Contacts
Board of Registration in Dentistry
The Details of Request an address change, name change, or duplicate license for dentistry
Fees for Request an address change, name change, or duplicate license for dentistry
You need to pay a fee if you are requesting:
- To change your name and receive a license with your new name
- A duplicate license to replace a missing license
There is no fee for just changing the address on your license. You can do so online by going to the Board’s website.
Please note that you can't go online to change your name or address on an individual or local anesthesia permit. You must send us a written request and payment for a new permit with your updated information.
Forms of payment
- We accept personal checks, business checks, or money orders. Make it payable to the Commonwealth of Massachusetts.
- All fees are non-refundable and non-transferable
- Please don't staple payment to the application
- Please don't send cash
| Name | Fee | Unit |
|---|---|---|
| Duplicate license | $17 | per license |
| Name change with new license | $27 | per license |
How to request Request an address change, name change, or duplicate license for dentistry
Go to the Health Professions Licensing Portal and create an account, or log into your existing account. If this is your first time using this new portal, please visit Health Professions Licensing System User Guide.
Contact for Request an address change, name change, or duplicate license for dentistry
Address
250 Washington Street, Boston, MA 02108
Phone
Fax
(617) 973-0980