Requirements

Educational Requirements

The applicant MUST have completed an advanced specialty education program in Pediatric Dentistry, a minimum of 24 months full time academic study leading to an advanced degree in Pediatric Dentistry.

Documentary Requirements

The following must be submitted:

1.     Completed “Application for Validation of Credentials” form

2.     Letter of Intent to start the Diplomate Process

3.     (addressed to Dr. Eric P. Hernandez, Membership and Credentialing, Philippine Board of Pediatric Dentistry)

4.     Curriculum Vitae (include research work, if any)

5.     List two names of references that should include the Department Head or the Training Officer where you graduated from residency or fellowship, or the Medical Director or department Chairman of the institution where you are connected or were last connected with.  Please include their complete designation, addresses and contact numbers.

6.     Completed “Attestation (New application and MOC)” form

7.     Completed “Initial Credentials Survey” form

8.     Completed “Release of Information Authorization” form

9.     “Verification of Program Completion”  form (complete part “A. Basic Inofrmation”)

10.  Certificate of good standing from PPDSI

11.  Scanned Colored Photographs:  1x1 and 2x2 white background (saved on a USB thumb drive)

12.  Notarized photocopy of Dental Diploma

13.  Notarized photocopy of Dental Board Certificate (PRC)

14.  Notarized copy of Official Certificate of Specialty Training

15.  Notarized copy of valid Philippine Dental Association card

16.  Notarized copy of a valid Professional Regulation Commission ID

17.  Scanned copy of updated Professional Tax Receipt (PTR)

18.  Scanned copy of Life Support Certification

19.  Application fee