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The Ongoing Growth and Evolution of the Top DSOs in the U.S.

By Planet DDS
July 23, 2020

Dentistry is ever-evolving. And much of that change revolves around the growth of the top DSOs in the U.S.

Our 2017 article, ‘Top 10 DSOs in the U.S.’, focused on trends in group dentistry, including what we referred to as “the year of the DSO.” Since then, the list of top DSOs has remained somewhat consistent. However, what has shifted are the numbers relative to each organization’s affiliation growth and the new DSOs added to the mix.

What’s driving the growth of the top DSOs in the U.S.?

Suffice to say, “support” appears to be in the “driver’s seat.” It’s unlikely anyone could foresee the challenges experienced within dentistry during 2020 as a result of the COVID-19 pandemic.

But the factors remain consistent related to why you, along with other solo, private practice dentists, would consider making the transition to the DSO model.

  • Uncertainties surrounding dentistry and the overall healthcare industry
  • Stress associated with cultural challenges and practice management
  • Increasing overhead the financial liabilities of starting or purchasing a dental practice
  • Approaching retirement or forced career change

These remain among the core drivers for DSO growth.

Who are the top DSOs in the U.S.?

Again, DrBicuspid provides due diligence in keeping the annual list of top DSOs up to date. The following list reflects available data from October 2019.

Noted changes and list rank are aligned with the number of affiliated practices. This is where the previously noted growth totals have increased for three of those included on the 2017 list of top DSOs in the U.S.

Heartland Dental

  • Supported/affiliated dental practices/offices: over 950 in 37 states (according to the company website)
  • More than 50 practices have been added (since April 2019 data)

Aspen Dental/Aspen Dental Management

  • Supported/affiliated dental practices/offices: approximately 780 in 42 states (according to October 10, 2019 press release)
  • First/new practices in California (early 2019)

Pacific Dental Services

  • Supported/affiliated dental practices/offices: over 740 in 20 states (according to October 1, 2019 press release)
  • More than 40 practices were added (since last available report)

Smile Brands

  • Supported/affiliated dental practices/offices: more than 400 in 17 states (according to a company press release)
  • Based in Irvine, CA their brands include: Bright Now Dental, Castle Dental, Monarch Dental

Affordable Care

  • Supported/affiliated dental practices/offices: 336 in 40 states (according to company website)
  • Brands include: Affordable Dentures & Implants, DDS Dentures + Implant Solutions
  • Recent expansion has included the states of Colorado and Washington

Western Dental

  • Supported/affiliated dental practices/offices: 322 in five states (according to October 2, 2019 press release)
  • Brands include: Western Dental & Orthodontics, Brident Dental & Orthodontics
  • The company moved one spot in DSO rankings from sixth to fifth (per the previous DrBicuspid publication)

Dental Care Alliance

  • Supported/affiliated dental practices/offices: more than 300 in 20 states (according to company website)
  • Multiple brands including: Advanced Dental Care, College Park Dental, Gentle Dental
  • 13 practices were added in 2019

Great Expressions Dental Centers

  • Supported/affiliated dental practices/offices: 300 in 10 states


  • Supported/affiliated dental practices/offices: approximately 200 in eight states
  • Brands include: Gentle Dental, Dedicated Dental, Capitol Dental, Smile Keepers, and Blue Oak
  • The company added a practice in Oregon in May 2019

Beckers Dental + DSO Review lists additional top DSOs in the U.S. to keep an eye on.

42 North Dental

  • Supports 58 dental practices and 15 brands in four New England states
  • Formerly known as Gental Dental Partners until 2018

Allied Dental

  • Provides support/affiliation to general dentists and dental specialists
  • Offers quarterly C.E. (Continuing Education) via its Allied University on topics that include tools, treatment protocols, scientific research, and business practices

ClearChoice Dental Implant Centers

  • Founded in 2005 and to date has treated over 50,000 patients
  • Support 51 dental implant centers throughout the U.S.

Cordental Group

  • Backed by a private equity group
  • Supports practices within the Mid-Atlantic, Midwestern, and Southeastern regions of the U.S.
  • Acquired two private practices in St. Louis and supports five dental practices in the St. Louis area

DecisionOne Dental Partners

Dental Associates

  • A nationally accredited dental organization through the Accreditation Association for Ambulatory Health Care
  • An “A+ rating” with the Better Business Bureau and recognized by Press Ganey for its patient satisfaction scores
  • Supports 14 practices throughout Wisconsin with over 800 employees


  • Supports 35 affiliated practices throughout the New York City metro area
  • Financial backing via White Oak Healthcare Finance is enabling rapid expanse
  • Recognized as the official dental partner of the New York Yankees providing preventive care, cosmetic dentistry, and oral surgical procedures to team members

Great Expressions Dental Centers

Rock Dental Brands

  • Founded in 2016 by two dentists
  • Acquired Apex Dental (a Little Rock, Arkansas dental group with six practices) in 2018
  • Manages 74 dental clinics throughout Arkansas, Missouri, and West Virginia

Signature Dental Partners

  • Affiliated with over 25 practices across Arizona, Colorado, Utah, Nevada, New Mexico, Oregon, and Washington
  • Provides new employee recruitment services via their online career portal that features dental job postings

Southern Dental Alliance

  • Supports over 30 practices in Georgia, Tennessee, and South Carolina
  • Operates under five brands: Carolina Dental Alliance, Children’s Dental Center, South Carolina Orthodontics Group, Vital Smiles Georgia, and Zoo Crew Pediatric Dentistry
  • Purchased in 2017 by Pouschine Cook Capital (New York-based private equity investment firm)

United Dental Partners

  • Formed via a 2014 four practice merger between a pediatric dentist and an orthodontist
  • Supports 28 “de novo” and affiliated practices throughout Illinois and Indiana
  • Supported brands include: Smiles Pediatric Dentistry, Westgate Implant and Oral Surgery Center, and Chicago Dental Professionals

Additionally, beyond the list the Dr. Bicuspid developed, here are some growing DSO to keep on your radar.

Lane & Associates

  • Provides family dentistry in 30+ locations throughout North Carolina – including Raleigh, Durham, Cary, and surrounding areas

Mid-Atlantic Dental Partners

  • Since launching in March of 2016, Mid-Atlantic Dental Partners has performed significantly ahead of its original business plans
  • Support more than 240 affiliate offices operating throughout 18 states

Lone Peak Dental Group

  • Over 50 dental practices/offices and dental brands in Washington, Idaho, Colorado

Cloud-based systems help DSOs securely and seamlessly manage their patient care across their entire organization – regardless of size.

  • Cost-effective technology and data management
  • Easy implementation for routine team and dental practice functions
  • Secure updates and scalable usage for organizational growth

How DSOs can manage their growth and improve their patient care systems

Cloud-based dental practice management solutions like Denticon are supporting the robust network requirements of top DSOs in the U.S. – including some on the previously shared list and the following…

Planet DDS’s Denticon is the proven cloud-based Dental Practice Management Software in today’s market among solo private practices, private group practices…and top DSOs in the U.S.

Read about how nearly half of the top 25 DSOs in the country now use Planet DDS solutions.

Contact us for more information about how Denticon can streamline your systems and operational tasks as a DSO.