Application for Licensure by Credential

Application for licensure based on meeting clinical practice requirements and holding a current active and unrestricted license in another U.S. state or territory.

Available Pathways to Obtain Licensure by Credential

  • Clinical Practice – (LBC3 Verification of Clinical Practice hours form) – Requires certification of 5,000 hours of clinical practice in five of the seven consecutive years preceding the date of the application.
  • Clinical Practice with Residency Completion – (LBC3 Verification of Clinical Practice hours form) Requires submission of a Residency Certificate with the application. The applicant receives 2,000 hours and 2 years of credit towards the clinical practice requirement of 5,000 hours and 5 years. Certification must be from a residency training program accredited by the Commission on Dental Accreditation (CODA) of the American Dental Association.

    NOTE: Self-employment – Applicants that own their practice must submit a copy of page 1 only of Schedule C Form 1040, for each year of qualifying practice time. Or, if incorporated, submit a copy of page 1 only of Form 1120S. This does not apply to independent contractors.

  • Pending Clinical Practice Contract – (LBC5 – Verification of Pending Contract for Clinical Practice Form) – The Clinical Practice Requirement may be fulfilled if the applicant agrees to a full-time, 2-year contract to teach or practice dentistry in the clinical settings specified in Business and Professions Code (BPC) section 1635.5, subdivision (a)(3)(B).

    The pending contract must be verified by a primary care clinic licensed under Health and Safety Code (HSC) section 1204 or a facility exempt from licensure pursuant to HSC section 1206.

  • Pending Faculty Practice Contract – (LBC6 – Verification of Pending Contract for Faculty Practice form) – The Clinical Practice Requirement may be fulfilled if the applicant agrees to a full-time, 2-year contract to teach or practice dentistry in educational facilities approved by the Dental Board as specified in BPC section 1635.5, subdivision (a)(3)(C).

    NOTE: Applicants should obtain the contract from their pending employer before submitting the completed application to the Board.

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.
  • Provide a color passport-style photo. Please ensure the photo is clear with a plain background and the applicant’s entire profile is visible. The photo should be included with the initial application, or it can be emailed to the Board for processing.
  • Provide proof of a current active license issued by another U.S. state or territory to practice dentistry. The license must not be revoked, suspended, or otherwise restricted. Submit an Out of State Certification Form.

    NOTE: The Board will accept an electronic copy only if emailed directly from the licensing agency. If your state does not send out verifications, the Board will review the state’s website and verify licensure if applicable.

  • Provide proof that the applicant has either been in active clinical practice or has been a full-time faculty member in a U.S.- accredited dental education program and in active clinical practice for a total of at least 5,000 hours in 5 of the 7 consecutive years immediately preceding the date of the application. This requirement can be met by one of the following pathways:

    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.

    • Clinical Practice – Completion of at least 5 years and 5,000 hours of clinical practice within the 7 years immediately preceding the date of the application.
    • Clinical Practice and Residency – Completion of CODA-approved residency program and at least 3 years and 3,000 hours of clinical practice within the last 7 years preceding the date of the application. A maximum of 2 years and 2,000 hours of clinical practice credit will be applied to the total 5 year and 5,000 hour requirement with proof of completion of that residency program. Completion certificates must be submitted with the application to receive credit.
    • Pending Clinical Practice Contract – The clinical practice requirement may be fulfilled if the applicant agrees to a full-time two-year clinical practice contract to teach or to practice dentistry in settings specified in BPC section 1635.5, subdivision (a)(3)(B).
    • Pending Faculty Practice Contract – The clinical practice requirement may be fulfilled if the applicant agrees to a full-time two-year faculty practice contract to teach or to practice dentistry in settings specified in BPC section 1635.5, subdivision (a)(3)(C).
  • Provide proof that the applicant has not failed the Western Regional Examining Board (WREB) examination within the last five (5) years and proof that the applicant has not failed the American Board of Dental Examiners (ADEX) examination on or after November 15, 2019, and within the last five (5) years. Acceptable proof is as follows:
    • A written self-certified statement that is signed and dated by the applicant stating that the applicant has never taken and/or failed the ADEX or WREB examination. This can be emailed to the Board for processing. This statement/letter is required even if you have never taken the WREB or ADEX examination.
    • An Individual Performance Report (WREB) or a Cumulative Score Report (ADEX) that shows no failures. This should be requested by the agency that administers the examination and can be emailed directly to the Board.
  • Provide classifiable sets of fingerprints either by Live Scan service (only available in California) or on hard fingerprint cards. Applicants must use hard cards provided by the Board or Standard FBI fingerprint cards. If submitting hard cards, the applicant must pay a processing fee of $49.
  • Provide proof of completion of fifty (50) units of continuing education (CE) completed within two years preceding the date of application, including all four current mandatory course certifications.

    Completion of the four mandatory courses count for up to (10) CE units:

    1. 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.

    2. 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.
    3. 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.
    4. 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 ApplicationThis paper application is required if applying by mail. If you are applying online through BreEZe, this form is not required.

LBC3 Verification of Clinical PracticeThis 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.

LBC5 – Verification of Pending Contract for Clinical Practice FormThis 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 – Verification of Pending Contract for Faculty PracticeThis 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 DentalBoard@dca.ca.gov.