To update your information with our Member Services Department, please fill out  and submit the form below. Member Services will review this information and update the member database accordingly. It may take up to two weeks for changes to appear in your account.

If you have questions, please contact Joanne Girardi.

Biographical Information 

Member ID:  
First Name   
Middle Initial  
Last Name  
Maiden Name  

Contact Information  

Home Address    
Home Address 2    
Home City  
Home State/Province  
Home Zip  
Home Country  
Home Phone      
Office Address
Office Address 2  
Office City  
Office State  
Office Zip  
Office Country  
Office Phone  
Office Fax  
If you have other office addresses you would like to update, please provide that information here.     
Please send CDS mail to my     
  1. Home Address
  2. Office Address
Occasionally, CDS provides companies with mailing labels of member addresses. Please include me in commercial mailings. 
(Please note: CDS will never sell your email address.)
  1. Yes
  2. No


Dental School Information  

Dental School Name  
  1. DDS
  2. DMD
Post Graduate Type
Dental School Graduation Year