TSDBE Questionnaire Requirement
*NOTE: The TSBDE has revised the deadline for this questionaire to August 31, 2014. Please visit their website for more information*
The Texas State Board of Dental Examiners (TSBDE) is requiring ALL Texas licensed dentists to complete the Board’s Dental License Renewal Questionnaire. The Questionnaire may be accessed at: http://tsbde.state.tx.us/ and may be completed in writing or online. Information needed to complete the Questionnaire includes:
Licensees who do not complete the questionnaire may be subject to action from the TSBDE.
General Information: Dentist's Name, Contact Information, Texas Dental License Number, Specialty Certifications Held.
Dental Practice Ownership: Number of Practices Owned; Practice Name(s) and Location(s) and Services Provided at Each Location.
Employed Dentists In the Practice: Full Name(s), Texas Dental License Number(s), Specialty Certification(s) held by each employed dentist.
Dental Service Organization Information: Ownership and Practice Location Information.
Dental Service Agreement Information: Number of Agreements Entered Into; Name and Location of the Dental Service Organization and Services the Dental Service Agreement provides for.
Program Participation in Medicaid and the Children’s Health Insurance Program.
The TSBDE is collecting this information pursuant to passage of HB 3201 last legislative session.