Name and Address Changes

Frequently asked questions

  • How do I change my name?
    • Name changes must be done in writing on the required Notification of Name Change form. In addition to the form, you must send in the required documentation, used as proof of a legal name change.
    • For licensees, if you are requesting a new license with your new name on it, you will need to return your actual license, a copy of your certified document as proof of the change, and $50 for the replacement of the license.
  • What documentation is acceptable for a name change?
    • You must submit photocopies or electronic copies of the following two required documents with your Notification of Name Change form:
      • 1. A current government issued photographic identification (e.g. driver license, alien registration, passport, etc.) AND
      • 2.One of the following additional legal documents as proof of name change.
        Certified Court Order
        Marriage Certificate
        Dissolution of Marriage (Divorce)
  • How long does it take to process a name change?
    • Once all documentation (and fee if applicable) has been received by the Dental Board (Board) the name change can be seen on the web site within 2 weeks. If the license is being replaced, the replacement license will be mailed within 4 weeks.

Examination Applicants

  • PSI will not allow me to sit for the exam, what do I do?
    • If PSI will not allow you to take the written exam because your name is different at the Board than on your drivers license, you must either change your drivers license to match your legal name, or change your name at the Board to your legal name using one of the acceptable documents listed above.
  • Why haven't I received my results of the practical exam?
    • If you presented an ID that did not match the Board's records, was expired or invalid, your results will not be sent until the Board receives sufficient proof if identification.

For more information, call (916)-263-2300 or email

Name change form