Application for Licensure by Credential

Application for licensure based on meeting clinical and non-clinical practice requirements and holding an active and unrestricted license issued by another state, district, or territory of the United States to practice dentistry that is not subject to any current or pending disciplinary action such as revocation, suspension, or probation. Authority: Business and Professions Code (BPC) section 1635.5

Available Pathways to Obtain Licensure by Credential

  • Clinical Practice – (LBC3-Certification of Clinical Practice of Dentistry Form) – This pathway requires certification of active clinical practice, or certification of being a full-time faculty member in active clinical practice in a U.S.- accredited dental education program for at least 5,000 hours in another state district, or territory of the United States.
    *Requires a completed LBC3 form available on the Boards website.
  • Clinical Practice with Residency Completion – (LBC3-Certification of the Clinical Practice Dentistry Form). This pathway, the applicant may receive credit of 1,000 hours for each year, up to 2,000 hours, of clinical practice completed in the residency training program. Certification must be from a residency training program accredited by the Commission on Dental Accreditation (CODA) of the American Dental Association.
    *Requires a completed LBC3 form available on the Boards website.
    *Requires submission of a residency certificate with the application.
  • Pending Clinical Practice Contract – (LBC5-Certification of Pending Contract for Clinical Practice Form) – This pathway requires a signed, full-time (minimum of 32 hours per week), 2-year contract to practice dentistry as specified in Business and Professions Code (BPC) section 1635.5, subdivision (a)(3)(B) in at least one of the following:
    • A primary care clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code.
    • A primary care clinic exempt from licensure pursuant to subdivision (c) of Section 1206 of the Health and Safety Code.
    • A clinic owned or operated by a public hospital or health system.
    • A clinic owned and operated by a hospital that maintains the primary contract with a county government to fill the county's role under Section 17000 of the Welfare and Institutions Code.

    *Requires a completed LBC5 form to be submitted.
    NOTE: For more information on underserved communities, please visit Health Professional Shortage Area (HPSA).

  • Pending Faculty Practice Contract – (LBC6-Certification of Pending Contract for Faculty Practice form) – This pathway requires a signed, full-time (minimum average of 40 hours per week), 2-year contract to teach or practice dentistry as specified in BPC section 1635.5, subdivision (a)(3)(C) in at least one accredited dental education program approved by the Board.
    *Requires a completed LBC6 form to be submitted.
  • Non-Clinical Practice – (LBC4-Certification of Full-Time Nonclinical Practice Form) – This pathway requires certification of the applicant being engaged in full-time nonclinical practice that requires an active dental license in a federal, state, or local public health programs in another state, district, or territory of the United States for at least five years immediately preceding the application.
    *Requires a completed LBC4 form available on the Boards website.

Application Requirements

Before applying to the Board for a dentist license, all applicants must:

  • Be at least 18 years of age.
  • Submit a completed application online through BreEZe or by mail using a paper application.
  • The paper application can be found at the following link: Licensure by Credential. It should be mailed to the following address:
    • Dental Board of California
      2005 Evergreen Street, Suite 1550
      Sacramento, CA 95815
  • Pay a non-refundable application fee of $525.00.
  • Submit proof of having an active and unrestricted license issued by another state, district, or territory of the United States to practice dentistry that is not subject to any current or pending disciplinary action such as revocation, suspension, or probation. Submit an Out of State Certification Form.
    NOTE: The Board will accept an electronic copy only if emailed directly from the licensing agency. The Board will not accept license verifications directly from the applicant, whether via BreEZe, email, or mail (unless delivered in a sealed unopened envelope.)
  • Submit proof that the applicant has either been in active clinical practice in another state, district, or territory of the United States, has been engaged in full-time nonclinical practice requiring an active dentist's license for federal, state, or local public health programs in another state, district, or territory of the United States for at least five years immediately preceding the application, or has been a full-time faculty member in an accredited dental education program and in active clinical practice for a total of at least 5,000 hours within the past five years immediately preceding the date of the application.
    NOTE: If there are any gaps in clinical practice, please provide a written and signed statement of what you were doing professionally or personally during the gap(s) in clinical practice.
  • Submit proof that the applicant has not failed a state, regional, or national examination for licensure to practice dentistry within five years prior to the date of the application. If the applicant subsequently passed the examination for licensure, the prior failure shall not make the applicant ineligible. Acceptable proof is as follows:
    • Complete and submit the Certification of Non-Failure of Licensure form. This can be emailed to the Board for processing. This form is required even if you have never taken the WREB or ADEX examination or a state, regional, or national exam for licensure.
  • Submit classifiable sets of fingerprints. (Click link for more information)
    • For Live Scan service (only available in California) once you have submitted this application, Board staff will review and send you the Live Scan forms via email with instructions.
    • Applicants located outside of California must use hard cards provided by the Board or Standard FBI fingerprint cards. If submitting hard cards, the applicant must pay a non-refundable processing fee of $49 at the time of application submission or mailed to the Board along with the hard cards with a check or money order made payable to the Dental Board of California. You can email the Board at [email protected] to request a set of fingerprint hard cards.
  • Submit proof of completion of fifty (50) units of continuing education (CE) completed within two years preceding the date of the application. The CE shall include mandatory coursework prescribed by the Board.
    • Completion of the mandatory courses count for up to (10) CE units:
      • Basic Life Support (BLS) – This course must be provided by the American Red Cross (ARC) or American Heart Association (AHA) or approved by the American Safety and Health Institute (ASHI), American Dental Association's Continuing Education Recognition Program (CERP) or the Academy of General Dentistry's Program Approval for Continuing Education (PACE). A maximum of 4 units will be awarded for completion of this course.

      NOTE: Online courses will not be accepted for the BLS requirement. The course must include a live, in-person skills practice session, a skills test, and a written examination.

    • California Infection Control* – This course must be taken through a Registered Provider who has been approved by the Board to offer this mandatory course. A maximum of 2 units will be provided for this course.
    • California Dental Practice Act* – This course must be taken through a Registered Provider who has been approved by the Board to offer this mandatory course. A maximum of 2 units will be provided for this course.
    • Responsibilities and Requirements of Prescribing Schedule II Opioids*– This course must be taken through a Registered Provider who has been approved by the Board to offer this mandatory course. A maximum of 2 units will be provided for this course.

    *In order for the mandatory course certificates to be accepted by the Board, the course must be taken from a Board-approved mandatory course provider. To verify whether a provider is Board-approved to teach the mandatory course you wish to take from them, please see the Mandatory Course Provider Lookup.

Additional Application Forms

Licensure by Credential Application – This paper application is required if applying by mail. If you are applying online through BreEZe, this form is not required.

LBC3 Certification of the Clinical Practice Dentistry – This form must be submitted if you are applying through the clinical practice or clinical practice and residency pathway. It must be submitted when applying by mail or uploaded when applying online through BreEZe.

LBC4 Certification of Full-Time Nonclinical Practice – This form must be submitted if you are applying through the nonclinical practice pathway. It must be submitted when applying by mail or uploaded when applying online through BreEZe.

LBC5 Certification of Pending Contract for Clinical Practice Form – This form must be submitted if you are applying through the pending contract for clinical practice pathway. It must be submitted by mail or uploaded when applying online through BreEZe.

LBC6 Certification of Pending Contract for Faculty Practice – This form must be submitted if you are applying through the pending contract for faculty practice pathway. It must be submitted by mail or uploaded when applying online through BreEZe.

For more information, call (916) 263-2300 or email [email protected].