Guidelines for New Dentists
Are you a new practitioner? Starting your own practice? Here are some suggestions and guidelines just for you, along with information for finding out about legal requirements in your city or county.
Business License
Controlled Substances Registration Certificate (Narcotics License; DEA Number)
Dental License
X-Ray Equipment Registration
Radiation Safety Certificate
Air Compressor Permits
EPA ID Number
Medical Waste Registration
Wastewater
Tax and Payroll Information
Professional Liability Insurance
Miscellaneous Employer Responsibilities
CDA Regulatory Compliance Manual
Postings
Other Resources
California Dental Association (CDA)
Business License
Most cities require a business license. Contact the city hall or seat of government where you intend to practice to find out if the treasurer, city clerk and/or business license department administers licenses. In Los Angeles or Sacramento, for example, contact:
Office of Finance
City of Los Angeles
200 North Spring St., Room 101
Los Angeles, CA 90012
213.473.5901
City of Sacramento
City Revenue Division
915 I St.
Sacramento, CA 95814
916.808.8500
www.cityofsacramento.org/webtech/business/business.htm
If you set up and then move your practice within a city, you may be required to notify the same agency about your address change.
Controlled Substances Registration Certificate (Narcotics License; DEA Number)
As a health-care professional, you may have to write prescriptions for controlled substances, so you must have a Drug Enforcement Administration (DEA) number issued by the U.S. Department of Justice. Applications are available online at http://www.deadiversion.usdoj.gov/online_forms.htm or through a field office. Contact:
Drug Enforcement Administration — San Francisco Division
Office of Diversion Control
450 Golden Gate Ave., 14th Floor
San Francisco, CA 94102
888.304.3251 / Fax 415.436.7907
Sacramento District — Fax 916.480.7208
Drug Enforcement Administration — Los Angeles Division
Office of Diversion Control
255 East Temple St., 20th Floor
Los Angeles, CA 90012
888.415.9822 / 213.621.6960 / Fax 213.894.3946
Drug Enforcement Administration — San Diego Division
Office of Diversion Control
4560 Viewridge Ave.
San Diego, CA 92123-1637
800.284.1152 / Fax 858.616.4326
Order Controlled Substance Prescription Forms from approved vendors listed by the state Board of Pharmacy at http://www.pharmacy.ca.gov/consumers/prescribe_dispense.htm. If you dispense (but do not prescribe) controlled substances, you are required to file a monthly log with the California Department of Justice’s Controlled Substance Utilization Review and Evaluation System (CURES program). Go to the California Board of Pharmacy website for more information about prescribing and dispensing controlled substances.
Dental License
The Application for Examination for Licensure form you received with your license notification from the Board of Dental Examiners must be completed and returned within 30 days of receipt to:
Dental Board of California
1432 Howe Ave., Suite 85
Sacramento, CA 95825
916.263.2300
The form is available at www.dbc.ca.gov/examform.html.
The current fee for a two-year renewal is $365. If you move your practice, notify the board office within 10 days by certified or registered mail.
X-Ray Equipment Registration
State law requires that owners of X-ray machines register with the California Department of Health Services and comply with state radiation-protection standards. For registration forms and standards information, contact:
Radiologic Health Branch
Department of Health Services
P.O. Box 997414
Sacramento, CA 95899-7414
916.327.5106
http://www.dhs.ca.gov/rhb/
Current registration is approximately $79 per year, per X-ray tube. The department bills every other year.
Radiation Safety Certificate
All oral-health team members who take X-rays must pass a board-approved radiation-safety course or a radiation-safety examination given by the Dental Board. For a list of approved radiation-safety courses, visit the Committee on Dental Auxiliaries (COMDA) at http://www.comda.ca.gov/courses.html.
Air Compressor Permits
Cal/OSHA requires a permit for compressors 1-cubic foot in volume or larger, or when the safety valve is set greater than 150 psi. All compressor tanks should have a nameplate with the ASME Code symbol (a clover leaf with a “U” or “UM”) to indicate compliance. Contact Cal/OSHA’s Pressure Vessel Section for your tank to be inspected and permitted. Charge for the inspection is $135. The permit is $15, plus travel time. A typical permit is issued for five years, after which the compressor must be re-inspected.
Cal/OSHA Pressure Vessel Section
Oakland: 510.622.3066
Anaheim: 714.939.0434
EPA ID Number
Many dental offices generate hazardous wastes—including amalgam, outdated chemicals and fixer—but manage these wastes as recyclable materials or as universal wastes. Generators of hazardous waste typically require an EPA ID number, but there are exceptions. Go to the Department of Toxic Substances Control (DTSC) fact sheet at http://www.dtsc.ca.gov/HazardousWaste/upload/EPA-Identification-Numbers.pdf to find out if you need a number. Forms and instructions for completing the application are available at http://www.dtsc.ca.gov/InformationResources/index.cfm, or by calling 800.618.6942 or 800.728.6942.
Medical Waste Registration
Generators of medical waste, including sharps, pharmaceuticals and biohazardous materials, are required to register and pay a fee to regional enforcement agencies. Some areas are regulated by a local enforcement agency (LEA), such as the county health department or environmental health department, while others are under the jurisdiction of the California Department of Health Services (DHS). If you’re not sure about the appropriate agency, contact DHS. The website also has information about mail-back sharps services, alternative waste treatment technologies, a list of LEAs, waste-generator application forms and instructions, and the Medical Waste Management Act.
California Medical Waste Management Program
Department of Health Services
916.449.5671 / 213.977.7379 / 213.977.6877
http://www.dhs.ca.gov/ps/ddwem/environmental/med_waste/default.htm
Wastewater
It is illegal in all jurisdictions to dispose of hazardous wastes by flushing them down the drain. However, it may be permissible to dispose of some chemicals in a sanitary sewer, if they are treated first—for example, photographic fixer, if it is processed through a silver-recovery unit that meets local standards. Check with the local sanitary sewer district before putting any chemical down the drain. Or call the CDA for information about waste-stream disposal options.
In addition, some jurisdictions require dental offices to secure a waste-discharge permit or industrial wastewater permit. If your practice will include the placement or removal of amalgam, contact your local sanitation agency to find out if a wastewater permit is required.
Also, check the CDA Compliance Manual, cda.org/library/public/policy/app5_waste.htm, for guidance about a broad spectrum of hazardous wastes.
Tax and Payroll Information
As an employer/businessperson, you need a federal tax identification number, which is not the same as your Social Security number. To obtain a federal tax ID number, register with a local office of the Internal Revenue Service. Forms and information about federal FICA (Social Security) quarterly tax returns are also available there.
Enrollment forms for state tax deductions are available from the local office of the California Employment Development Department (EDD). If you have employees, enrollment is mandatory. The EDD can also give you information about State Disability Insurance (SDI) and an explanation of mandatory payroll reports.
Internal Revenue Service — Small Business and Self-Employed Resources
http://www.irs.gov/businesses/small/index.html
Employment Development Department
http://www.edd.ca.gov/taxind.htm#Overview
Professional Liability Insurance
Although California law does not require dentists to carry professional liability insurance, they are legally liable for actions under the Dental Practice Act. In order to protect your professional and personal assets, professional-liability insurance is a necessity. Information is available through The Dentists Insurance Company (TDIC), a wholly owned subsidiary of the California Dental Association. TDIC offers professional- and premises-liability coverage and risk-management services to dentists and their employees.
The Dentists Insurance Company (TDIC)
P.O. Box 1582
Sacramento, CA 95812
800.733.0633
Miscellaneous Employer Responsibilities
California state law requires that employees be covered by workers' compensation insurance. Information is available through:
TDIC Insurance Solutions
P.O. Box 1582
Sacramento, CA 95812-1582
800.733.0633
The state also requires employer compliance with provisions governing working conditions, including wages. For information, refer to a set of posters provided by CDA and your local component; or to the California Department of Industrial Relations website; or to your local office of the state agency.
Department of Industrial Relations
http://www.dir.ca.gov/wp.asp
Every California employer must establish, implement and maintain a written Injury and Illness Prevention (IIP) Program and keep a copy at each office. Dental offices also must have a written Hazard Communication Plan and an Exposure Control Plan for blood-borne pathogens. For information, contact:
California Division of Occupational Safety and Health (Cal/OSHA)
800.963.9424
http://www.dir.ca.gov/occupational_safety.html
CDA Regulatory Compliance Manual
This manual (free to members) can help you meet Cal/OSHA and waste management requirements. Order a copy at cda.org/page/CDA_Regulatory_Compliance_Manual, or through the CDA Resource Center at 800.736.8702.
Postings
Federal and state laws require employers to display posters about employee safety and health, job discrimination, wages and other employee issues. We have compiled these posters into a set, available through your local component dental society. CDA also provides a list of Web sites you can use to print individual posters. CDA List of Required Postings
cda.org/page/Required_Postings_in_a_Dental_Office
Other Resources
Your local chamber of commerce, the U.S. Small Business Administration, your certified public accountant or attorney's organization, and even your bank loan officer may prove excellent sources for small business start-up information. Many groups offer courses for people just starting out, so don’t hesitate to call and ask.
California Dental Association (CDA)
Our benefits support you at every stage of your practice. We offer professional placement, Scientific Sessions and continuing education classes, peer review, regulatory-compliance manuals, patient referrals and much more. Call 800.CDA.SMILE for details today.