The Complete Checklist for Starting a Dental Practice in the USA

The U.S. dental industry is worth over $160 billion, with strong demand for quality dental care. Starting your own practice is a significant undertaking, but with proper planning, it can be incredibly rewarding. This comprehensive checklist ensures you don't miss critical steps.

Phase 1: Licensing & Credentialing

State Dental License

✓ State dental board license - Each state has its own requirements
✓ Specialty certification - If applicable (orthodontics, endodontics, etc.)
✓ Continuing education compliance - Most states require ongoing CE credits
✓ Sedation/anesthesia permits - Additional permits for conscious sedation

Federal Requirements

✓ DEA registration - Required to prescribe controlled substances
✓ NPI number - National Provider Identifier for insurance billing
✓ CLIA waiver - If performing any lab tests in-office

Insurance Credentialing

✓ Delta Dental - Largest dental insurance network
✓ Cigna Dental - Major PPO network
✓ MetLife Dental - Extensive employer plans
✓ Aetna Dental - Wide network coverage
✓ United Healthcare Dental - Growing market share

Credentialing Timeline

Insurance credentialing takes 90-180 days. Start this process 6 months before your planned opening. You cannot bill insurance until credentialing is complete.

Phase 2: Business Formation

✓ Entity selection - LLC, S-Corp, or PC (varies by state)
✓ EIN (Tax ID) - Apply through IRS.gov
✓ State business registration - Secretary of State filing
✓ Local business license - City/county requirements
✓ Business bank accounts - Separate operating and payroll accounts
✓ Accounting system - QuickBooks, Xero with dental-specific tracking

Phase 3: Location & Build-out

Site Selection

✓ Demographics analysis - Population, income, insurance coverage
✓ Competition mapping - Dentist-to-population ratio
✓ Visibility and access - Signage, parking, ADA compliance
✓ Lease negotiation - TI allowance, rent abatement, terms

Build-out Requirements

✓ State dental board compliance - Operatory requirements
✓ X-ray shielding - State radiation control requirements
✓ OSHA compliance - Hazard communication, bloodborne pathogens
✓ ADA accessibility - Americans with Disabilities Act compliance
✓ Plumbing specifications - Dental-specific requirements

Phase 4: Equipment & Technology

✓ Dental chairs and delivery systems - Budget $25,000-$75,000+ per operatory
✓ Digital X-ray systems - Sensors, panoramic, CBCT if needed
✓ Sterilization equipment - Autoclaves, ultrasonic cleaners
✓ Compressors and vacuum - Dental-grade, oil-free systems
✓ Practice management software - Dentrix, Eaglesoft, Open Dental
✓ Digital imaging software - Integration with PMS

Phase 5: Insurance & Compliance

✓ Malpractice insurance - Occurrence vs claims-made policies
✓ General liability - Premises coverage
✓ Property insurance - Equipment, build-out, contents
✓ Workers compensation - Required in most states
✓ Cyber liability - HIPAA breach coverage
✓ Employment practices liability - Recommended

HIPAA Compliance

✓ Privacy policies - Notice of Privacy Practices
✓ Security risk assessment - Annual requirement
✓ Business Associate Agreements - All vendors handling PHI
✓ Staff training - Document all HIPAA training
✓ Breach notification procedures - Written policies

Phase 6: Staffing

✓ Dental hygienists - State-licensed, verify credentials
✓ Dental assistants - Certification requirements vary by state
✓ Front office staff - Insurance verification, scheduling expertise
✓ Office manager - Practice management experience
✓ Employee handbook - Policies, benefits, procedures
✓ Payroll system - Gusto, ADP, or Paychex

Phase 7: Marketing & Patient Acquisition

The #1 Challenge

Most new dentists focus on clinical excellence but underinvest in marketing. Empty chairs don't pay bills. Your online presence determines how many new patients find you.

Essential Digital Presence

✓ Google Business Profile - Critical for "dentist near me" searches
✓ Professional website - Mobile-optimized, fast-loading (see our hosting solutions)
✓ Online appointment booking - Patients expect 24/7 booking (see our booking solution)
✓ Review generation - Actively request and manage reviews (see our review management)
✓ Social media presence - Facebook, Instagram for community engagement

Traditional Marketing

✓ New mover programs - Target people new to your area
✓ Insurance welcome letters - To patients in your network
✓ Community involvement - Sponsor local events, schools
✓ Physician referral relationships - Network with local MDs

Ready to Launch Your Practice?

We help dental practices across America build their online presence. From lightning-fast websites to Google optimization and review management - we handle the digital side so you can focus on patients.

Get a Free Visibility Audit

Estimated Startup Costs

Category	Cost Range (USD)
Lease deposit & legal	$20,000 - $50,000
Build-out (4 operatory)	$150,000 - $350,000
Equipment	$150,000 - $300,000
Technology & software	$20,000 - $50,000
Initial supplies	$15,000 - $30,000
Marketing launch	$15,000 - $40,000
Working capital (6 months)	$75,000 - $150,000
Total Estimated	$445,000 - $970,000