Dentist

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​​​ ​​​​Now Live: Easier Online License Applications!

LicensE, our new, online, self-guided occupational license application platform is now live! The list of licenses available via LicensE is available HERE​.  Starting on May 16, 2022, those applicants can apply at license.wi.gov.​

LicensE is for new, initial applications only. To renew your license, click HEREYou should not use LicensE to renew your license at this time.​


For additional information, please see the LicensE User Guides and Video page. ​Check back for updates, FAQs, and application tips.

License Information

Per Wis. Stat. § 440.08 (2), the required renewal date for the Dentist credential is 09/30/odd years.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.

CPR and AED must be current to practice dentistry.


Pre-Credential Education Information

Graduate from a dental school accredited by the American Dental Association Commission on Dental Accreditation.

  • A foreign trained Dentist may qualify for a license if he or she submits to the Board evidence of one of the following, in addition, a foreign trained Dentist must submit the same information required of non‑foreign trained Dentists listed in Wis. Admin. Code. § DE 2.01(1)(a) to (d),(f) and (g):
    • Having been awarded a DDS of DMD degree from an accredited dental school;
    • verification of having received a dental diploma, degree, or certificate from a full time, undergraduate supplemental dental education program of at least two academic years at an accredited dental school.  The program must provide didactic and clinical education to the level of a DDS or DMD graduate.

Conscious Sedation

Dentists administering minimal sedation do not need to obtain a sedation permit from the Dentistry Examining Board. Dentists administering moderate or deep anesthesia or sedation must obtain a permit from the Board. Once attained, the conscious sedation permit is renewed automatically at the time of license renewal without further education.

Changes to Wis. Admin. Code ch. DE 11, Anesthesia, became effective September 1, 2020. Please click on the following hyperlink for further information: Dentist Sedation Permit Information. 

Note to Conscious Sedation Training Providers

  • The permit application includes form # 2758 for training providers to verify that courses already provided to individuals meet the requirements. Providers/ schools must return verification directly to DSPS. You may fax/email with facility fax cover sheet or facility cover letter to: (608) 251-3036 or dspscreddentistry@wisconsin.gov.

Anesthesia Record Keeping and Reporting

​​​Anesthesia record keeping requirements are listed in Wis. Admin. Code § DE 11.09(9). For convenience, the following links provide a sample form and sample record from the American Dental Association (ADA) website:
                          ADA Sample Sedation Anesthesia Record-Blank
                      ADA Sample Sedation Anesthesia Record-Completed
Adverse occurrences related to anesthesia administration reporting requirements are listed in  Wis. Admin. Code § DE 11.10. Form 2764​ (below) may be used for reporting purposes. 

Application for Licensure
FormDescription
512Credentialing Information for Dental Applicants
​3217​Application for Fee Reduction (If applying for a fee reduction, this form must accompany the application for the credential.)
1471

Dentist Certificate of Professional Education (This form must be completed by your school and returned directly to the Department)

2829Malpractice Suits or Claims Form (if applicable)
​3085​Application for Predetermination (Optional-Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other and you desire a review of your conviction record before applying for a credential.)​
2252​Convictions and Pending Charges
3071​Fax Payment Form

Application for Certificate to Administer Anesthesia/Conscious Sedation

FormDescription
2759​Application for Permit to Administer Anesthesia or Conscious Sedation 
​2758Anesthesia or ​Conscious Sedation Education Verification Form
2764​Report of Adverse Occurrences Related to Anesthesia Administration
​3071Fax Payment Form

​Application for Faculty License

FormDescription
2650
Credentialing Information for Dental Faculty Applicants
2653​Faculty Dentist Certification of Offer of Employment
2252​Convictions and Pending Charges
2829Malpractice Suits or Claims Form (if applicable)
​3071Fax Payment Form

​Application for Temporary Permit to Practice Dentistry Without Compensation

FormDescription
2850Credentialing information for Dentistry Practice without Compensation Applicants​
​2759​Application For Dental Permit to Administer Conscious Sedation
2252Convictions and Pending Charges
2829​Malpractice Suits or Claims Form (if applicable)
3071​Fax Payment Form

Profession Forms

FormDescription
1817Documentation of Training Delegable Procedures to Unlicensed Person (Dental Assistant Delegation Form)

Renewal Information

Requirements

  • FEE (See Renewal Dates and Fees)
  • SIG (Signature regarding the completion of Continuing Education, included in on-line renewal and paper form see Continuing Education Information for details)
  • CPR (Current CPR/AED certification is required)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at (608) 266-2112 or dsps@wisconsin.gov.

Renewal Methods

FormDescription
RDAFRenewal Dates and Fees
R210Active Duty/Discharge Renewal Extension

Wisconsin Act 210 (effective June 1, 2012)

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship.  Please view Active Duty/Discharge Renewal Extension Form #R210.