How to Open A Dental Practice from Scratch

If you want to start your own dental practice from scratch, but you’re struggling to get started because you’re not sure where to begin – this video is for you!

My goal with this video is to clarify and help YOU understand the major steps involved in starting your Dental practice from scratch.

From the blog posts I’ve written so far on Dental Startup Academy,

I’ve gotten emails from you asking the same questions:

Where do I start?

What should I do first?

Should I talk to the bank first?

Or should I decide on the location and have the lease document signed first?

When should I be talking to my accountant or attorney?

There’s not an exact sequence in which things are going to be done. Some of the things are going to be occurring at same time in parallel.

The goal is to give you a bigger picture of what’s involved –

  • The things you’ll need to have in place.
  • The right team to have in place to help you get to the point of opening the doors to your own practice.
  • The timeline of how things should be moving

I won’t go over all the steps in detail because that’s not the point of this video.

But I’ll link to the detailed articles I’ve written for these topics, so you can reference them as you’re going through the steps during your dental startup journey!

Before you get overwhelmed with all different aspects of starting up a dental practice from scratch – let’s talk about what you need to consider.

Before I got started with my office, I was an associate for full time between two different offices. I was in my comfort zone – making good income, making only minimum payments on my student loans, paying bills and spending the rest on travel and leisure, trying to live the life I craved as a dental student.

However, I realized I was too comfortable. I was trading time for money and realized that no matter how hard I worked, there is going to be a cap on how much I can actually take home and wasn’t making much of a dent in my student loans.

I made up my mind to go out on my own – to practice dentistry my way to support the lifestyle I wanted to create for myself.

I want to emphasize LIFESTYLE here.

Whatever business you’re in, do it in a way that supports your lifestyle. But what is your lifestyle? This is a question you need to answer for yourself to decide what kind of dream office you’d like to work in.

When starting a new business venture, we tend not to think too far out. You need to think not 2-3 years out, but think what kind of practice you see yourself in 5 years, 10 years, or 15 years.

Start by answering the following two questions and write down the answer somewhere:

Where do you see yourself working and living?

The initial investment into a dental practice is not small, so think of a place you wouldn’t mind going to for work. You may also want to think about your commute.

How far are you willing to commute from where you live.

Don’t forget about your restrictive covenant clause in your existing associateship agreement / contract.

Your contract may restrict you from opening your office in certain number of miles in radius from your associateship.

What kind of practice do you want and how big?

Do you want an office where you potentially see multiple associates / specialists working together in a group practice setting?

This is important because you need to know possibly how big of an office you want – 3 ops, 5 ops or 7+ ops?

Depending on what you decide, it will determine the approximate total square footage you need. For now start looking for 300-400 sqft / operatory.

For instance, if you plan on having seven operatories, you want to start looking for total sqft office in range 2100-2800.

These numbers are not set in stone, some people may prefer LOTS of open space within an operatory, restrooms or for waiting area.

On the contrary, some may decide to go even smaller than that.

All depends on how YOU want to practice. We’ll get into the dental practice design details later in the future posts.

After you’ve thought about what kind of practice setting you want for your self, now you need to take some concrete steps to turn your vision into reality.

Financing Your Dental Startup Practice

The first thing you’ll need to do is get financing, so start by talking to banks!

If you don’t need a loan for the construction and the startup of your practice, then this doesn’t apply to you, but I’d assume for the majority of you, you should start talking to the Banks for your dental practice startup loan.

I would start talking to some of the big banks first – such as Bank of America Practice Solutions, Wells Fargo or Live Oak, etc.

These banks have tons of experience working with dentists, so they know exactly what it takes to get an office started from scratch.

You can also start talking to local small banks and credit unions, but get ready to start filling out some serious paperwork – such as estimated costs, a business plan, and revenue projections.

Once you have an idea what you can get pre-approved for from the banks, you’ll be able to form a budget – so you know how much you want to spend on your office.

Dental Startup Practice Business Plan

Some banks may require this. I never did one of these as Bank of America, which is the bank I got my loan with never required it then.

It’s going to ask for things like your

  • projected revenue for the first 1-3 years,
  • estimated capital required in starting the practice,
  • growth strategies
  • marketing plan
  • market demographics, etc.

Don’t pull your hair out just yet, they’re not looking for exact numbers, so do your best to figure out estimated values.

But this is a good exercise for you to start thinking about these things even if the banks didn’t require a business plan.

Legal Business Entity for your practice

Before you can sign off on a bank loan, you’re going to need to form a legal business entity for your practice.

Talk to an attorney or a CPA to form a business entity such as an LLC or C-Corp or S-corp.

You need this registration to get a TAX ID, which is what you’re going to need to sign off on a bank loan.

Location for your Startup Dental Practice

Deciding on a location for your dental practice is super critical – and it’s not something you should rush.

To help you narrow down your location, you should’ve already answered the two questions I brought up earlier – 1) where do you see your self living and working and 2nd) How big of a practice do you need.

The first is going to help you narrow down the area, and the 2nd is going to help you decide how big of a space you’ll need.

Some factors to consider before you decide on a location for your dental practice are things like: space availability, visibility, signage, zoning, parking, co-tenants, etc.

I go over these in detail in this post: 7 Factors to Consider For Deciding On a Location For a Dental Office

You’re also going to need to look at dentist: population ratio – but also remember it isn’t EVERYTHING when choosing a location.

I’ve got a detailed post that covers the resources you can utilize to figure out dentist to population ratios: Why Dentist to Population Ratio Isn’t Everything When Choosing a Location for Your Dental Office

From that post, you’ll be able to download the excel sheet, which you can use to do a 1,3,5 mile radius study around your prospective location.

So make sure to check the links to both of these articles below this video!

Company / Attorney for Dental office Lease Negotiation

Once you’ve narrowed down your options to about 2-3 locations, you’re going to want to start negotiating the lease for your office space.

Why would you negotiate on multiple spaces?

Because if one falls through and you’ve been negotiating back and forth for some time – which can take sometimes couple of weeks to a month or two – and if it falls through for any reason, you’ll have wasted plenty of time!

So if possible, start this process on more than one property!

Speaking of lease negotiations for your dental startup practice, you don’t want to do this yourself.

You do need to work with a lease attorney or lease expert.

When I was going through this, I did work with a lease expert who had tons of experience working with dentists.

Again, to see more information on all of the things involved in lease negotiations, I’ve included the links to two articles that I wrote on lease negotiations, so make sure to read through them when you get to that phase of your startup journey!

Dental Office Lease Negotiation: What you need to know before starting
Dental Office Lease Signing: What You Need to Know And Do Before Signing On the Dotted Line

Contractors for Design & Construction of your startup dental practice

For the Design & construction of your dental startup practice, you’re going to need a team.

  • A contractor – whether it’s dental specific or not, will completely depend on your risk tolerance.
  • An architect who does the initial drawings of your office design and gives you the official stamped blueprint of the design – which you’ll be submitting to the local building department for a building permit
  • If you decide to go with the larger known dental companies – like Henry Schein – they pretty much provide it all – the equipment, the design as well as the construction of the full office – but of course, do your research!

When selecting a contractor, there are things you’ll need to consider before you even decide to move forward and sign on the dotted line.

You’ll have to figure out what questions you need to ask your potential contractors when you interview them.

There are things you’ll need to watch out for in the contract for the construction of your practice to minimize going over your budget!

I’ve covered this in detail in a separate article: Dental Office Contractor: Choosing the Right One and Reviewing Your Contract

So make sure you go through it when you’re looking for a contractor to build your practice.

In the beginning of this video, I asked you to answer the question: “What kind of practice do you want and how big”

Well, if you don’t have an answer for that, it’ll be difficult trying to come up / brainstorm initial designs or drawings for the floor plan for your startup practice.

This is exactly what your dental architect or the contracting company is going to ask you, so make sure you take some time to think about this.

Once you receive your initial drawings from your architect or the contracting company, you’ll need to know how to review it, so you can go back and ask for revisions.

I’ve also talked about this in detail in another post: Dental Office Design Floor Plan – How to Review and Revise

So please review it to understand what you need to be looking for!

Dental Startup Equipment List

Ordering instruments and supplies for a dental startup practice is a tedious and a time consuming process.

But it’s another critical step in your startup journey!

When you’re starting out, you’re going to want to have just enough to get started. You definitely don’t want inventory of stuff sitting on the shelves and in the drawers.

Remember, cash flow is king – especially when you’re starting out.

As dentists, we’re all comfortable with different things when it comes to certain products or brands. I always believe in using whatever works best in my own hands, so you should stick to what works for you.

To stay organized in this step, you should have a list or a template so you can start checking things off as you order them.

First step is to break down everything you need into different categories: Restorative, Crown & Bridge, Oral Surgery, Lab supplies, Endo, etc.

To help you with this step, I’ve linked below to a post (Dental Office Equipment List – Where to Begin for your Startup) where you’ll be able to download an excel file with a list of all instruments and supplies I started with.

While reading the article, you should reference the excel file.

IT Set up for Startup Dental Office

Let’s move onto the IT set-up for your practice:

How you have your IT set up for your startup dental office will significantly impact efficiency and patient flow throughout your office.

That’s why it’s so important to have a vision of what you’re trying to achieve in your dream practice.

When I mention IT, I mean everything from the type of phone system you choose to implement in your startup, to the type of server and computers you’re going to have, to the Practice management software, things you’ll need to send claims to insurance companies, etc.

To help you get started, make sure to review my posts on IT set up – where I talk about things that I use in my practice and things you need to think about when you’re ordering.

Here’s the links to IT related posts you’ll find helpful when you reach this step in your journey:

Start Credentialing process if you’re going to accept insurance in your practice

When you’re about three or so months away from opening the door to your practice for your 1st set of patients, this is the time you need to start the credentialing process with insurance companies – that is, if you decide to accept insurance in your practice.

Usually for most plans, the credentialing process can take anywhere from 45-90 days.

Make sure to give yourself enough time to be enrolled in the plans, so you’re ready when you open your practice!

The way you start credentialing is by contacting the Provider Relations department at each of the plans you plan to enroll in.

So what you can do is start calling them up and request the application packet.

Some of the plans actually allow you to request the application packet online, which will be much faster so I would recommend you go that route as well.

If I was starting today, I’d have a professional company reach out on my behalf for fee negotiations with insurance companies as they specialize in this.

The fee you pay for this service is definitely well worth the investment considering the number of years you’re going to be practicing in your office.

Marketing for your Dental Startup Practice

Have an approximate target date of opening, so you can plan your Marketing!

Marketing for your startup dental office is the most important element along with your clinical skills that will determine the success of your practice – the one that is in line with your vision.

For your scratch startup, goal is to have patients the first day you’re open – which means, your marketing starts BEFORE you even open the doors to your dental practice!

The first step in marketing is the LOCATION of your practice!

So while your office is in construction, put the biggest banner you can outside.

You’re going to again need permission to put a banner like this – but put the biggest sign that says “COMING SOON” – make sure the word DENTAL or DENTIST is BIG and is visible.

You’re also going to want to start a a Direct Mail campaign probably a month prior to when you plan to open, to start bringing awareness of your new practice in your community.

Don’t expect to drive patients right away, but how I marketed my practice back in 2013 when I started, is going to differ slightly from how you should market today!

If I was starting today, I’d go all in on social media – specifically digital marketing of my practice.

Start a Facebook page of your office name as soon as you have one – from the day you sign the lease of your practice!

Share the ENTIRE process of your construction, the design, etc – with your audience!

Go LIVE. You can even boost these videos / and posts through Paid Ads.

Do the same on YouTube through YouTube ads.

Marketing is a topic we can talk about all day.

But I won’t get into all the details, and instead point you two detailed posts I’ve written on Marketing for startups. Again, you’ll find the links below the video.


Those are the essential steps – sort of a big picture of what’s involved in getting started!

Going out on your own is an exciting venture!

It’s okay if you’re a bit nervous. You are an entrepreneur and you must become comfortable being challenged on a regular basis.

Don’t try to sprint. Set your mind up as if you’re starting a marathon – just keep moving ahead at a steady pace!

The most important thing you can do is reference the articles I’ve linked to for details as you’re going through that step in your journey of staring a dental practice from scratch.

I’ll be bringing you more useful videos moving forward, so make sure to tune in and subscribe, share with your friends or colleagues who’ll find this helpful!

Thanks for watching, until next time!