Top 10 DSOs: The largest companies keep growing

2021 04 23 00 16 9585 Businessman Plan Graph 400

This list has been updated. See the 2023 list here.

Of the 10 largest dental service organizations (DSOs) in the U.S., Heartland Dental continues to hold first place. Though it held the top spot since our last updated list in 2021, it's not the only DSO to add new affiliates.

As of May 19, Heartland Dental added 37 practices -- 25 affiliate offices and 12 DeNovos practices -- in the past year. In 2022, Heartland Dental expects to collaborate on opening 100 DeNovos practices and affiliate with more than 100 dental practices.

TAG - The Aspen Group, Aspen Dental Management's parent company, has grown by about 200 practices over the last year. Meanwhile, Pacific Dental Services added about 50 affiliates, and MB2 Dental, which made our top 10 for the first time in 2021, added 100 practices.

Western Dental inched up the ranks with the addition of about two dozen affiliates and is poised to grow even more with the recently announced acquisition of Mid-Atlantic Dental Partners. Once the acquisition is complete, Western Dental is expected to be among the top five largest DSOs.

Top 10

Organizations are ordered by the number of affiliated practices. All company websites were last accessed on May 19, 2022.

  1. Heartland Dental
    Number of affiliated/supported practices/offices: 1,600+
    Brands: Individualized
    Locations: 38 states
    Note: Heartland says it supports more than 2,400 dentists and anticipates supporting another 250 this year.
    Source: Press release dated May 19
  2. TAG - The Aspen Group
    Number of affiliated/supported practices/offices: 1,100
    Brands: Aspen Dental
    Locations: 45 states
    Note: Tag - The Aspen Group recently partnered with Ace Surgical Supply.
    Source: Press release dated April 26
  3. Pacific Dental Services
    Number of affiliated/supported practices/offices: 850+
    Brands: Individualized
    Locations: 26 states
    Note: Pacific Dental Services recently opened the Sahara Health Group, a supported medical practice in Las Vegas that will conduct operations in the same location as Sahara Modern Dentistry.
    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 not added any new practices since our 2021 list.
    Source: Company website
  5. Affordable Care (tied)
    Number of affiliated/supported practices/offices: 400
    Brands: Affordable Dentures & Implants, DDS Dentures + Implant Solutions
    Locations: 42 states
    Note: Each practice has an onsite laboratory, according to the company.
    Source: Company website

    MB2 Dental (tied)
    Number of affiliated/supported practices/offices: 400
    Brands: Individualized
    Locations: 35 states
    Note: MB2 Dental, which brands itself as a "Dental Partnership Organization," added 100 practices since our last update, allowing it to climb from its previous No. 9 spot.
    Source: Press release dated March 3, 2022
  6. Dental Care Alliance
    Number of affiliated/supported practices/offices: 360+
    Brands: Advanced Dental Care, College Park Dental, Gentle Dental
    Locations: 21 states
    Note: Adding several new practices resulted in Dental Care Alliance rising one spot from its previous No. 7 spot on our list.
    Source: Company website
  7. Western Dental
    Number of affiliated/supported practices/offices: 356
    Brands: Western Dental & Orthodontics, Brident Dental & Orthodontics
    Locations: 5 states
    Note: Once the acquisition of DSO Mid-Atlantic Dental Partners is complete, Western Dental will grow to 571 practices in 17 states and rise to the No. 5 spot on our list.
    Sources: Press releases dated May 17 and May 5
  8. Great Expressions Dental Centers
    Number of affiliated/supported practices/offices: 349
    Brands: Great Expressions
    Locations: 10 states
    Note: Great Expressions has not added any practices since our 2021 update, causing it to slide from its previous No. 6 ranking.
    Source: Company website
  9. North American Dental Group
    Number of affiliated/supported practices/offices: 250+
    Brands: Individualized
    Locations: 15 states
    Note: North American Dental Group has extended its commitment to diversity, equity, and inclusion.
    Source: Press release dated November 18, 2021
  10. InterDent
    Number of affiliated/supported practices/offices: 172
    Brands: Gentle Dental, Smile Keepers, and Blue Oak Dental
    Locations: 8 states
    Note: In 2022, InterDent opened two new offices.
    Source: Press release dated April 1, 2022

    Honorable mention:
    Specialty1 Partners
    Number of affiliated/supported practices/offices: 150
    Brands: Endo1 Partners, Perio1 Partners, OS1 Partners
    Locations: 23 states
    Note: Specialty1 Partners is a dental surgical specialty group representing more than 275 specialists.
    Source: Company website

    Number of affiliated/supported practices/offices: 120
    Brands: Individualized
    Locations: 17 states
    Note: Benevis recently named Bryan J. Carey as its CEO.
    Source: Press release dated March 30, 2022

    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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