You must complete this online application and pay the applicable $100 fee to begin the certification process. Application fees are not refundable; it is your responsibility to be aware of the requirements for licensure and be sure that you wish to apply.
Before You Begin
Information Needed For Application
- Contact Information, including mail & email addresses and phone number(s).
- Post-doctoral educational history, including degrees, locations and dates.
- Current New York State Dentist license number.
- Documentation of course completion for Advanced Cardiac Life Support (ACLS) and/or Pediatric Advanced Life Support (PALS) can be uploaded with application.
- Professional licensure, including details about any other professional licenses held.
- Endorsement applicants will need to provide electronic copies of anesthesia records.
- Payment information (payment is only accepted by MasterCard, Visa, or American Express).
- To save and return to the application you must have a Social Security Number.
If you require assistance with the online application, please email OPOnlineApplications@nysed.gov.
Receipt For Application
Once NYSED has received this initial application form and payment electronically, you will receive an email indicating the document and payment have been received. Please retain this email notification as your proof of payment. It is your responsibility to follow up with anyone you have asked to send us material.