Dentist

​Additional Resources

Other Forms

Statutes and Administrative Code

Continuing Education Information

Exam Information

Offenses that May Result in Refusal, Bar, or Termination of Licensure

Related Links

Dentistry Examining Board

Orders and Disciplinary Actions

Conviction Self Report

Professional Assistance Procedure

Monitoring

File a Complaint

Wisconsin Emergency Assistance Volunteer Registry (WEAVR)

Pursuant to 2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record.  To apply for a predetermination, please fill out Form #3085 and submit all required documentation specified on the form.  Pursuant to Wis. Stat. § 111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.


License Information

Fee Reduction

Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee.  Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.

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 anesthesia or sedation (other than nitrous oxide inhalation or anxiolysis) 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.

Airway Management or ACLS must be current to practice conscious sedation.

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.


Application for Licensure

FormDescription
512Application for Dental License
​3217​Application for 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 (Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal, state, or local law, including municipal ordinances, in this state or any other)
2252​Convictions and Pending Charges
3071​Fax Payment Form

Application for Certificate to Administer Anesthesia/Conscious Sedation

FormDescription
2759​Application For Dental Permit to Administer Conscious Sedation
​2758​Conscious Sedation Provider School Verification Form (This form is for course providers to verify courses already approved)
2764​Report of Adverse Occurrences Related to Anesthesia Administration
​3071Fax Payment Form

​Application for Faculty License

FormDescription
2650Application For Dental Faculty License
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
​2850​Application to Practice Dentistry without Compensation
​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.