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Dentrix Developer Program
Ascend Developer Program
Dentrix Smart Image Program
Business Information
Company Name *
Company Physical Address *
Company Address 2
City *
State *
Zip Code *
Country *
State or Province of Incorporation*
Business Classification *
Independent Software Vendor (ISV)
Dentrix User
Non-Profit Organization
Business Stage *
Seed
Start-Up
Growth
Established
Expansion
Mature
Exit
Company Entity Type *
Sole Proprietorship
Limited Liability Corp
Cooperative, C
Corporation, S
Corporation, General
Partnership, Limited
Partnership, Joint
Venture, 501(c)(3)
Business Description *
Legal Signee *
Legal Signee Title
Contact Name *
Email Address *
Name of Company Contact/s for Notice*
Email Address of Company Contact/s for Notice*
Work Number *
Mobile Number *
Fax Number
Website *
Date of Incorporation
API Access Type *
READ
READ/WRITE
SCHEDULING
Developer Connector – Foundation Write-Back
HSPS Connector – Foundation
HSPS Connector – Premier
Ascend API
Annual Revenue
Intended API Use *
Commercial
Non-Commercial
Development
Development Experience
Name of Developer Application
Version of Developer Application
Desktop Platforms
Windows
Linux
OS X
Mobile Platforms
iOS
Android
Windows Phone
Integration
Have you ever integrated an application with Dentrix? *
Yes
No
If so, what was the name of the product(s)? *
Which API functional area do you have interest in? *
Charting
Diagnostics
EHR
Imaging
Patient
Education
Insurance
Office Administration
Patient Communication
Patient Acquisition and Retention
Hardware and Equipment
Integrators and Links
Training and Events
Dental Lab
analytics/reporting
Other
Have you ever marketed or distributed a Dentrix application? *
Yes
No
If so, what was the name of the product(s)? *
When do you plan to develop your integration? *
Please explain briefly what this integration will do. *
Certification
Do you plan to
certify
your application with the Dentrix Connected Program ? *
Yes
No
If you certify, when is the planned date for this? *
Do you plan to distribute your application through the
Dentrix Marketplace
? *
Yes
No
Marketing
What marketing and distribution channels are you considering ? *
My Own Company
3rd Party Distributor
Dentrix Marketplace
Do you have an existing relationship with Henry Schein Practice Solutions (Dentrix), or Henry Schein? *
Yes
No
Specify your existing relationship with Henry Schein Practice Solutions (Dentrix), or Henry Schein *
×
Contact Us
For program-related questions:
Henry Schein Practice Solutions
1220 South 630 East, Suite 100
American Fork, UT 84003
C/O: Dentrix Developer Program
Email Address:
ddp@dentrix.com
Phone Number: 801.847.4278
