Board of Dentistry
When completing the application process below, you will be required to submit an official transcript from the institution where you completed your education. The transcript must be mailed directly from the educational institution to the board office located at 665 Mainstream Drive, Nashville, TN 37243.
Applications
Dentists, Dental Hygienists, and Registered Dental Assistants
- Declaration of Citizenship (Paper Application PH-4183)
- Declaration of Eligibility for Expedited Licensure Process for a Military Member (Paper Application PH-4279)
- Declaration of Eligibility for Expedited Licensure Process for a Spouse of Military Member (Paper Application PH-4280)
- Name and Address Change Request (Paper Application PH-3619)
- Retirement - Affidavit of Retirement From Practice in Tennessee (Paper Application PH-3460)
- Course Evaluation Form for Individual Licensees/Registrants Seeking Approval of Continuing Education Courses (Paper Application PH-3867)
- Application for Duplicate License (Paper Application PH-3872)
- Reinstatement/Reactivation Application (Paper Application PH-3870)
- Jurisprudence Exam
Dentists
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Application Instructions for Licensure as a Dentist (by exam, by criteria, by dual degree and for limited or limited educational licenses)
- Application for Licensure as a Dentist (Paper Application PH-3168) NOTE: Effective August 12, 2019, the clinical examination must include a prosthetic component, a periodontal component, an endodontic component, and a live human patient anterior and posterior restorative component. October 10, 2019 - Policy Statement on Dental Examination Requirements
Dentists who are graduating in 2020 and 2021 will not be required to have completed a live human patient anterior and posterior restorative component during the clinical examination pursuant to an Executive Order signed by Governor Lee that expires February 27, 2021. In response to questions regarding the periodontal portion of the exam, Rule 0460-02-.05 does not currently require the periodontal portion of the exam to be completed in person. The rule regarding examination requirements can be found at https://publications.tnsosfiles.com/rules/0460/0460-02.20190812.pdf
- Application for Licensure as a Dentist by Criteria (Reciprocity) (Paper Application PH-3802)
- Application for Limited and Limited Educational Licensure (Paper Application PH-3592)
- Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers (Paper Application PH-3585)
- Application Instructions for Conscious Sedation Permit (Paper Application PH-2865)
- Application Instructions for Deep Sedation/General Anesthesia Permit (Paper Application PH-3172)
- Application for Specialty Certification (Paper Application PH-3873)
- Application for Inactive Pro Bono Dental License (Paper Application PH-3892)
- Application for Special Volunteer License for Dentists and Dental Hygienists (Paper Application PH-3891)
- Jurisprudence Exam
- Dental Facility Permit Application (Paper Application PH 4348)
- List of Approved Dental Facility Inspectors
Dental Hygienists
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Limited Prescriptive Authority Certification Application
- Application Instructions for Licensure as a Dental Hygienist (by exam, by criteria and for limited educational licenses)
- Application for Licensure as a Dental Hygienist (Paper Application PH-0915)
- Application for Dental Hygienists to Practice Under Written Protocol (Paper Application PH-4187)
- Administration of Local Anesthesia Certification Application (Paper Application PH-3966)
- Certification of Successful Completion of the Injections Required for the Administration of Local Anesthesia Certification (Paper Application PH-4005)
- Application for Special Volunteer License for Dentists and Dental Hygienists (Paper Application PH-3891)
- Jurisprudence Exam
Dental Assistants
► Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Application for Registration as a Dental Assistant (Paper Application PH-3166)
- Certification Application for Registered Dental Assistants (Paper Application PH-3967)
- Sealant Certification Application for Registered Dental Assistants (Paper Application PH-3871)
- Certification of Sealant Placement During Externship (Paper Application PH 4262)
- Jurisprudence Exam
Programs and Certification Courses
- Application for Board Approval of a Certification Course in Administration Of Local Anesthesia (Paper Application PH-3968)
- Application for Board Approval of a Certification Course in Dental Radiology (Paper Application PH-3965)
- Application for Board Approval of a Certification Course in Administration and Monitoring Nitrous Oxide (Paper Application PH-3864)
- Application for Board Approval of a Certification Course in Coronal Polishing (Paper Application PH-3865)
- Application for Board Approval of a Certification Course in Monitoring Nitrous Oxide (Paper Application PH-3868)
- Application for Board Approval of a Certification Course in Prosthetic Functions (Paper Application PH-3863)
- Application for Board Approval of a Certification Course in Restorative Functions (Paper Application PH-3866)
- Application for Board Approval of a Certification Course in Sealant Application (Paper Application PH-3862)
- Application for Board Approval of a Registered Dental Assisting Program