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Tuesday, 21 October 2014
 
 
General Info: How Do I...? Print E-mail

EXISTING LICENSE

How do I...

Request a Duplicate Renewal Form

Request a Duplicate Annual Registration Certificate (Certificate displayed where services are provided)

Request a Change of Address

Request a Name Change

Replace a Lost or Destroyed Dental or Dental Hygiene License

Learn about CPR Requirements

Learn About Military Active Duty Fee Exemption

Submit a Retirement Request Form

Reinstate a Retired License


DUPLICATE RENEWAL FORMS

Renew Online without a Renewal Form!  Click  HERE  to Renew Online if you are within 45 days of your expiration date or if your expiration date has passed.  (Cancelled licenses and registrations are nonrenewable)

Print Your Own Renewal Form! - Fast and Easy!:  Click   HERE   to print your renewal form and mail it to the Dental Board.

Not Have a Printer?  You may submit your request for a Renewal Form by fax at (512) 463-7452 or by e-mail to This email address is being protected from spam bots, you need Javascript enabled to view it . Include your full name, and current mailing address, include your dental profession, license number or dental assistant registration number.


 

DUPLICATE ANNUAL REGISTRATION CERTIFICATE REQUESTS

(For Dentists, Dental Hygienists and Dental Assistants)

Duplicate or additional copies of your license or registration certificate are available by submitting to the SBDE a Duplicate Annual Registration Certificate Request Form to our office.  There is a fee of $25 per document.  Please use the form below to make your request.  Please allow two weeks for processing.

FILE NAMEAcrobat File (PDF)
Duplicate Annual Registration Certificate Request
PDF Icon


CHANGE OF ADDRESS REQUEST

All requests for a change of address must be submitted in written form. You can also use the form below to submit your request. The SBDE is not able to accept address change requests verbally. You may submit the change via e-mail to This email address is being protected from spam bots, you need Javascript enabled to view it or by fax to (512) 463-7452 or via U.S. Postal Service. Provide your name, Texas License Number or Dental Assistant Registration Number and indicate which address is changing and which one you want designated as your primary mailing address and include your phone number.

FILE NAMEAcrobat File (PDF)
Change of Address Request FormPDF Icon

 


REPLACE A LOST OR DESTROYED DENTAL OR DENTAL HYGIENE LICENSE
The License bears the names of the Board Members of the State Board of Dental Examiners The License is issued once, shortly after the initial license application has been processed.

FEE:  $25

Dentists and Dental Hygienists who have lost their License or their license has been destroyed, need to pay a $25 fee, write a letter requesting a new license be issued and include the Affidavit of Destruction or Loss of Texas Dental / Dental Hygiene License Form.

FILE NAMEAcrobat File (PDF)
Affidavit of Destruction or Loss of Texas
Dental / Dental Hygiene License Form
PDF Icon

 



NAME CHANGE REQUEST

      Dentists and Dental Hygienists

Name changes on licensing records may only be accomplished following a submission of the following:

1) SBDE Dental & Dental Hygienist Name Change Request Form.

2) Photocopy of legal documentation of the change (marriage license, divorce decree, court order, etc.)

3) Original Texas License (Original license reflects the signature of all SBDE Board Members).

4) License Renewal Form (if request is made at the time of renewal)

5) Non-refundable fee of $25 if the request is made at the time of renewal or $50 if requested at any other time.

6) In the event the licensee does not have the Original SBDE License reflecting the names of all SBDE Board Members, an Affidavit of Destruction or  Loss of Texas Dental/Dental Hygiene License Form must accompany the name change request form.
 

FILE NAMEAcrobat File (PDF)
DDS - RDH Name Change Request FormPDF Icon

     
        Dental Assistants

Name changes on registration records may only be accomplished following a written request from the registered dental assistant and submission of all required documentation of the change, SBDE Registration Certificate Name Change Request Form and fee. Legal documents include a marriage license, divorce decree, court order, etc.) Fees for name changes:

1) Name change at the time of registration renewal: No Charge
2) Name change request submitted any other time: $25.00

FILE NAMEAcrobat File (PDF)
Registration Name Change Request Form for Dental AssistantsPDF Icon

 


CPR CERTIFICATION

All dental office personnel must hold a current CPR certification in basic life support.  Certifications are current as indicated on your card’s recommendation.  Please look on your card to determine the recommendation for renewal.

CPR training must include a written assessment and a demonstration of skills. Computer and video-based CPR training courses given by a live instructor that include a written assessment of skills and hands-on manikin training by the applicant are acceptable.  Online courses that do not include hands-on manikin training by the applicant and a written assessment of skills are not acceptable. 


MILITARY ACTIVE-DUTY FEE EXEMPTION

Dentists and Dental Hygienists on active duty with the armed forces are exempt from annual renewal fees; however, a copy of the military ID card must be submitted annually with the renewal form in lieu of fee payment, and the card must bear the title “Armed Forces of the United States”. Uniformed Services do not qualify for the exemption.


RETIREMENT REQUEST

Dentists and Dental Hygienists with active licenses in good standing may apply for retirement of their license. During the period of retirement all fees and continuing education requirements are waived. You must submit a Retirement Request Form prior to the license expiring.

FILE NAMEAcrobat File (PDF)
Retirement Request FormPDF Icon


REINSTATEMENT OF A RETIRED LICENSE

Dentists and Dental Hygienists wishing to reinstate a retired license can click here to be directed to information on how to submit an application and supporting documentation for reinstatement of a retired Texas License.

SBDE Rules pertaining to the reinstatement of a retired license are:

Dentists:                      SBDE Rule 101.7 – Retired License Status
Dental Hygienists:      SBDE Rule 103.7 – Retired License Status

 

 
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