N.H. Admin. Code § Den 301.02 - Application for Dental License
(a) Each applicant
for a license to practice dentistry in the state of New Hampshire shall
complete and submit the "Universal Application for Initial Licensure" required
by Plc 304.01(a)(1).
(b) In
addition to the information required by (a) above the applicant for dental
license shall provide and submit the following information on the "Dentist
Addendum to the Universal Application for Initial Licensure":
(1) Any other names by which the applicant
has been known;
(2) Whether the
applicant has taken and passed the examinations of the:
a. Joint Commission on National Dental
Examinations; and
b. ADEX
examination, or other equivalent U.S. regional or state board clinical
examination for dentists, including a clinical periodontal scaling component or
the manikin examination; and
(3) Has ever had a Drug Enforcement
Administration (DEA) license revoked, suspended, denied, placed on probation,
restricted, or otherwise sanctioned by a state or federal licensing regulatory
board or agency, or which is currently involved in an investigation or
disciplinary process.
(c)
The following shall be submitted with the application for initial licensure:
(1) At least 3 "Statement of Professional
Character" forms, as described in
Den
301.01(c)(2), completed by at least 2
licensed dentists in good standing if the applicant has previous dental
employment. The dentist shall sign and complete the "Statement of Professional
Character" form within 4 months of the date of submission of the
application;
(2) Signed
certification of graduation or, if not more than 3 months prior to the date the
degree will be conferred, a certification of completion by the dean or
registrar of the dental college granting the applicant a degree;
(3) One of the following:
a. An original or certified copy of the
applicant's birth certificate written in English or translated to
English;
b. A certified copy of the
applicant's valid passport written in English or translated to English;
or
c. A driver's license or other
state issued identification;
(4) Proof of current basic life support for
healthcare providers (BLS-HCP), if applicable;
(5) A criminal offender record check provided
in accordance with Plc 304.01(b);
(6) An official copy of the applicant's
dental school transcript and, if applicable, a copy of a specialty training
certificate bearing the registrar's original signature and the school's seal or
a letter on school letterhead sent directly to OPLC. An unofficial transcript
and a diploma stamped with the dental school seal may be provided until the
official transcript is ready;
(7)
The applicant's original grade card denoting successful completion of the
examination of the Joint Commission on National Dental Examinations and the
American Board of Dental Examiners (ADEX) or other equivalent examination
described in (b)(2)b., above;
(8) A
certified statement from the dental examining board of each state in which the
applicant has been licensed as to whether the applicant's license to practice
in that state based on the records of the board, as follows:
a. Has been subject to disciplinary
action;
b. Has disciplinary action
pending;
c. Has been under stayed
probation; or
d. Is under
investigation; and
(9)
The fee required pursuant to Plc 1002.11.
(d) Applicants shall have successfully passed
their regional boards and provide verification directly to OPLC from the CDCA
or other equivalent U.S. regional or state board that the applicant has taken
and passed the board clinical examination or manikin examination for dentists,
including a clinical periodontal scaling component, within the 3 years
immediately prior to submitting the application.
(e) Endorsement certification shall be
considered for each applicant in accordance with Plc 313.22.
(f) The education requirements specified in
RSA
317-A:8 shall apply to all applicants for
licensure under this section.
(g)
An applicant shall be a graduate of a dental school general dentistry program
which:
(1) Is of at least 2 academic years in
duration;
(2) Is accredited by the
Commission on Dental Accreditation (CODA); and
(3) Awards the degree of Doctor of Dental
Medicine (DMD) or Doctor of Dental Surgery (DDS).
(h) When the required materials have been
approved by the OPLC, the applicant shall take a jurisprudence exam on the
contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through
Den 500, the American Dental Association's Principles of Ethics and Code of
Professional Conduct, and the American Dental Hygienists' Association Code of
Ethics for Dental Hygienists.
(i)
The passing score on the jurisprudence exam shall be 75% or higher.
(j) After passage of the jurisprudence exam
in (h) above, the OPLC shall issue an active New Hampshire dental
license.
(k) When an applicant
possesses a DEA number to prescribe schedules II-IV controlled substances
pursuant to RSA
318-B:41, I(a), the
applicant for licensure shall register with the New Hampshire Controlled Drug
Prescription Health and Safety Program (PDMP), pursuant to
RSA
126-A:91. If the applicant possesses a DEA
number, the applicant shall provide it to the OPLC. Failure to register within
90 days of the initial issuance of a license shall constitute professional
misconduct within the meaning of
RSA
317-A:17, II and shall be
grounds for disciplinary action. A licensee shall not engage in the prescribing
or dispensing of controlled substances in schedules II-IV without having
registered with the New Hampshire PDMP.
Notes
#287.2, eff 1-17-74; ss by #2981, eff 2-28-85; amd by #4257, eff 4-15-87; ss by #5110, eff 4-4-91; rpld by #5755, eff 12-14-93
New. #5755, eff 12-14-93 (from Den 301.04); amd by #6186, eff 2-17-96; amd by #6541, eff 7-18-97; ss by #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(a) Each applicant for a license to practice dentistry in the state of New Hampshire shall provide the following on the "Dentist Application for Licensure":
(1) Applicant's name;
(2) Applicant's date of birth;
(3) Applicant's place of birth;
(4) Applicant's social security number, pursuant to RSA 161-B:11, VI-a;
(5) Any other name by which the applicant has been known;
(6) Applicant's current residential address, telephone number, and primary email address either business or personal;
(7) Applicant's educational background, including:
a. The names of the colleges attended;
b. The date of graduation and degree, if any;
c. The names of the dental schools attended;
d. The dates of attendance and graduations;
e. The types of post graduate dental programs completed; and
f. The certificates or degrees, if any, including specialty training certificate;
(8) Whether the applicant has taken and passed the examinations of the:
a. Joint Commission on National Dental Examinations; and
b. American Board of Dental Examiners (ADEX) examination, or other similar U.S.regional or state board clinical examination for dentists, including a clinical periodontal scaling component or the manikin examination;
(9) A listing of the following:
a. All places where the applicant has possessed a license to practice dentistry, including the state and license number, issue date, whether active or inactive, and dates of practice; and
b. Professional employment history including the dates, locations, and status;
(10) Whether the applicant:
a. Has been convicted of a felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;
b. Has been convicted of the illegal practice of dentistry;
c. Has ever been denied dental licensure;
d. Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education;
e. Possessed a dental license that has been revoked, suspended, placed under probation or stayed probation, restricted, not renewed, involuntarily relinquished, or otherwise sanctioned, or is currently under review in any jurisdiction or state;
f. Has had any physical or mental illness that impairs the ability to practice dentistry;
g. Has been advised by a health practitioner or mental health practitioner that a physical or mental illness impairs the ability to practice dentistry;
h. Has investigations or disciplinary actions pending against the applicant's dental license;
i. Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending;
j. Has had hospital privileges revoked, suspended, restricted, denied, not renewed, or involuntarily relinquished; or
k. Has ever had a DEA license revoked, suspended, denied, placed on probation, restricted or otherwise sanctioned by a state or federal licensing regulatory board or agency, or which is currently involved in an investigation or disciplinary process;
(11) Whether the applicant has an addiction to alcohol, narcotics, or other mind altering drugs which impairs the applicant's ability to practice dentistry;
(12) A listing of the dental continuing education courses taken during the last 2 years;
(13) At least 3 signed certifications of good professional character, with at least 2 by licensed dentists in good standing, if the applicant has previous dental employment;
(14) Signed certification of graduation or, if not more than 3 months prior to the date the degree will be conferred, a certification of completion by the dean or registrar of the dental college granting the applicant a degree; and
(15) Whether the applicant's CPR certification is current, and if so, provide proof.
(16) Whether the applicant has a DEA number to prescribe schedule II-IV controlled substances and if yes:
a. Provide the DEA number; and
b. Indicate whether or not the DEA number will be associated with the applicant's dental license.
(b) An unmounted passport-type photograph of the applicant shall be:
(1) Attached to the;
(2) Taken not more than 6 months before the date on the application;
(3) No smaller than 2 and 1/2 inches square; and
(4) Impressed or stamped by a portion of the seal of the dental school from which the applicant graduated.
(c) The shall be signed by the applicant, notarized, and filed with the office of professional licensure and certification. Deceptive or false statements, knowingly made by the applicant shall result in denial of license. By signing the, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against his or her license to practice dentistry and consents to a criminal background check.
(d) The shall be accompanied by the following documents:
(1) A certified check or money order made payable to the "Treasurer, State of New Hampshire" for the application fee specified in Den 301.08;
(2) Either of the following:
a. An original or certified copy of the applicant's birth certificate written in English or translated to English; or
b. A certified copy of the applicant's valid passport written in English or translated to English; and
(3) A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board.
(e) The following documents shall be filed with the board directly by the issuing agency:
(1) An official copy of the applicant's dental school transcript and, if applicable, a copy of a specialty training certificate bearing the registrar's original signature and the school's seal or a letter on school letterhead sent directly to the board's office. An unofficial transcript and a diploma stamped with the dental school seal may be provided until the official transcript is ready;
(2) The applicant's original grade card denoting successful completion of the examination of the Joint Commission on National Dental Examinations; and
(3) A certified statement from the dental examining board of each state in which the applicant has been licensed as to whether the applicant's license to practice in that state based on the records of the board, as follows:
a. Has been subject to disciplinary action;
b. Has disciplinary action pending;
c. Has been under stayed probation; or
d. Is under investigation.
(f) The board shall verify directly with the CDCA or other similar U.S.regional or state board that the applicant has taken and passed the board clinical examination for dentists, including a clinical periodontal scaling component, within the 3 years immediately prior to submitting the application.
(g) Endorsement certification shall be considered for each applicant who holds a current, unsuspended, unrestricted license to practice dentistry who deposits with the board the required credentials if:
(1) The applicant has taken and passed the American Board of Dental Examiners (ADEX) examination, or other similar U.S.regional or state board clinical examination for dentists, including a periodontal scaling exam; and
(2) Throughout the 3 years immediately prior to submitting the application, the applicant:
a. Has practiced clinical dentistry in one or more states;
b. Has been in dental specialty training;
c. Has been in active military dental service; or
d. Has been in any combination thereof.
(h) The education requirements specified in RSA 317-A:8 shall apply to all applicants for licensure under this section.
(i) Pursuant to RSA 317-A:8, an applicant shall be a graduate of a dental school general dentistry program which:
(1) Is of at least 2 years duration;
(2) Is accredited by the Commission on Dental Accreditation (CODA); and
(3) Awards the degree of Doctor of Dental Medicine (DMD) or Doctor of Dental Surgery (DDS).
(j) When the required materials have been approved by the board, the applicant shall take a test on the contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through Den 500, the American Dental Association's Principles of Ethics and Code of Professional Conduct, and the American Dental Hygienists' Association Code of Ethics for Dental Hygienists.
(k) After passage of the test in (j) above, the board shall issue an active New Hampshire dental license upon payment of the full registration fee adopted in Den 301.08.
(l) Required materials that are subject to change shall be updated if more than 4 months old at the time of completion of application.
(m) After 6 months, the board shall discard the applications of applicants who choose not to complete the application process.
(n) If an applicant possesses a DEA number to prescribe schedules II-IV controlled substances pursuant to RSA 318-B:41, I(a), the applicant for licensure shall register with the New Hampshire Controlled Drug Prescription Health and Safety Program (PDMP), pursuant to RSA 126-A:91. If the applicant possesses a DEA number, the applicant shall provide it to the board. Failure to register within 90 days of the initial issuance of a license shall constitute professional misconduct within the meaning of RSA 317-A:17, II and shall be grounds for disciplinary action. A licensee shall not engage in the prescribing or dispensing of controlled substances in schedules II-IV without having registered with the New Hampshire PDMP.
Notes
#287.2, eff 1-17-74; ss by #2981, eff 2-28-85; amd by #4257, eff 4-15-87; ss by #5110, eff 4-4-91; rpld by #5755, eff 12-14-93
New. #5755, eff 12-14-93 (from Den 301.04); amd by #6186, eff 2-17-96; amd by #6541, eff 7-18-97; ss by #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13