Skip to content
Fulkerson Advisors
Schedule

How much of Main Street private equity owns

4.8% of US dental offices belong to dental groups backed by private equity.

We counted the offices of nine dental groups on their own websites, took the stated size of the groups that don't list their offices, and compared both with the government's count of US dental offices.

The findings.

  1. Dental groups backed by private equity run 4.8% of US dental offices. 2.0% are in groups that list their offices, and the rest in groups that don't, counted at the size each one states.
  2. At its stated size, Heartland Dental, the largest, runs 1.4% of the country's dental offices.
  3. Aspen Dental is the largest group that lists its offices, with 0.8%.
  4. Lender-owned groups, among them Dental Care Alliance and Affordable Care, run 0.9% of dental offices.
  5. Counting every multi-site group in the study at its stated size, the share is 6.7%.
  6. By state, the counted share is highest in Wisconsin, at 5.7%.

Who owns the most dental offices.

At its stated size, Heartland Dental runs 1.4% of US dental offices. Aspen Dental, the largest group that lists its offices, runs 0.8%.

  1. Heartland Dental: 1.4%, at the size it statesKKR
  2. Aspen Dental: 0.8%Leonard Green & Partners and Ares Management
  3. PDS Health: 0.7%, at the size it statesPrivately held
  4. MB2 Dental: 0.6%, at the size it statesCharlesbank Capital Partners
  5. Smile Doctors: 0.3%Linden Capital Partners and THL
  6. Smile Brands (Bright Now!, Castle, Monarch, Midwest): 0.3%Private equity
  7. Dental Care Alliance: 0.3%, at the size it statesOwned by its lenders
  8. Sonrava (Western Dental, Brident): 0.3%New Mountain Capital
  9. Affordable Care (Affordable Dentures & Implants): 0.3%Owned by its lenders
  10. SGA Dental Partners: 0.2%, at the size it statesThurston Group
  11. Specialized Dental Partners: 0.2%, at the size it statesQuad-C
  12. Specialty Dental Brands: 0.2%, at the size it statesOwned by its lenders
  13. US Oral Surgery Management: 0.2%, at the size it statesPrivate equity
  14. Great Expressions: 0.2%Owned by its lenders
  15. North American Dental Group: 0.1%, at the size it statesPrivately held
  16. SALT Dental Partners: 0.1%, at the size it statesLatticework Capital
  17. Specialty1 Partners: 0.1%, at the size it statesPrivate equity
  18. Guardian Dentistry Partners: 0.1%, at the size it statesFamily office
  19. DECA Dental (Ideal Dental): 0.1%Private equity
  20. Dental365: 0.1%The Jordan Company
  21. Sage Dental: 0.1%, at the size it statesPrivate equity
  22. Mortenson Dental Partners: 0.0%Privately held

fulkersonadvisors.com

Where private equity owns the most dental offices.

Counting the groups that list their offices, Wisconsin leads at 5.7%, then Rhode Island, Ohio, Iowa and Texas at 3.2% to 3.7%.

  1. ALAlabama: 1.7%
  2. AKAlaska: 0.0%
  3. AZArizona: 1.3%
  4. ARArkansas: 2.7%
  5. CACalifornia: 1.3%
  6. COColorado: 1.6%
  7. CTConnecticut: 2.1%
  8. DEDelaware: 0.7%
  9. DCDistrict of Columbia: 0.0%
  10. FLFlorida: 2.0%
  11. GAGeorgia: 2.5%
  12. HIHawaii: 0.0%
  13. IDIdaho: 0.8%
  14. ILIllinois: 1.7%
  15. INIndiana: 2.0%
  16. IAIowa: 3.2%
  17. KSKansas: 1.0%
  18. KYKentucky: 1.8%
  19. LALouisiana: 1.5%
  20. MEMaine: 2.2%
  21. MDMaryland: 2.0%
  22. MAMassachusetts: 1.4%
  23. MIMichigan: 1.9%
  24. MNMinnesota: 2.9%
  25. MSMississippi: 2.0%
  26. MOMissouri: 2.1%
  27. MTMontana: 0.6%
  28. NENebraska: 0.9%
  29. NVNevada: 0.3%
  30. NHNew Hampshire: 3.1%
  31. NJNew Jersey: 1.2%
  32. NMNew Mexico: 1.3%
  33. NYNew York: 1.5%
  34. NCNorth Carolina: 2.3%
  35. NDNorth Dakota: 2.1%
  36. OHOhio: 3.3%
  37. OKOklahoma: 1.5%
  38. OROregon: 0.9%
  39. PAPennsylvania: 2.2%
  40. RIRhode Island: 3.7%
  41. SCSouth Carolina: 2.6%
  42. SDSouth Dakota: 2.2%
  43. TNTennessee: 3.2%
  44. TXTexas: 3.2%
  45. UTUtah: 0.6%
  46. VTVermont: 2.6%
  47. VAVirginia: 1.6%
  48. WAWashington: 1.2%
  49. WVWest Virginia: 1.9%
  50. WIWisconsin: 5.7%
  51. WYWyoming: 2.2%

fulkersonadvisors.com

Software for a roll-up.

A roll-up runs the same work at every site it buys, from booking and estimates to billing and payroll. We write the software those sites share, one process at a time, and the owner keeps the code. How we work with buyers and operating partners.

Book a thirty-minute callHow a build works

The data.

We counted the locations on September 30, 2026.

Groups and owners (CSV)States (CSV)
Questions

What share of dental offices does private equity own?

Dental groups backed by private equity run 4.8% of US dental offices. 2.0% are in groups that list their offices, and the rest in groups that don't, counted at the size each one states.

Does private equity own dental practices?

Many states only let a dentist own a practice, so private equity usually owns the dental service organization (DSO) that runs the offices' business side. An office counts here when it's part of a group backed by private equity.

What is the largest dental group in the US?

Heartland Dental, which at its stated size runs 1.4% of US dental offices. Aspen Dental is the largest group that lists its offices, with 0.8%.

How does this compare with other estimates?

A 2024 Health Affairs study found almost 5% of US dental offices affiliated with private equity in 2021, close to the share here. The American Dental Association counts 16.1% of dentists in practices tied to a dental service organization in 2024. That's a share of dentists rather than offices, across every kind of owner, and the groups' offices tend to be larger.

Why are some groups counted at their stated size?

Some of the largest groups, Heartland Dental and MB2 Dental among them, keep each office's own name and don't list their offices in one place. They're counted at the size each one states and shown apart.

Who owns Heartland Dental?

KKR owns Heartland Dental. It runs 1.4% of US dental offices, at the size it states.

Who owns Aspen Dental?

Leonard Green & Partners and Ares Management own Aspen Dental. It runs 0.8% of US dental offices.

Who owns MB2 Dental?

Charlesbank Capital Partners owns MB2 Dental. It runs 0.6% of US dental offices, at the size it states.

Who owns Smile Doctors?

Linden Capital Partners and THL own Smile Doctors. It runs 0.3% of US dental offices.

Every group
GroupBrandsOwnerLocationsShare
Heartland Dentallocal namesKKR1,900 stated1.4%
Aspen DentalAspen DentalLeonard Green & Partners and Ares Management1,0930.8%
PDS Health... Modern DentistryPrivately held1,000 stated0.7%
MB2 Dentallocal namesCharlesbank Capital Partners800 stated0.6%
Smile DoctorsSmile Doctors (ortho)Linden Capital Partners and THL4630.3%
Smile Brands (Bright Now!, Castle, Monarch, Midwest)Bright Now!; Monarch; Castle; 75+ brandsPrivate equity4520.3%
Dental Care Alliance150+ local brandsOwned by its lenders400 stated0.3%
Sonrava (Western Dental, Brident)Western Dental; BridentNew Mountain Capital3860.3%
Affordable Care (Affordable Dentures & Implants)Affordable Dentures & ImplantsOwned by its lenders3650.3%
SGA Dental PartnersThurston Group250 stated0.2%
Specialized Dental Partnersendo/perio/OSQuad-C250 stated0.2%
Specialty Dental BrandspediatricOwned by its lenders250 stated0.2%
US Oral Surgery Managementlocal namesPrivate equity242 stated0.2%
Great ExpressionsGreat ExpressionsOwned by its lenders2240.2%
North American Dental Groupregional/local brandsPrivately held200 stated0.1%
SALT Dental PartnerspediatricLatticework Capital200 stated0.1%
Specialty1 PartnersJVsPrivate equity200 stated0.1%
Guardian Dentistry PartnersFamily office164 stated0.1%
DECA Dental (Ideal Dental)Ideal DentalPrivate equity1610.1%
Dental365Dental365 + othersThe Jordan Company1580.1%
Sage DentalSage DentalPrivate equity150 stated0.1%
Mortenson Dental PartnersMortenson Family DentalPrivately held440.0%
Every state
StateEstablishmentsPrivate equityShare
Alabama1,608271.7%
Alaska31500.0%
Arizona2,922371.3%
Arkansas965262.7%
California23,4863131.3%
Colorado3,027471.6%
Connecticut1,625342.1%
Delaware29420.7%
District of Columbia32600.0%
Florida9,9111952.0%
Georgia4,2771082.5%
Hawaii73200.0%
Idaho1,01480.8%
Illinois5,7811011.7%
Indiana2,248452.0%
Iowa1,035333.2%
Kansas1,021101.0%
Kentucky1,581281.8%
Louisiana1,681251.5%
Maine457102.2%
Maryland2,561502.0%
Massachusetts3,188461.4%
Michigan3,795721.9%
Minnesota1,884552.9%
Mississippi1,006202.0%
Missouri2,001432.1%
Montana52930.6%
Nebraska75970.9%
Nevada1,48940.3%
New Hampshire586183.1%
New Jersey4,539561.2%
New Mexico68491.3%
New York8,0011171.5%
North Carolina4,219992.3%
North Dakota28262.1%
Ohio3,8141253.3%
Oklahoma1,373201.5%
Oregon1,954170.9%
Pennsylvania4,6491032.2%
Rhode Island327123.7%
South Carolina1,865492.6%
South Dakota31772.2%
Tennessee2,409763.2%
Texas12,9594123.2%
Utah1,890120.6%
Vermont23562.6%
Virginia3,675601.6%
Washington3,135371.2%
West Virginia48391.9%
Wisconsin1,8881075.7%
Wyoming22452.2%
How we did it

We counted the US locations of the largest dental groups on September 30, 2026, from each group's own website. Groups that don't list their locations in one place count at the size each one states and are shown apart.

The number of dental offices is the Bureau of Labor Statistics count of private establishments with employees for the first quarter of 2026, 138,982 dental offices (NAICS 621210). A state's count of businesses is the larger of the Bureau of Labor Statistics count for the first quarter of 2026 and the Census Bureau's 2023 County Business Patterns count. The first can fold a chain's sites in a state into one report, and the second misses sites opened since 2023, so the larger count keeps a state's share from running high. Washington, West Virginia, Wisconsin and Wyoming use the first count only.

These shares are floors. Groups we didn't count aren't in them. The full method

Cite this page

Fulkerson Advisors (2026). Who Owns US Dental offices: Private Equity's Share, September 2026. https://www.fulkersonadvisors.com/research/private-equity-ownership/dental-offices

Use any of these numbers or charts. Credit Fulkerson Advisors and link to this page. The data is under a CC BY 4.0 license.