Enter your DENTPIN. This is a unique identification number that is assigned by the American Dental Association. Visit the American Dental Association site for more information or to obtain a DENTPIN.
Language Proficiency
Select your first language (the language of your birth). If you speak additional languages, click Add Another Language. Then, select the language(s) and the level of your proficiency in each.
License Infraction
Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, or in any way restricted by an institution, state, or locality. If yes, enter an explanation in the spaces provided.
Relatives in Oral Health
In this section, you can enter information about your relative(s) in oral health, including their role within your household, school attended, and degree(s). This information is only used for data and recruitment purposes.
Add a Relative
Select the relationship between you and the relative.
Enter their first and last names.
Enter their school attended. Note that this list only contains US-based schools. If your relative attended a foreign school, leave this field blank.
Select the type of degree or certification they earned or anticipate earning. If multiple degrees were earned, select the primary one.
