First steps to starting a dental practice, in order

The first steps to starting a dental practice are: decide what kind of practice you want, get your finances and a dental lender lined up, choose the market and then the specific site, negotiate the lease, plan the build-out and equipment, handle licensing, insurance and credentialing, and hire and market before you open. Location comes early for a reason: it shapes your lease, build-out, patient mix and how quickly the schedule fills, and it is the hardest thing to change later.

This guide walks through each step and spends the most time on location, because that's where startups most often go wrong.

What you won't get from an instant report. An automated report can describe one address. It can't tell you where other dentists are already looking, whether the offices nearby actually exist, or whether a busy market is still open. Dentagraphics can: 118,330 practices verified by hand, 12 years of research from more than 10,000 paid customers, and custom reports with handwritten analysis by a demographer.

Step 1: Define the practice you want

Write down your model before you look at sites:

Type: general, pediatric, orthodontic or another specialty.
Payer mix: fee-for-service, PPO, Medicaid or a mix.
Size: number of operatories now and later.
Patients: families, older adults, a specific community or language.

Every later step depends on this. A fee-for-service practice and a Medicaid practice need very different neighborhoods.

Step 2: Get your finances and lender in place

Talk to a lender that specializes in dental practices early. Knowing what you can borrow sets your budget for the lease, build-out, equipment and working capital, and lenders often want to see your market research before they approve a startup loan.

Step 3: Choose the market, then the site

Work from wide to narrow:

Region: the state and metro where you can get licensed and want to live. Compare residents per general dental practice by state and the 25 largest metros.
County and town: where there are more residents per practice than nearby areas, with income and growth that fit your model.
Site: compare the area within about 5 miles or a short drive of each possible space.

At the site level, check:

Verified competition. Count active general practices from a list checked by a person. Online maps include closed offices, duplicates and dentists who moved.
Demographics: household income, age, insurance mix, growth and language.
Visibility and access: parking, signage, traffic and nearby anchors.
Who else is looking. On Dentagraphics' metro pages, the areas dentists research most are often already crowded, while open areas nearby get little attention.

See our full guide to dental practice site selection and how to tell if an area has too many dentists.

Step 4: Negotiate the lease

A dental lease is long and expensive to get out of. Look closely at term length, renewal options, build-out allowances, exclusivity (whether the landlord can lease to another dentist nearby), and assignment terms if you ever sell. Have a dental real estate attorney review it before you sign.

Step 5: Plan the build-out and equipment

Work with a dental-specific designer and contractor. Plumbing, electrical, compressed air and suction all affect cost and timing. Choose equipment and practice management software early enough to plan around them.

Step 6: Licensing, insurance and credentialing

Confirm your state license and any facility permits, set up your business entity, get malpractice and business insurance, and start insurance credentialing early. Credentialing with insurers can take months, and you can't bill them until it's done.

Step 7: Hire and market before opening day

Hire your core team a few weeks before you open, set up your website and online listings, and start marketing to the area you chose. The demographics you studied in Step 3 tell you who to market to.

Frequently asked questions

What is the most important first step in starting a dental practice? Defining your practice model, then choosing the location. The location decides your patients, your competition and how fast the practice grows, and it's the hardest thing to change later.

How do I know if a location can support a new dental practice? Compare residents per verified general practice within about 5 miles with nearby areas and the US average of about 3,850, then check income, age, insurance mix and growth.

Should I do my own market research or hire someone? You can do a first pass with free market pages. Before you sign a lease, a custom analysis from a demographer is worth it: Dentagraphics' Single-Site Study ($695) is written by hand for your specific site, practice model and target patients.

How long does it take to open a dental practice? It varies, but site selection, lease negotiation, build-out and insurance credentialing each take time. Starting the location work and credentialing early shortens it.

Is it better to start from scratch or buy? It depends mostly on the market. See start a dental practice from scratch or buy one.