US dental groups and DSOs, mapped
Largest dental groups in the US (2026): the top 10 run 17% of group locations.
For PMS, imaging, supply, billing, staffing, and marketing teams selling into dental. The DSO logo is rarely the buyer. The regional director or the owner-dentist on the lease is.
The market, in three numbers
A long tail of small groups, not a DSO oligopoly.
of US dentists work inside a DSO
Roughly 13 percent of practicing dentists are affiliated with a DSO or large group. The share has doubled in a decade but is still a minority position.
share held by the top 10 groups
Heartland, Aspen, Pacific Dental Services, Western Dental, Smile Brands, Affordable Care, Dental Care Alliance, MB2, North American Dental Group, and Mortenson run roughly 17 percent of US group practice locations combined.
supported offices at Heartland
Heartland Dental, the largest DSO in the country, supports about 1,800 offices across more than 38 states. That is still a rounding error against 192,000 practicing US dentists.
Source: Orbital classifier, market Dental and Orthodontic Care, June 2026 snapshot.
Methodology
Why our dental groups list moves and the published rankings do not.
The public DSO rankings ship once a year. Workforce surveys ship every 18 to 24 months. Those are static lists of brand names with office counts, not maps of who actually picks up the phone at each office. The Orbital map refreshes monthly and resolves down to the decision-maker.
How the 11,400 figure is built
- Start with the Orbital classifier market. We pull every active US practice tagged to the Dental and Orthodontic Care classifier market, then filter for multi-location groups and DSO-affiliated offices. Solo private practices are counted separately in our broader dental dataset.
- Reconcile against the wider universe. The 11,400 group count is set against the broader US dentist universe of roughly 192,000 practicing dentists, of which about 13 percent sit inside a DSO or large group.
- Resolve each office to a parent. A Heartland-supported office is owned by the doctor on paper, but the buyer for PMS, imaging, and supply usually sits at the DSO regional level. We map both the office and the parent, and we keep them linked.
- Find the named decision-maker. Regional director at a DSO, office manager at an independent group, owner-dentist at a partner-owned group. We pull a verified email and direct dial for each one. Most of these people have no LinkedIn profile to scrape.
- Drop the closed pins. DSO consolidation moves fast. MB2 alone added more than 100 affiliations in the past 18 months. Published lists carry stale brands for a year. We refresh monthly.
If you want the source breakdown for a specific parent DSO or state, ask. We do not hide the working.
By state
Where US dental groups actually concentrate.
California, Texas, Florida, and New York carry roughly 38 percent of US group-practice offices between them. The Sun Belt has been the fastest-growing region for DSO expansion, driven by patient migration and the corporate practice of dentistry rules being looser than in the Northeast.
| # | State | Group offices | Per 100k residents |
|---|---|---|---|
| 1 | California | 1,520 | 3.9 |
| 2 | Texas | 1,140 | 3.7 |
| 3 | Florida | 880 | 3.8 |
| 4 | New York | 760 | 3.9 |
| 5 | Pennsylvania | 510 | 3.9 |
| 6 | Ohio | 470 | 4.0 |
| 7 | Illinois | 450 | 3.6 |
| 8 | Georgia | 430 | 3.8 |
| 9 | North Carolina | 410 | 3.8 |
| 10 | Arizona | 390 | 5.2 |
| 11 | Michigan | 340 | 3.4 |
| 12 | Virginia | 320 | 3.6 |
| 13 | New Jersey | 300 | 3.2 |
| 14 | Tennessee | 290 | 4.0 |
| 15 | Washington | 270 | 3.4 |
Counts rounded to the nearest ten for display. The dataset itself resolves to the practice address. Source: Orbital classifier, market Dental and Orthodontic Care, June 2026 snapshot. Arizona overindexes because Pacific Dental Services is headquartered in Irvine and pushed hard into the Phoenix metro early.
The top 10 dental groups
The largest DSOs and how much of the group market they actually run.
Ranked by US supported-office count from the Orbital practice map. The 10 brands below run roughly 17 percent of US group-practice locations between them.
| # | Group | US offices | Parent / note |
|---|---|---|---|
| 1 | Heartland Dental | ~1,800 | PE-backed (KKR, since 2018). Effingham, IL. Largest US DSO by supported-office count. Doctor-led ownership model, with Heartland providing back-office support. |
| 2 | Aspen Dental | ~1,100 | PE-backed (Leonard Green, since 2015). Syracuse, NY. Branded retail-style model focused on edentulous and underserved markets. Sister brands include WellNow Urgent Care and ClearChoice. |
| 3 | Pacific Dental Services | ~950 | Privately held. Irvine, CA. Modern Dentistry brand. Aggressive Sun Belt expansion. Pioneered the same-day crown CEREC integration at scale. |
| 4 | Western Dental and Orthodontics | ~370 | PE-backed (New Mountain Capital). Concentrated in California, Arizona, Nevada, and Texas. Heavy Medicaid and underserved-market exposure. |
| 5 | Smile Brands | ~430 | PE-backed (TSG Consumer Partners, since 2019). Irvine, CA. Operates under multiple regional brands including Bright Now Dental and Castle Dental. |
| 6 | Affordable Care | ~430 | PE-backed (Berkshire Partners). Morrisville, NC. Affordable Dentures and Implants brand. Specialty focus on dentures and full-arch implants. |
| 7 | Dental Care Alliance | ~390 | PE-backed (Mubadala, since 2021). Sarasota, FL. One of the oldest US DSOs (founded 1991). Multi-brand portfolio. |
| 8 | MB2 Dental | ~700 | PE-backed (Charlesbank). Carrollton, TX. Doctor-partner equity model, fastest-growing top-10 DSO by affiliation count in 2024-2025. |
| 9 | North American Dental Group | ~280 | PE-backed (Jacobs Holding). New Kensington, PA. Multi-brand portfolio including Refresh Dental, Dental365, Riccobene Associates. |
| 10 | Mortenson Dental Partners | ~140 | PE-backed (Charlesbank, alongside MB2). Louisville, KY. Concentrated in Kentucky, Indiana, Tennessee, and Ohio. |
Office counts marked "~" are approximate. MB2 ranks 8 here on office-count methodology but ranks higher on affiliation count under a different methodology. The buyer for your PMS, imaging, supply, or marketing software is rarely the corporate logo. It is the regional director or office manager who runs a cluster of offices for that parent. Source: Orbital classifier, market Dental and Orthodontic Care, June 2026 snapshot.
Our take
Dental is the most fragmented healthcare vertical PE has tried to roll up, and the math is not bending.
We believe
If you sell into dental groups and you only target the top three DSOs, you are walking past 9,400 buyers.
The pitch deck story for the last decade has been DSO consolidation. PE rolls up dental, the top names get bigger, the independents disappear. The math does not support it. The ADA Health Policy Institute has 13 percent of US dentists inside a DSO in 2024. Ten years ago it was 7 percent. That is doubling, in absolute terms, off a small base, while solo and small-group practices still hold the other 87 percent of the workforce. There are roughly 11,400 multi-location dental groups in the country. The top 10 run about 17 percent of those offices. The other 9,400 group operators sit with two, three, ten, sometimes thirty practices each, and almost none of them show up in the published DSO rankings.
One of those operators reached out to us last quarter. He runs nine offices across three states under a doctor-partner model, no PE involvement, growing two offices a year. His PMS vendor had not called him in two years. His imaging supplier was still selling him into one office at a time as if he were a solo. His marketing agency thought he was a single location. Every meeting his team booked, he had to source himself. The vendors were not lazy. They were searching for "Heartland" and "Aspen" in their CRM, and his name simply was not in the list.
Who buys this data
B2B vendors selling into 11,400 dental groups.
This page is for the teams selling INTO dental practices, not the practices themselves. The buyer for this dataset usually falls into one of these categories.
Dental practice management software
Dentrix, Eaglesoft, Open Dental, Curve Dental, Denticon, and the next wave of cloud PMS vendors selling the upgrade off a server-based install. The buyer is the regional director at a DSO or the owner-dentist at an independent group.
Dental imaging and CAD-CAM
Cone-beam CT, intraoral scanners, same-day crown systems, panoramic upgrades. The conversation is with the doctor on the chair and the practice owner on the capital expense.
Dental supply distributors
Henry Schein, Patterson Dental, Benco Dental, Darby Dental rep teams looking for the next 500 multi-location accounts. The decision sits with the office manager on the consumables and the doctor on the capital.
Dental billing and revenue cycle
Insurance verification, claims management, AR follow-up, eligibility checks. The buyer is the practice administrator or the DSO billing lead, not the doctor.
Dental staffing platforms
Hygienist and assistant temp platforms like Cloud Dentistry and TempMee. The decision-maker is the office manager who has a chair empty Thursday morning. Speed of contact wins.
Dental marketing and SEO
Practice growth agencies, patient acquisition platforms, local SEO and review management vendors. The buyer is the owner-dentist at independent groups and the marketing director at PE-backed networks.
Adjacent universes built the same way: the broader by-industry email lists, the gas-station owner universe, and the /data/insights hub.
Plain-spoken
When the dental groups dataset is the wrong fit.
Do not buy this if any of the following are true.
You only sell at the corporate level into the top three DSOs. If your motion is one annual contract with Heartland, one with Aspen, and one with Pacific Dental Services, you do not need 11,400 records. You need three account executives. Save your budget.
You are looking for solo private-practice dentists. This page is the multi-location group and DSO universe, roughly 11,400 records. The broader 192,000-strong US dentist universe, including solo practices, is a different dataset. Ask and we will route you to the right one.
You need clinical outcomes or claims data. Patient cohorts, treatment outcomes, payer mix at the claim level. That lives with the carriers and with a handful of clinical-data vendors. We map the practice and the buyer, not the chart and the claim.
Your product is for patients. Find-a-dentist directories, patient acquisition for consumers, insurance shopping tools. The data here is operator-side, not patient-side.
The honest version
Why most dental groups vendor data is wrong.
Search "largest dental groups in the US" and the top results split between two shapes. Annual brand-level rankings of the top 10 DSOs, and workforce datasets on the dentist headcount. Both are useful. Both are also static lists of brand names with office counts. They tell you Heartland has roughly 1,800 supported offices. They do not tell you who at Heartland decides which intraoral scanner the Phoenix region buys next quarter. They do not tell you the names of the 9,400 smaller group operators outside the top 10. They do not refresh between annual cycles, which is awkward when MB2 Dental adds 100 affiliations in a year and a competitor closes 40.
The workforce view sits at about 192,000 active US dentists, roughly 13 percent affiliated with a DSO or large group. That is the universe-of-people angle. It is also indexed to the person, not the practice, which means it is the wrong shape if your software is sold per office or per chair.
This is exactly the gap Orbital was built for. We map the universe of US small and mid-market businesses, find the named decision-maker at each one, and validate the contact before it reaches you. Nothing about that is dental-specific, which is why we can also map gas stations, HVAC contractors, veterinarians, restaurants, and auto dealers the same way. What is specific to dental is the layer on top. Parent DSO affiliation, specialty mix, practice size band, and whether the office is doctor-owned or fully corporate-operated.
One more piece of context worth pricing in. Public DSO rankings and workforce datasets publish annually or biennially. For a vendor doing outbound this quarter, the question is which practices are open this Monday, which regional director took the new role last month, and whether the parent DSO got acquired in February. That is the gap a practice-by-practice, decision-maker-by-decision-maker map closes, and it is the gap brand-level ranking lists cannot close by design.
Questions
Before you ask sales about dental groups data.
How many dental groups are there in the US?
There are roughly 11,400 multi-location dental groups and DSO-affiliated practice networks in the United States, based on the Orbital practice-by-practice map for June 2026. The broader US private-practice dentist universe sits around 192,000 active dentists, but only about 13 percent of those dentists work inside a DSO or large group, which is the segment this page covers.
Who owns the largest dental group in the US?
Heartland Dental, backed by KKR, operates the largest US footprint at roughly 1,800 supported offices across more than 38 states. Aspen Dental follows with around 1,100 branded offices. Pacific Dental Services rounds out the top three at about 950. Even combined, the top 10 dental groups support roughly 17 percent of US group-practice locations. The market remains structurally fragmented.
How is your dental groups count different from public DSO rankings?
Public workforce sources count individual licensed dentists. Annual DSO rankings list brand names by office count. None of those resolves the practice down to the regional director, office manager, or owner-dentist who actually makes a software or supply decision. Orbital builds the list from practice-level signals refreshed against the universe of US small businesses, with the decision-maker contact on every record.
What percentage of US dentists work for a DSO?
Roughly 13 percent of US dentists are affiliated with a DSO or large group practice. That share has roughly doubled over the past decade, driven by private equity acquisitions of regional groups and new graduates joining DSO networks instead of buying solo practices. The other 87 percent of dentists still work in solo practices or small partner groups, which is where most of the buying decisions for clinical software, imaging, and supply still sit.
Which states have the most dental groups?
California has the largest concentration of group practices and DSO offices, followed by Texas, Florida, and New York. The Sun Belt has been the fastest-growing region for DSO expansion over the past five years, driven by population migration and lower regulatory friction on corporate practice of dentistry than in states like New Jersey and Rhode Island. Pacific Dental Services and Western Dental anchor the West Coast, Heartland and Aspen dominate the Midwest and Southeast.
Who buys dental groups data?
Vendors selling into dental practices. Practice management software vendors like Dentrix, Eaglesoft, and Curve. Dental imaging and CAD-CAM vendors. Dental supply distributors and specialty suppliers. Dental billing and revenue cycle teams. Dental staffing platforms. Dental marketing and SEO agencies. The common thread is that they need the named decision-maker, the regional director at a DSO or the owner-dentist at an independent group, not a generic practice address.
Can I filter dental groups by state, parent DSO, or specialty?
Yes. The export includes state, parent DSO affiliation, specialty mix (general, ortho, pedo, oral surgery, endo, perio), and practice size band. You can pull just California Pacific Dental Services offices, or just MB2 Dental affiliated practices in Texas, or just the Heartland offices that added an oral surgery chair in the past year.
When is dental groups data the wrong fit?
If you only sell at the corporate level into the top three DSOs, you do not need 11,400 records. You need three contracts. If your product is for consumers searching for a dentist, this is operator-side data, not consumer-side. If you need clinical outcomes data or insurance claims data, that lives with the carriers, not here. We map the practice, the parent, and the buyer, not the patient and not the claim.
See the dental groups dataset before you pay for it.
Tell us the parent DSOs, states, or specialty mixes you want. We send a free sample of around 100 verified decision-maker records you can check against your own pipeline. No commitment, no email-list back-and-forth.
Get the sample