# How do you start a dental practice? Starting a new dental practice means a state license, a business entity, a practice NPI, a site and build-out, financing, equipment, staff and payer credentialing, and fewer dentists take that step now: 72.5% of U.S. dentists owned a private practice in 2023 against 84.7% in 2005 (ADA Health Policy Institute). It is the first stage of the [practice lifecycle](https://ddsintel.com/lifecycle). By DDSIntel Editorial. Source: DDSIntel, https://ddsintel.com/lifecycle/starting-a-practice. Published 2026-10-26; data as of 2026-10-25. ## Key numbers - **72.5%** of U.S. dentists owned a private practice (ADA Health Policy Institute, 2023; https://www.ada.org/resources/research/health-policy-institute/dental-practice-research) - **84.7%** owned a private practice in 2005 (ADA Health Policy Institute, 2005; https://www.ada.org/resources/research/health-policy-institute/dental-practice-research) - **5,000,000** dollars, the maximum SBA 7(a) loan amount (SBA, 2026; https://www.sba.gov/partners/lenders/7a-loan-program/terms-conditions-eligibility) - **16.1%** of U.S. dentists were DSO-affiliated (ADA Health Policy Institute, The U.S. Dentist Workforce, 2025 update, 2024; https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/US_dentist_workforce_2025.pdf) - **7,443** dental shortage area designations at the end of 2025 (HRSA, via KFF State Health Facts, As of December 31, 2025; https://www.kff.org/other-health/state-indicator/dental-care-health-professional-shortage-areas-hpsas/) ## What are the steps to start a dental practice? An owner needs an active state dental license, a business entity, an organizational NPI from the federal provider registry, a leased or purchased site with build-out permits, financing, equipment, staff and payer credentialing. The first four steps each create a public record, which is why new practices appear in [facilities signals](https://ddsintel.com/signals/facilities-signals) and corporate filings. ## How is a new practice financed? Practice lenders and the SBA commonly finance new practices. The SBA describes 7(a) as its primary program for long-term financing for a variety of purposes, and states the maximum 7(a) loan amount is $5 million. Terms, collateral and the owner’s plan vary, so a CPA and a lender should review any budget. ## How do you choose a location? Owners weigh dentist supply, unmet need, growth and competition. HRSA designations show need: 7,443 dental shortage area designations covered 63,700,964 people at the end of 2025, per KFF. Need in an area does not guarantee demand for one practice, so local research matters; see [dental shortage areas](https://ddsintel.com/data/dental-shortage-areas). ## Is it better to start a practice or buy one? Starting avoids paying for goodwill but takes time to build patients and cash flow; buying brings both from the first day at a price. TUSK Practice Sales cited dental practice valuations of 5x to 9x+ EBITDA in 2026. [Associate-to-owner paths](https://ddsintel.com/lifecycle/associate-to-owner) compares buy-ins, purchases and start-ups. Related guides: [what drives practice value](https://ddsintel.com/lifecycle/value-drivers), [dental practice succession planning](https://ddsintel.com/lifecycle/succession-planning), [the options for exiting a practice](https://ddsintel.com/lifecycle/exit-options). About 16.1% of U.S. dentists were DSO-affiliated in 2024; see [how consolidated dentistry is](https://ddsintel.com/dso) and [dentist retirement statistics](https://ddsintel.com/data/dentist-retirement-statistics). New entities and licenses are among the [dental transition signals](https://ddsintel.com/signals) that DDSIntel reads in aggregate. ## Frequently asked questions ### How do I start a dental practice? Hold a state license, form an entity, obtain an NPI, secure a site and permits, arrange financing and equipment, hire staff and credential with payers. ### What public records does a new practice create? Typically an entity filing, a provider registry entry, license records at the address and a county build-out permit. ### Is a new practice cheaper than buying one? It avoids paying for goodwill but takes longer to become profitable; a CPA can model both for a specific market. ### Do DSOs open new offices? Many do, which adds competition for sites and staff; see [consolidation and DSOs](https://ddsintel.com/dso). ## Sources 1. ADA Health Policy Institute. Dental practice research. https://www.ada.org/resources/research/health-policy-institute/dental-practice-research 2. U.S. Small Business Administration. 7(a) loans. https://www.sba.gov/funding-programs/loans/7a-loans 3. HRSA, via KFF State Health Facts. Dental Care Health Professional Shortage Areas (HPSAs), as of December 31, 2025. https://www.kff.org/other-health/state-indicator/dental-care-health-professional-shortage-areas-hpsas/ 4. TUSK Practice Sales, via PR Newswire. TUSK Practice Sales assesses the state of the dental industry in its Q3 2026 dental market report (July 10, 2026). https://www.prnewswire.com/news-releases/tusk-practice-sales-assesses-the-state-of-the-dental-industry-in-its-q3-2026-dental-market-report-302823046.html 5. ADA Health Policy Institute. The dentist workforce. https://www.ada.org/resources/research/health-policy-institute/dentist-workforce --- DDSIntel is a dental transition intelligence platform that detects pre-market dental practice transition signals for brokers, DSOs, lenders and the firms that serve them.