Current through Register Vol. 35, No. 18, September 24, 2024
Except as otherwise required by Subsection F of
16.5.7.8
NMAC, presumptive public service practitioners do not need to comply with the
following for temporary or public service licensure. Residents or students as
defined in Subsection C of
16.5.7.8
NMAC shall provide only documents described in Subsection F of this section.
All other applicants for temporary or public service licensure shall submit the
required fees and following documentation:
A. completed application signed and notarized
with a passport quality photo taken within six months; applications are valid
for one year from the date of receipt;
B. verification of licensure in all states
where the applicant holds or has held a license to practice dentistry, or other
health care profession; verification shall be sent directly to the office from
the other state(s) board, shall include an embossed seal, and shall attest to
the status, issue date, license number, expiration date and other information
contained on the form;
C. proof of
current basic life support (BLS) or cardiac pulmonary resuscitation (CPR)
certification accepted by the American heart association, the American red
cross, or the American safety and health institute (ASHI); cannot be a
self-study course;
D. an affidavit
from the New Mexico licensed dentist who is sponsoring the applicant attesting
to the qualifications of the applicant and the activities the applicant will
perform; applicants for temporary licensure in underserved areas and state
institutions shall:
(1) provide an affidavit
from the administrative supervisor of the applicant's proposed employer
organization as defined in Subsection C of
16.5.7.8
NMAC attesting to supervision and oversight by a New Mexico licensed dentist,
and bearing the signature of both; or
(2) provide an affidavit from the New Mexico
department of health specifying supervision will be by a licensed New Mexico
dentist and bearing the signature of both;
(3) report any changes in supervision or
oversight of the temporary licensee to the board within 30 days of the change;
and
(4) provide proof of acceptable
liability insurance coverage;
E. in addition, applicants requesting
temporary licensure in public health dentistry or as a replacement practitioner
shall submit the following:
(1)official
transcripts or an original letter on letterhead with an embossed seal verifying
successfully passing all required courses from the dental school or college, to
be sent directly to the board office from the accredited program;
(2) copy of national board examination
certificate or score card;
(3) copy
of clinical examination score card or certificate from the accepted examining
agent;
(4) proof of having taken a
course in infection control technique within the past 12 months;
(5) applicant shall authorize the drug
enforcement administration (DEA) and American association of dental examiners
clearinghouse to send verification of status directly to the board
office;
(6) the board will obtain
verification of applicant status from the national practitioners data bank;
and
(7) a level III status report
from a board designated professional background service shall be received
directly from a board designated professional background service; the results
of the background check shall either indicate no negative findings, or if there
are negative findings, those findings will be considered by the board; the
board may deny, stipulate, or otherwise limit a license if it is determined the
applicant is guilty of violating any of the provisions of the act, the Uniform
Licensing Act, the Impaired Dentists and Hygienists Act, these rules, or if it
is determined that the applicant poses a threat to the welfare of the
public;
(8) in addition to the
documentation required above, an applicant for temporary licensure in a
specialty area shall request official transcripts from the residency program or
postgraduate training program to be sent directly to the board office from the
accredited program.
F.
Residents or students as defined in Subsection C of
16.5.7.8
NMAC shall submit the required fees and following documentation:
(1) completed application signed and
notarized with a passport quality photo taken within six months; applications
are valid for one year from the date of receipt;
(2) official transcripts in the event that
official transcripts are not available at the time of application, a letter
from the dean of the dental school or college, on official letterhead,
verifying the applicant's successful completion of all required courses, may be
submitted but must be supplemented with final graduation documentation no later
than 45 days from the start of the residency program.
(3) copy of national board examination
certificate or score card;
(4)
proof of having taken a course in infection control technique within the past
12 months or have graduation from dental school within the past 12
months;
(5) pass the jurisprudence
exam with a score of at least 75 percent;
(6) if resident or student has or holds a
license to practice dentistry or other health care profession they shall submit
verification of licensure in all states where the applicant holds or has held a
license to practice dentistry, or other health care profession; verification
shall be sent directly to the office from the other state(s) board, shall
include an embossed seal, and shall attest to the status, issue date, license
number, expiration date and other information contained on the form;
and
(7) issue date of the license
will correspond with the first date of the residency start date.
