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Entrepreneurial dentists, DSOs, and consolidation

Oct. 10, 2017
Over the past few years, Dental Economics has covered the growing trend of dentists who own multiple practices. No doubt you're also aware of the successes of the dental service organization (DSO) model and how it is contributing to the consolidation of practices.
Chris Salierno, DDS, Chief Dental Officer, Tend

Over the past few years, Dental Economics has covered the growing trend of dentists who own multiple practices. No doubt you’re also aware of the successes of the dental service organization (DSO) model and how it is contributing to the consolidation of practices.1 If you’re a solo practitioner, you might be alarmed to see the traditional marketplace for practice transitions being disrupted.

First, let’s review our best data. According to the latest research by the ADA’s Health Policy Institute, only 7.4% of practicing dentists are currently affiliated with DSOs.2 There is no solid data for tracking dentists who own multiple practices, but it should be safe to assume that those numbers are not larger than DSOs. So, the majority of dentists and practices follow the traditional business model. No cause for alarm there.

Second, what if you were to become one of those entrepreneurial dentists? What if you grew beyond the traditional model and owned more than one practice? You might think that would mean you’d have to treat patients in each location, but what if you were to share those clinical duties with another dentist? What if you were to reduce your clinical hours and take on more managerial ones?

This month, Brady Frank, DDS, and Vincent Cardillo both introduce you to their game plans for fueling your inner entrepreneur by adopting the elements of a DSO structure. While industrious dentists may still maintain full control and not look toward private equity investors, they might still want to take a few lessons from the DSO playbook while growing their empires. For example, how should we classify and compensate a dentist who is the sole care provider in an office? Even a well-compensated associate may lose interest after a few years. On the other hand, a well-compensated equity partner (Dr. Frank prefers the term “co-owner”) could stick with you for the long term.

We’ll continue to monitor the multipractice ownership trend in DE. Even if you have no such aspirations, I hope you’ll at least agree that it’s a terrific time for dentists to be in business. There is no single practice model that is expected to dominate the market in the near future. So, whichever model you’re a part of, be inspired by the progress of others.


Chris Salierno, DDS

[email protected]


1. Guay A, Wall T. Considering large group practices as a vehicle for consolidation in dentistry. Health Policy Institute Research Brief. American Dental Association. Published April 2016. Accessed August 29, 2017.

2. Vujicic M. How big are dental service organizations? [webinar] Health Policy Institute. American Dental Association website. Published March 2017. Accessed August 29, 2017.

About the Author

Chris Salierno, DDS | Chief Dental Officer, Tend

Chris Salierno, DDS, is a general dentist from Long Island, New York. He graduated from Stony Brook School of Dental Medicine in 2005. Dr. Salierno lectures internationally on clinical dentistry, practice management, and leadership development. In 2017 he became a chief development officer with the Cellerant Consulting Group, and he was the chief editor of Dental Economics from 2014 to 2021. In 2021, he became the chief dental officer at Tend. He can be reached on Instagram @the_curious_dentist.

Updated May 13, 2022

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