New Jersey Division of Consumer Affairs

Congratulations!

You have completed the Online Orientation, one of the requirements for a dentistry license.

Please complete the Orientation Verification form below
to alert the Board that you have satisfied this requirement.

Thank you!



Orientation Verification Form

□ = Required Field
△ = Required if you currently hold a NJ Dentistry License.

□ Full Name:
□ Email Address:
□ Phone Number:
(ex: 9995551111)


  • If you are a licensee, please enter your license number below. Your license number will start with "22DI __________"

  • If you are an applicant, please enter "0000" below.
△ License Number:22DI