Self Service Portal

Create Your Profile below
Please complete all fields below to create your membership account.
If you want to check to see if you already have an account, we can check for an existing account.
Institution (or Company)
Department
Prefix*
First Name*
Middle Name (or first initial)
Last Name*
Suffix
Degrees

Create a Username & Password

Usernames must be:
1) all lowercase (email recommended)
2) 5-16 characters
Username (email is suggested)*
Password*
Repeat *
Enter DENTPIN if applicable:

To meet ADA CERP reporting requirements, ADEA would like to know if you are a dentist.

Create Your Profile below