Top 10 DSOs: Pandemic didn't curb corporate growth

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The top 10 largest dental service organizations (DSOs) in the U.S. have grown considerably since we last updated our list in October 2019. Unlike private dental practices, the corporations do not appear to have been shaken by the COVID-19 pandemic.

Heartland Dental once again topped the list of the largest DSOs in the country, growing by about 200 practices in almost two years. The mega-DSO is poised to grow even more with the recently announced acquisition of American Dental Partners (ADPI). In prior years, ADPI consistently made our list of the largest DSOs in its own right.

At the same time, our list features two new entries: Texas-based MB2 Dental and Pennsylvania-based North American Dental Group. All DSOs on the list, including the two new firms, have at least 250 affiliated practices. In 2019, a DSO could make the list with fewer than 200 practices.

Top 10

Organizations are ordered by the number of affiliated practices. All company websites were last accessed on July 27, 2021.

  1. Heartland Dental
    Number of affiliated/supported practices/offices: 1,150+ on its own and 1,400 locations in merge with ADPI
    Brands: Individualized
    Locations: 38 states
    Note: Heartland said it supports 1,800 dentists and anticipates supporting another 250 this year.
    Source: Press release dated May 14, 2021; Blog post dated July 2, 2021
  2. Aspen Dental
    Number of affiliated/supported practices/offices: 900+
    Brands: Aspen
    Locations: 43 states
    Note: The larger Aspen Dental Management organization also supports broader medical centers, including urgent care and medical aesthetics facilities, in 46 states.
    Source: Press release dated June 16, 2021
  3. Pacific Dental Services
    Number of affiliated/supported practices/offices: 800+
    Brands: Individualized
    Locations: 24 states
    Note: During the pandemic, Pacific Dental Services has hosted and participated in numerous educational webinars.
    Source: Company website
  4. Smile Brands
    Number of affiliated/supported practices/offices: Nearly 700
    Brands: Bright Now! Dental, Castle Dental, Merit Dental, Midwest Dental, Monarch Dental, Mondovi Dental
    Locations: 30 states
    Note: Smile Brands has burgeoned from more than 400 practices in our last update.
    Source: Press release dated July 6, 2021
  5. Affordable Care
    Number of affiliated/supported practices/offices: 370+
    Brands: Affordable Dentures & Implants, DDS Dentures + Implant Solutions
    Locations: 41 states
    Note: Each practice has an onsite laboratory, according to the company.
    Source: Company website
  6. Great Expressions Dental Centers
    Number of affiliated/supported practices/offices: 349
    Brands: Great Expressions
    Locations: 10 states
    Note: Great Expressions is one of the biggest movers from our last update, rising from No. 8 in 2019.
    Source: Company website
  7. Dental Care Alliance
    Number of affiliated/supported practices/offices: 335
    Brands: Advanced Dental Care, College Park Dental, Gentle Dental
    Locations: 20 states
    Note: Dental Care Alliance has 85 brand names that represent all dental specialties, according to the company.
    Source: Press release dated July 15, 2021
  8. Western Dental
    Number of affiliated/supported practices/offices: 333
    Brands: Western Dental & Orthodontics, Brident Dental & Orthodontics
    Locations: 5 states
    Note: With the addition of only 11 practices, Western Dental has gotten knocked down from the No. 6 spot in our last update.
    Source: Press release dated May 4, 2021
  9. MB2 Dental
    Number of affiliated/supported practices/offices: 300
    Brands: Individualized
    Locations: 30 states
    Note: MB2 Dental brands itself as a "Dental Partnership Organization" and emphasizes clinical autonomy for affiliated dentists.
    Source: Press release dated May 27, 2021
  10. North American Dental Group
    Number of affiliated/supported practices/offices: 250+
    Brands: Individualized
    Locations: 15 states
    Note: North American Dental Group recently signed Julie Penn as chief growth officer.
    Source: Press release dated July 6, 2021

The list of the largest DSOs is based on research of readily available public information. The information presented is not meant to be definitive but rather to provide a snapshot of the available data on the largest DSOs. In each instance, the information has been gathered through an organization's website, press releases, previously published material, or other sources.

Some companies and information are not on this list because the information could not be confirmed by press time. If you are aware of missing information or an organization that should be on this list, please contact us.

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