure you have the following information/documentation to complete the application.

Attachments:

Proof of Completing at least 40 hours of Continuing Dental Education - Completed during the 2-year period immediately preceding renewal. Must include 2-hours of opioid prescribing. CE LOG

The Board has the ability by law to excuse licensed dentists and/or hygienists, as a group or as individuals, from all or any part of the CE requirements.

Recent Graduates - The Board exempts Licensees/Certificate holders who have completed their training within their first registration biennium of dental school, dental hygiene program, or an initial training program for dental x-ray machine operators. In order to renew, you must answer "Yes" to the question regarding completion of your CE and upload documentation/evidence of completion of your school, program, or training. Regardless of your initial licensure/certificate with the Board, if you have not completed a program within the biennium you are required to obtain the minimum hours of CE to renew.

Dental Residents and Dental Hygiene Graduate Students - The Board exempts Licensees who are furthering their dental/dental hygiene education in Commission on Dental Accreditation (CODA) approved residency or graduate level dental hygiene programs (i.e., dental hygiene master's degree completion programs). In order to renew, you must answer "Yes" to the question regarding completion of your CE and upload documentation/evidence of attendance to your school, program, or training during any portion of the biennium. Regardless of your current status, if you have participated in the program at any time between January 1 to December 3 of the current biennium, you need only submit proof of attendance.

Valid Credit Card (MasterCard or Visa)

Fee $312.00

Late Fee $127.00 - After December 31st.

Renew online through the portal here: elicense.ohio.gov

Reinstatement Application

Registration - notice of change of address - ORC 4715.14

Continuing Education requirements - OAC 4715-8-01

Continuing education requirements for renewal or reinstatement - OAC 4715-8-04

Reinstatement Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Attachments:

Proof of Completing at least 40 hours of Continuing Dental Education - Completed during the 2-year period immediately preceding renewal. Must include 2-hours of opioid prescribing.

Medical Report- Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Criminal Records Check:

Instructions and Information- Both the FBI and BCI are required.
BCI and FBI Fingerprint Cards - If completing out-of-state.

Valid Credit Card (MasterCard or Visa)

Inactive/Retired Status Fee $312.00
Inactive/Expired Status Fee $693.00

Reinstate online through the portal here: elicense.ohio.gov

Please note: It does not matter when your license is reinstated, you will be required to renew by December 31st of the odd year.

Limited Continuing Education License

Initial & Renewal Application

Application for Limited License - Review Section (C) - ORC 4715.16

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Proof of being a resident of a state other than Ohio, and licensed to practice dentistry in such state and is in good standing - (See License Verification above for instructions)

Attachments:

Certificate of Registration to Participate in a Continuing Dental Education Practicum - Form must be completed.

Medical Report - Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

Valid Credit Card (MasterCard or Visa)

Fee $127.00

Apply online through the portal here: elicense.ohio.gov

Renewal Application

Fee $94.00

Renew online through the portal here: elicense.ohio.gov

Limited Dental Teaching License

Initial & Renewal Application

Application for limited license - Review section (B) - ORC 4715.16

Limited teaching license - OAC 4715-7-02

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Authorized to practice dentistry in another state or country - (See License Verification above for instructions)

Attachments:

One of the following:

Unaccredited Dental College Graduate - Transcripts and Diploma (English translation required) - Graduation date and degree received are required. School seals must be visible and legible on a scanned upload, or

Certificate of Appointment as a Teacher - Full-time appointment to the faculty of the endorsing dental college - Form must be completed.

Medical Report - Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

Criminal Records Check:

Instructions and Information- Both the FBI and BCI are required.
BCI and FBI Fingerprint Cards - If completing out-of-state.

Valid Credit Card (MasterCard or Visa)

Fee $127.00

Apply online through the portal here: elicense.ohio.gov

Renewal Application

Fee $127.00

Renew online through the portal here: elicense.ohio.gov

Limited Resident License

Initial Application

Application for limited license - Review section (A) - ORC 4715.16

Limited resident's license - OAC 4715-7-01

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Attachments:

One of the following:

Dental Resident Appointment Form - Appointed a dental resident at an accredited dental college in this state or at an accredited program of a hospital in this state. Form must be completed and signed by the Program Director and/or the Chief of Dental Services.

Medical Report - Form must be completed by a Physician, Physician Assistant, or Nurse Practitioner within the last 6 months.

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

Valid Credit Card (MasterCard or Visa)

Fee $13.00

Apply online through the portal here: elicense.ohio.gov

General Anesthesia Permit

Initial & Renewal Application

Use of general anesthesia and deep sedation - OAC 4715-5-05

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Attachments:

One of the following:

Completed an approved, accredited post-doctoral training program which affords appropriate training necessary to administer deep sedation and general anesthesia; and or

Completed an approved Accreditation Council for Graduate Medical Education (ACGME) accredited post-doctoral training program in anesthesiology which affords appropriate training necessary to administer deep sedation and general anesthesia; and/or

Completed a minimum of two-year advanced clinical training in anesthesiology from an American Dental Association Commission on Dental Accreditation (ADA CODA) accredited institution that meets the objectives set forth in the "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students" as adopted by the October 2016 American Dental Association House of Delegates.

Proof of current successful completion of an Advanced Cardiac Life-Support Course, or its age appropriate equivalent.

Copy of your blank patient medical history form.

Copy of your blank patient sedation record form - This form must incorporate a time-oriented record of drug administration and regularly measured vital signs (must incorporate a grid or table).

Describe your drug control program - Explain record keeping requirements for prescribing, dispensing and storage of controlled substances in your office.

Proof of maintaining a permanent address within the State of Ohio - Where you conduct business pursuant to your Ohio Dental License - Address Attestation Form.

Proof of Properly Equipped Facility Checklist - Has properly equipped facility(s) whether fixed, mobile or portable, for the administration of general anesthesia or deep sedation in which the permit holder agrees to have available and utilize adequate monitoring, personnel, emergency equipment and drugs as recommended in the "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the October 2016 American Dental Association House of Delegates and/or the American Association of Oral and Maxillofacial Surgeon's "Office Anesthesia Evaluation Manual", 9th edition.

Valid Credit Card (MasterCard or Visa)

Application Fee $127.00

Evaluation Fee $400.00

Apply online through the portal here: elicense.ohio.gov

Please note: You must be a current Ohio licensed dentist to apply. Login to the portal, click OPTIONS on your dental license and select Apply for an endorsement.

Renewal Application

The board shall without charge renew the general anesthesia permit biennially at the time of dental licensure renewal, provided the permit holder attests to the Ohio State Dental Board that he or she has maintained successful completion of a basic life support course, and maintains successful completion of a course in advanced cardiac life support or its age appropriate equivalent, or a minimum of six hours of board approved continuing education devoted specifically to the management and/or prevention of emergencies associated with general anesthesia/deep sedation.

Conscious Sedation Permit

Initial & Renewal Application

Use of conscious sedation - OAC 4715-5-07

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Attachments:

One of the following:

Completed comprehensive pre-doctoral or continuing education conscious sedation training in an accredited educational institution or program, which included a minimum of sixty hours of didactic instruction and twenty cases of clinical experience commensurate with each intended route(s) of administration, whether:

Oral for children twelve years or younger; or

Non-intravenous parenteral; or

Intravenous

Training in intravenous conscious sedation qualifies the permit holder to administer any route of conscious sedation. Didactic and clinical training shall conform to the principles in the "Guidelines for Teaching Paint Control and Sedation to Dentists and Dental Students" as adopted by the October 2016 American Dental Association House of Delegates, with clinical experience commensurate with the intended route of administration; or

Completed an accredited post-doctoral training program which included conscious sedation training equivalent to above; or

Completed the qualifications governing the use of general anesthesia in rule OAC 4715-5-05.

Proof of current successful completion of an Advanced Cardiac Life-Support Course, or its age appropriate equivalent.

Copy of your blank patient medical history form.

Copy of your blank patient sedation record form - This form must incorporate a time-oriented record of drug administration and regularly measured vital signs (must incorporate a grid or table).

Describe your drug control program - Explain record keeping requirements for prescribing, dispensing and storage of controlled substances in your office.

Proof of maintaining a permanent address within the State of Ohio - Where you conduct business pursuant to your Ohio Dental License - Address Attestation Form.

Proof of Properly Equipped Facility Checklist - Has properly equipped facility(s) whether fixed, mobile, or portable, in which the permit holder agrees to have available and utilize adequate monitoring, personnel, emergency equipment and drugs as recommended in the "Guidelines for the Use of Sedation and General Anesthesia by Dentists" as adopted by the October 2016 American Dental Association House of Delegates.

Valid Credit Card (MasterCard or Visa)

Application Fee $127.00

Evaluation Fee $200

Apply online through the portal here: elicense.ohio.gov

Please note: You must be a current Ohio licensed dentist to apply. Login to the portal, click OPTIONS on your dental license and select Apply for an endorsement.

Renewal Application

The board shall without charge renew the conscious sedation permit biennially at the time of dental licensure renewal, provided the permit holder attests to the Ohio State Dental Board that he or she has maintained successful completion of a basic life support course, and maintains successful completion of a course in advanced cardiac life support or its age appropriate equivalent, or a minimum of six hours of board approved continuing education devoted specifically to the management and/or prevention of emergencies which may result from the use of conscious sedation.

Oral Health Access Supervision Permit

Initial Application

Application for permit; dentist - ORC 4715.362

Application for oral health access supervision permit: dentist - OAC 4715-10-01

Initial Application

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Valid Credit Card (MasterCard or Visa)

Fee $25.00

Apply online through the portal here: elicense.ohio.gov

Renewal Application

Expiration of oral health access supervision permit; renewal - ORC 4715.369

Expiration of oral health access supervision permit; renewal - OAC 4715-10-02

Renewal Application

Annual reports - ORC 4715.375

The Ohio State Dental Board shall annually report the status of the Oral Health Access Supervision Program (OHASP).

You will notice new sections on the OHASP renewal - This is to collect required data for reporting purposes.

How to complete the new sections on the updated OHASP Renewal:

Section 1 - Personal Information - under Additional Information - last question: Have you used the permit since issue or last renewal? Yes/No

If you answer, "Yes" to the above question, additional information will be requested on Section 2 - Background - under Specialty Tracking Component.

Instructions: Please report the data for your permit you currently hold. Only enter unique (no duplicate) locations for the Service Site Name, Service Site City and Service Site County).

Only enter a Service Location once. Please do not enter the same location more than once, even if you provided services there on more than one date.

To complete this requirement - click ADD SPECIALTY and enter the following information:

Service Site Name

Service Site City

Service Site County

OHAD (Dentist) permit holders will then enter - Total Number of Patients Clinically Evaluated at this location After Hygiene Services.

OHAH (Hygienist) permit holders will then enter - Total Number of Patients Provided Hygiene Services at this location.

Click ADD after the location is entered. If additional locations need to be entered, click ADD SPECIALTY again and repeat the process until complete.

Section 4 - Attachments - Upload the Oral Health Access Supervision Permit Reporting Form.

If you have not used the permit since issue or since last renewal - You can either:

1. Upload a Word document stating that you have not utilized the permit since issue or since last renewal, or

2. Upload the form provided and write/type that you have not utilized the permit since issue or since last issue.

Attachments:

Oral Health Access Supervision Permit Reporting Form

Valid Credit Card (MasterCard or Visa)

Fee $25.00

Renew online through the portal here: elicense.ohio.gov

Oral Health Access Supervision Permit Information

Definitions - ORC 4715.36

Permit required - ORC 4715.364

Authority under permit - ORC 4715.365

Compliance with protocols; appointments with authorizing dentist - ORC 4715.366

Maximum number of permittees under authorizing dentist - ORC 4715.367

List of locations where services are provided - ORC 4715.368

Authorized activities - ORC 4715.373

Teledentistry Permit

Initial Application

Requirements for teledentistry permit - OAC 4715-23-01

Initial Application

A Teledentistry Permit applicant must have a current license to practice dentistry in the state of Ohio.

You will need to answer Eligibility Questions before starting the application.

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Attachments:

Teledentistry Permit Equipment Checklist & Eligibility - Form must be completed with handwritten initials.

Teledentistry Service Locations - List of the locations where dental services will be provided through teledentistry.

Teledentistry Staff - List of the staff (Names and License/Registration Numbers) performing dental services through teledentistry when the dentist is not physically present and the location where they will provide these services.

Valid Credit Card (MasterCard or Visa)

Fee $20.00

Apply online through the portal here: elicense.ohio.gov

Renewal Application

Expiration; renewal - ORC 4715.432

Renewal Application

Verifies with the board the locations where dental hygienists and expanded function dental auxiliaries have provided services pursuant to the dentist's authorization since the teledentistry permit was most recently issued or renewed.

How to complete location tracking sections on the Teledentistry Permit Renewal:

Section 1 - Personal Information - under Additional Information - last question: Have you used the permit since issue or last renewal? Yes/No

If you answer, "Yes", to the above question, additional information will be requested on Section 2 - Background - under Specialty Tracking Component.

Instructions: Please report the service location(s) where Dental Hygienists and EFDAs have your authorization to provide services under your Teledentistry Permit.

Enter a service location only once. Please do not enter the same location more than once.

To complete this requirement - click ADD SPECIALTY and enter the following information:

Service Location Street Address

Service Location City

Service Location State

Service Location 5-digit Zip Code

Service Location County

Click ADD after the location information is entered. If additional locations need to be entered, click ADD SPECIALTY again and repeat the process until complete.

Section 4 - Attachments - Teledentistry Staff - Please upload information regarding your staff: Dental Hygienists and EFDAs that have provided service pursuant to the dentist's authorization since the Teledentistry Permit was most recently issued or renewed.

If you have not used the permit since issue or since last renewal - You can upload a Word document stating that you have not utilized the permit since issue or since last renewal.

Valid Credit Card (MasterCard or Visa)

Fee $20.00

Renew online through the portal here: elicense.ohio.gov

Teledentistry Information

Teledentistry; definitions; permit - ORC 4715.43

Scope of permit - ORC 4715.431

Suspension or revocation - ORC 4715.433

List of locations - ORC 4715.434

Authorized persons - ORC 4715.435

Rules - ORC 4715.436

Construction of teledentistry provisions - ORC 4715.437

Courses on proper placement of interim therapeutic restorations and applications of silver diamine fluoride - OAC 4715-23-02

Requirements for obtaining informed consent - OAC 4715-23-03

Procedures not permitted - OAC 4715-23-04

Equipment requirements for teledentistry - OAC 4715-23-05

Authorization - OAC 4715-23-06

Volunteer's Certificate

Initial Application

Volunteer's certificate - ORC 4715.42

Volunteer's certificate issued to retired dentist or dental hygienist to provide free services to indigent and uninsured persons; immunity - OAC 4715-22-01

Initial Application

A Volunteer Certificate is issued to a Retired Dentist or Hygienists to provide free service to indigent and uninsured persons.

Before you start, make sure you have the following information/documentation to complete the application.

Mailing/Public Address:

Education History:

Employment History:

Minimum requirement - Enter your most recent or current employment information if applicable. You can also list additional office locations here if applicable.

License Verification:

Email: licensing@den.ohio.gov
Mail: 77 South High Street, 17th Floor, Columbus, Ohio 43215-6135

Background Questions:

Attachments:

Copy of Degree from Accredited Dental College or Dental Hygiene School

Copy of most recent license to practice Dentistry or Dental Hygiene - Issued by a jurisdiction in the United States or in one or more branches of the United States armed services.

Proof of maintaining full licensure for at least 10 years prior to retirement - Full licensure in good standing, used by a jurisdiction in the United States or in one or more branches of the United States armed services, by means of a certification/verification letter(s).

Hepatitis B Immunity or Immunization - Hepatitis B Antibodies Titer, or Vaccination Record.

Color Photo - Taken in the last 6 months - Must be clear image of your face. Do not use filters commonly used on social media. Use a plain background.

No Fee

Apply online through the portal here: elicense.ohio.gov

Volunteer's Certificate Information & Renewal

Volunteer's certificate issued to retired dentist or dental hygienist to provide free services to indigent and uninsured persons; immunity - OAC 4715-22-01

A volunteer's certificate shall be valid for a period of 3 years.

Renewal Application

Proof of completion of 60 hours of continuing dental education, or 18 hours of continuing dental hygiene education. The nonprofit shelter or health care facility in which the holder provides dental or dental hygiene services may pay for or reimburse the holder for any costs incurred in obtaining the required continuing education credits.

No Fee

Renew online through the portal here: elicense.ohio.gov