Practice Start-Up

Please note: This list is for your informational use and not intended to replace the advice of professional advisors and specialists, including, but not limited to, attorneys and certified public accountants.

General Requirements

  • DDS or DMD degree
  • Completion of a postdoctorate program in orthodontics
  • State dental license
  • Résumé/CV (may be required for financing)
  • Business plan
  • Budget
  • Funding
  • Business accounts
  • Business permit
  • Employer identification number (EIN)
  • Articles of incorporation
  • National provider identification (NPI)
  • Practice location
  • Purchase or lease agreement
  • Office design and layout
  • Local occupancy, zoning, and building permits
  • Equipment and supplies
  • Hardware and software systems
  • Office policies and procedures
  • Regulatory compliance
  • Personnel
  • Insurance – malpractice, life, health, long-term disability, property, commercial general liability, practice interruption, office overhead expense, worker’s compensation


  • May purchase or lease property and build practice to meet preferred specifications
  • May choose to share building or office space with general dentists, dental specialists, and/or other professionals

Financial Risk

  • High financial risk to invest and manage a business
  • High start-up, overhead, and operating costs
  • Requires significant investment in technology, infrastructure, marketing, employee recruitment, training, etc.
  • Financing may be necessary
  • Factors such as debt, credit history, experience, the financial strength of the practice startup, and proof of collateral may affect the ability to obtain financing from a lending institution
  • May require other household income (e.g., spouse income or other associate arrangement) to secure financing

Income and Other Compensation

  • Variable income based on revenue, costs, and expenses
  • May likely experience lower income in early years compared to other practice modalities
  • Income potential is greater compared to associate, independent contractor, academic, and military opportunities
  • Responsible for benefits such as vacation and sick leave, health insurance, life insurance, disability, retirement plan, professional dues, continuing education reimbursement, liability and malpractice insurance, etc.
  • Responsible for payroll, income, sales, and property taxes

Practice Operations

  • Requires managerial and administrative responsibilities
  • Offers guaranteed autonomy and control over practice decisions
  • Must be able to balance patient care and business operations
  • Requires awareness and evaluation of market conditions and practice performance
  • Opportunity to choose practice location, office design, equipment, technology, and staff
  • Must establish patient pool and referral base, develop practice management systems, and hire and train new employees
  • Delegation can be difficult with fewer employees
  • May encounter administrative difficulties with limited support and practice management experience

Learning Development Opportunities

  • Opportunity to obtain and utilize clinical, technical and practice management skills
  • Responsible for seeking out learning and professional growth opportunities

Legal Considerations

  • Must understand and comply with federal, state, and local business laws, regulations, and requirements related to office design, employment, office safety, patient treatment, collections, malpractice, marketing, antitrust, taxation, and more
  • Responsible for selecting a business structure and understanding how it affects day-to-day operations, taxes, and personal liability
  • Responsible for liability issues such as malpractice claims, customer injuries, and employee activities

Contractual Considerations

  • Will enter into several contracts including business loans, consulting agreements, purchase/lease agreements for real estate and equipment, dental provider agreements, employment and compensation agreements, and more
  • Will be responsible for complying with all contractual obligations

Work Life Considerations

  • Can be difficult to enter certain communities due to market conditions
  • Will have flexibility to set work hours
  • Can be difficult to take extended time off

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