How to Open a Dental Practice

In this episode, Arminco CEO Art Safarian speaks with Dr. Lior Tamir (https://www.thedentalapp.com/), whose journey into dentistry took an unexpected turn. After graduating during the 2009 financial crisis and struggling to find work, he left dentistry and built a successful marketing technology company before returning to the profession.Today, he runs a multi-location dental group and shares how entrepreneurship, technology, and patient experience shape modern dental practices. We also discuss The Dental App, a platform designed to help practices manage operations, marketing, and patient relationships in one system.

After seven deep dives into real estate, construction, legal review, CPAs, marketing, and consultants — we close the series by bringing it all together.This recap episode reinforces one central idea:We’re not saying brokers, contractors, attorneys, consultants, or banks are doing a bad job.We’re saying you need to understand how their roles overlap — and where confusion costs you time and money.In this episode, we revisit:• Why “build your team” is incomplete advice• The importance of understanding each professional’s lane• How overlapping roles create inefficiencies• Why project management is often the missing piece in healthcare startups• The difference between simply not defaulting and actually building wealth• The hidden cost of waste, misalignment, and poor coordinationDental practices statistically succeed. Default rates are low. But that doesn’t mean startups are efficient.Success by default is not the same as success by design.If you’re opening a dental practice, this final episode challenges you to step into your role as a true business owner — not just a clinician assembling vendors.

Marketing. Branding. Consultants. Gurus.In Part 7, we shift from legal and financial advisors to two areas that heavily influence dental startups: marketing strategy and practice consultants.This episode dives into:• The minimum marketing requirements every dental startup needs• Why marketing should not be cookie-cutter• How branding, design, and location must align• Why marketing dollars continue long after opening• The importance of consistency for long-term valuation and resale• The difference between hiring a consultant for a task vs. “running your practice”We also unpack a growing trend in healthcare: practice consultants who position themselves as full-spectrum startup experts — from site selection to construction to operations.Here’s the reality:No one professional should be your sole decision-maker.Consultants can play an important role in revenue growth, systems, and administration — but they are not substitutes for real estate professionals, attorneys, designers, or contractors.If you’re opening your dental practice, this episode will challenge you to think like a business owner first — and understand exactly who you’re hiring, and why.

Attorneys review leases.But who’s reviewing your construction contract?Who’s aligning your contractor’s agreement with your master lease?And when should your CPA actually be involved?In Part 6 of this series, we expand the conversation beyond lease review and dive into the broader professional team that shapes your dental startup.This episode covers:• Why every legally binding contract — not just your lease — should be reviewed• The risk of misalignment between your lease and contractor agreement• Builder’s risk insurance and the common misconceptions around it• The difference between liability coverage and developer risk• When to involve your CPA in the startup process• Why CPAs give perspective — not permission• The financial reality of startup vs. acquisition decisionsWe also begin discussing startup marketing — and why branding, design, and marketing must speak the same language from the beginning.Opening a dental practice isn’t just about finding space and signing contracts.It’s about aligning every professional involved — legally, financially, and strategically.If you’re early in the process, this episode will help you avoid costly miscommunication between advisors.

Attorneys. CPAs. Consultants.By the time you reach this stage of opening your dental practice, you’ve likely signed a proposal, negotiated major lease terms, and now you’re bringing in legal representation.But when exactly should an attorney get involved — and what is (and isn’t) their role?In Part 5, we break down:• When to involve a lease attorney in the process• What attorneys should be reviewing vs. what’s already been negotiated• Why personal guarantees must be addressed early — not at lease draft stage• The difference between a lease-review attorney and a litigation attorney• Why every lease comes back “redlined” — and why that’s normal• The assignability clause most startups forget to negotiateWe also address a major misconception: thinking an attorney replaces a real estate professional. They don’t. Their roles overlap — but they are not interchangeable.Most importantly, we discuss the balance between under-valuing and over-valuing legal advice. An attorney protects you legally — but they don’t make business decisions for you.If you’re entering lease drafting or evaluating legal counsel, this episode will help you understand how to use your attorney properly — without derailing your deal.

You signed the lease.You love the test fit.You have a budget in mind.Now the real work begins.In Part 4 of this series, we dive into architectural drawings — and why this stage is where expectations, budgets, and reality often collide for dental startups.Many doctors mistake a test fit for a finalized design. But a test fit is exactly what it sounds like: a preliminary layout to see what fits. It is not engineered, not code-reviewed in depth, and not ready for construction pricing.In this episode, we discuss:• Why test fits are not construction drawings• How existing conditions (HVAC closets, panels, VAV units) change layouts• Why moving one element can trigger a domino effect in design• The difference between permit drawings and fully detailed construction sets• How incomplete MEP (mechanical, electrical, plumbing) plans cause change orders• Why cheaper architectural fees can lead to higher construction costsWe also unpack a critical misconception: comparing architects solely by design appearance or upfront fee — instead of evaluating scope, engineering inclusion, and level of detail.If you’re early in design or comparing architectural proposals, this episode will help you avoid costly redraws, timeline delays, and change orders.Because once drawings go from “concept” to “permit,” the real financial implications begin.

In Part 3 of this series, we dive into one of the most overlooked risks in a dental startup: leasing a space “as-is” without truly understanding what that means.Many doctors assume that if HVAC units are present, they work.If a contractor walks the space, it’s been “inspected.”If the lease says the landlord provides something, it’s covered.That assumption can cost tens of thousands of dollars.In this episode, we discuss:• Why commercial leases are typically “as-is”• The difference between seeing HVAC units and verifying functionality• Why contractors walking a space are not performing inspections• How estimate “wars” create unrealistic expectations• What happens when budget numbers turn into hard quotes• The danger of bringing contractors in too late in negotiationsWe also break down a key concept: procuring cause — and why switching brokers mid-process can legally complicate your deal.If you’re about to sign a lease or compare construction numbers, this episode will help you understand what should be verified before you commit.Because once you sign — there’s no going back.

In Part 2 of this series, we move beyond real estate selection and into one of the most misunderstood areas of a dental startup: what happens after you find the space.Many doctors believe they’re negotiating aggressively or “double-checking” professionals — but in reality, they may be weakening their leverage, confusing contractors, and distorting pricing without realizing it.This episode breaks down:• Why LoopNet doesn’t show the full commercial market• The difference between usable vs. rentable square footage• How inconsistent communication between contractors skews pricing• Why a “budget number” is not the same as a final construction bid• What’s actually missing when you ask for pricing from a basic floor plan• The HVAC misconception that costs doctors tens of thousandsWe also unpack a major issue: lease language around construction and HVAC. Just because a lease says the landlord is “providing HVAC” doesn’t mean you understand what that includes — or when it’s delivered.If you’re comparing contractor numbers, reviewing lease clauses, or trying to lock in build-out costs too early, this episode will change how you approach the process.An educated consumer doesn’t just ask for a lower number.They understand what they’re actually pricing.

Opening a dental practice is one of the biggest financial decisions of your career — and yet many doctors approach commercial real estate the same way they bought their first home.In Part 1 of this series, we break down why that mindset can quietly sabotage your startup before it even begins.From using multiple brokers at the same time, to working with professionals who don’t understand healthcare-specific zoning, lease structures, or build-out timelines — small decisions early on can weaken your negotiating power, delay permits, and cost you significantly more in the long run.We discuss:• Why commercial real estate is not “fill-in-the-blank” like residential• What happens when landlords realize you’re shopping multiple brokers• How inexperience in healthcare real estate can hurt your lease terms• Why exam-room layouts you see during tours usually get gutted anyway• How trust and alignment directly impact negotiation strengthIf you’re planning a startup or renegotiating a lease, this episode will help you understand what questions to ask — and how to protect your leverage before you even submit a proposal.Being an educated consumer isn’t about controlling every step.It’s about choosing the right guide — and committing to the process.

In this episode of How to Open a Dental Practice, Art sits down with Dr. Michael Gertsen, a South Florida general dentist who is in the middle of relocating and expanding a long-standing family practice. After operating in the same location for 25 years, Dr. Gertsen shares what it’s really like to purchase a commercial building, design a larger practice from the ground up, and plan for future growth.The conversation covers common (and costly) decision points dentists face during a relocation—choosing the right contractor, understanding why early construction “bids” are often just estimates, and knowing when to stop revising floor plans and move forward. Art also breaks down best practices for operatory count, sterilization layout, equipment decisions, portable vs. pass-through X-rays, and how to minimize patient disruption during a move.This episode is especially valuable for dentists considering a relocation, expansion, or real estate purchase, offering real-world insights into design planning, budgeting, contractor selection, and avoiding regrets during a major practice transition.

Financing expert Dan Lewis from Huntington Bank delivers a data‑driven breakdown of how lenders evaluate dental startups and acquisitions—and the key financial indicators dentists must understand before choosing a path. Dan explains why banks view dental borrowers differently from other industries, what factors strengthen or weaken a loan application, and how new graduates, associates, and multi‑location owners can position themselves for approval.Listeners will learn how cash flow, production history, practice value, borrower experience, and market conditions influence lending decisions—and why the “best deal” is not always the one with the lowest rate.Topics include:●       How banks evaluate startup vs. acquisition risk●       What lenders look for in production history, credit, and liquidity●       Why cash flow matters more than collections in practice valuation●       Common mistakes borrowers make during loan applications●       How to secure stronger terms through preparation and documentation●       Financing considerations for multi‑location expansion●       What borrowers misunderstand most about dental lending

Technology expert Dan De‑Steno dives into the operational and cybersecurity challenges dentists face when starting or acquiring a practice. With decades of experience supporting dental IT infrastructure, Dan outlines the hidden costs, risks, and long‑term implications of both paths—especially when it comes to outdated hardware, inconsistent data systems, network vulnerabilities, and HIPAA compliance gaps.This episode provides a practical, behind‑the‑scenes look at how technology impacts production, efficiency, patient experience, and team performance—making it essential listening for any dentist evaluating a practice or preparing to build one.Topics include:●       Startup IT requirements vs. acquisition IT cleanup●       Legacy systems, outdated hardware, and hidden upgrade costs●       Cybersecurity risks unique to dental offices●       HIPAA compliance mistakes and how to fix them●       Server vs. cloud considerations for growing practices●       How poor technology slows production and frustrates teams●       What to evaluate before signing a purchase agreement or lease

Dr. Ben Liu shares one of the most dynamic ownership journeys featured in this series—relocating to a new state, rapidly expanding across multiple locations, acquiring underperforming practices, and launching startups inside existing orthodontic spaces. His path includes buying distressed practices, relocating them, scaling from 2 ops to 5+, and using systems to turn stagnant offices into high‑growth pediatric dental practices.Dr. Liu also discusses the unique challenges of specialty ownership, the importance of trust when evaluating acquisition opportunities, and how market selection and landlord relationships shape long‑term expansion strategy.Topics include:●       Starting with two practices overnight—one leased startup, one small acquisition●       Relocating an outdated two‑op practice and growing it into a high‑volume office●       Acquiring distressed practices and scaling patient bases●       Expanding to 4–5 locations through strategic opportunity, not randomness●       How startups differ when launched inside an existing ortho space●       Financial, operational, and staffing challenges of multi‑location growth●       Acquisition vs. startup strategy for pediatric specialists

In this episode, Rafael A. Martinez brings an operations and business‑systems perspective to the acquisition vs. startup conversation. Drawing on his extensive experience supporting dental practices, Rafael explains the operational blind spots that cause practices to underperform—and how buyers and new owners can use systems, leadership, and metrics to create immediate improvements. He highlights why relying solely on the seller’s processes can be limiting, and how new owners can introduce structure that improves collections, patient flow, team accountability, and financial clarity.This episode is especially valuable for dentists who feel unsure about the “business side” of ownership and want a framework for evaluating or improving a practice.Topics include:●       The operational red flags to identify before buying a practice●       Why systems—not the seller’s habits—determine long‑term success●       Leadership expectations for new owners●       How to correct weak scheduling, AR issues, and workflow breakdowns●       Startup vs. acquisition: which offers more control over systems?●       What numbers reveal about practice health and hidden inefficiencies●       Building accountability across the team during a transition

In this episode, Dr. Izzat Sebeih shares the story behind launching his large, 5,000 sq. ft. dental startup—built from scratch after a failed partnership opportunity pushed him to create his own path. Dr. Sebeih explains how he evaluated acquisition opportunities, why the numbers didn’t make sense for the practices he considered, and how his risk tolerance shaped his decision to open a fee‑for‑service startup in a highly competitive market. He also breaks down the realities of growing slowly, expanding operatories over time, and securing financing when traditional lenders initially said no.Listeners gain a candid look at space selection, loan challenges, insurance strategy, and why starting from scratch—despite higher upfront risk—gave him the control and long‑term scalability he wanted.Topics include:●       Why he rejected multiple acquisition opportunities despite bank approval●       Opening a 5,000 sq. ft. startup and growing it from 4 to 10 ops●       How fee‑for‑service impacted early growth and patient flow●       Lease negotiation challenges and selecting the right location●       Overcoming multiple loan rejections and finding the right lender●       Evaluating practice purchases as a risk‑averse dentist●       How systems, metrics, and financial analysis guide long‑term success

Dr. George Kreisheh shares his compelling journey from graduating dental school to opening a startup practice just one year later—followed by navigating COVID-19 within his first year of ownership. He explains why early acquisition opportunities felt overpriced, how he leveraged lender relationships, and why having a dual-income household allowed him to pursue startup ownership with confidence. Dr. Kreisheh also discusses the challenges of inexperience, the realities of learning the business side as you go, and how the pandemic unexpectedly accelerated his practice growth.This episode offers a transparent look at taking risks early, evaluating acquisition opportunities, and building resilience as a new practice owner.Topics include:●       Evaluating outdated or overpriced acquisition opportunities●       Transitioning from associate to owner after just one year●       Leveraging lender relationships and realtor referrals in the startup process●       How COVID-19 impacted new practices and patient flow●       Using low overhead and rent abatement to survive early challenges●       Building confidence and clinical boundaries (what to treat vs. refer out)●       Why some dentists thrive by “jumping in” and learning ownership on the job

Marketing expert Michael Anderson of Wonderist Agency breaks down the critical role that marketing plays in the success of dental startups and acquisitions. With over a decade helping more than 800 practices grow, Michael explains why startups face immense pressure to generate new patients quickly, how to budget realistically for launch-stage marketing, and why the first 100 patients often determine long-term success. He also demystifies SEO, Google My Business optimization, and the difference between onsite and offsite search strategies.This episode is essential for dentists who want to understand modern marketing expectations, the cost of visibility in competitive markets, and how to avoid running out of funds mid-buildout.Topics include:●       Why startups must invest heavily in early marketing to survive●       Budgeting for marketing inside your loan, not after●       How to make the first 100 patients your “raving fans”●       SEO basics: onsite optimization vs. offsite signals (reviews, backlinks, listings)●       Google My Business and local ranking strategy for new dentists●       Why multiple clients in the same zip code creates SEO conflicts●       Startup vs. acquisition marketing pressures and expectations

Dr. Williams, a seasoned clinician with decades of academic and private practice experience, provides a historical and practical perspective on dental practice ownership. From building a multi-operatory faculty practice within a HUD building to growing alongside Baltimore’s Inner Harbor redevelopment, he explains how dentistry—and the process of opening or acquiring a practice—has evolved across generations. His insights highlight the realities of starting lean, expanding as demand increases, and navigating patient demographics long before modern marketing tools existed.Dentists will gain an appreciation for how practice models have changed, what challenges remain constant, and how ownership decisions differ dramatically between eras.Topics include:●       Building a practice from one operatory to a multi-suite facility●       Using used equipment and lean resources to grow sustainably●       How patient demographics and urban development shaped practice growth●       The limited acquisition opportunities available in earlier decades●       How associateships and slow buy-ins functioned historically●       Differences between past and modern startup challenges●       Lessons today’s dentists can learn from long-term practice evolution

Prosthodontist Dr. Harshit Aggarwal shares a data-driven, highly intentional journey into practice ownership—from relocating to the DC market, to evaluating cities nationwide, to purchasing a practice and later relocating it for growth. Dr. Aggarwal explains why he considered both startup and acquisition options, how his risk tolerance shaped his choice, and why cash flow was the deciding factor early in his career. He also discusses non-compete strategy, market evaluation, associate experience, and the importance of aligning long-term location goals with demographic and economic stability.This episode provides exceptional insight for specialists and general dentists who want to approach practice ownership with strategy rather than chance.Topics include:●       How he evaluated cities using economic stability, demographics, and opportunity●       Why he chose acquisition over startup at that career stage●       Strategic use of non-competes while preparing for ownership●       Analyzing 25+ practices before selecting the right one●       Keeping the seller on staff—and how transition expectations evolved●       Relocating a purchased practice for better space, workflow, and scalability●       How specialists can assess risk vs. reward in ownership decisions

Dr. Rae Orraca-Tetten shares her journey from considering an acquisition to ultimately launching a successful dental startup that grew from 3 to 10 operatories. She explains why a startup was more cost‑effective for her personality, clinical style, and long-term goals—despite early recommendations to purchase the practice she worked in. Dr. Orraca-Tetten breaks down how she phased her buildout, accelerated production from day one, and strategically expanded into a neighboring suite as patient demand exploded.Her experience provides a candid and highly practical look at startup budgeting, confidence, production expectations, and the mindset required to scale quickly.Topics include:●       Why purchasing an older practice didn’t fit her vision or financial goals●       How she launched with 3 operatories and expanded to 10 within six years●       Cost differences she observed between startups and acquisitions●       Building a team, managing overhead, and optimizing operatory utilization●       Expanding into adjacent space and planning for future associate opportunities●       How personal drive and clinical confidence shape the startup path●       Advice for dentists choosing between buying and building

In this episode, Dr. Harry Snydman brings a rare dual perspective as both a long-time practice owner and a current dental practice broker. With over 27 years of ownership experience and a deep understanding of today’s transition market, Dr. Snydman explains what has changed—and what hasn’t—when comparing starting a dental practice from scratch versus purchasing an existing one. He shares the real challenges he faced during his 1996 startup, how he grew his operatories, and why finding a suitable practice to buy was far more difficult than expected.Listeners gain insight into market shifts, risk tolerance, startup timelines, leasing considerations, and the rise of modern buyer expectations in today’s dental landscape.Topics include:●       Why a lack of viable acquisition options pushed him into a startup●       What the startup process looked like 30 years ago vs. today●       Overcoming hesitation, financing limitations, and buildout challenges●       How strong retail co-tenants (grocery, banking, restaurants) impact patient flow●       The role of PPOs, HMOs, and insurance strategy during early practice growth●       How brokers evaluate practices and guide buyers in the modern market●       Key lessons for today’s dentists choosing between acquisition and startup

Dr. Jesse Ritter shares his real-world journey of purchasing a dental practice in Towson, Maryland—including why he chose acquisition over a startup, how he evaluated opportunities, and what risk factors mattered most as a young dentist with student loans. He explains the importance of autonomy, owning your clinical decisions, and assessing the true stability of a seller’s patient base. Dr. Ritter also details how he negotiated purchasing the building, transitioned patients, and expanded his operatories over time.New dentists considering ownership will find valuable insights into balancing risk tolerance, cash flow needs, real estate strategy, and patient retention during a practice transition.Topics include:●       Why acquisition felt less risky than a startup early in his career●       How to evaluate a practice opportunity for cash flow and growth●       Buying the real estate: when it makes sense and why it matters●       Structuring seller transitions—and why continuity builds patient trust●       Expanding operatories and modernizing a legacy practice●       How associate experience shaped his decision to own●       Key considerations for dentists relocating to a new market

Industry veteran Brian Frederick, with over 30 years in dental development, shares a high-level strategic view of when dentists should acquire a practice, when they should start one from scratch, and why the decision is rarely black-and-white. Brian explains how practice size, market demand, leasing strategy, and long-term growth planning shape the right path for each doctor. He also discusses why many new dentists undervalue build-outs, underestimate future expansion needs, and overlook the power of merging acquired practices into a well-designed startup.This episode offers a realistic roadmap for doctors trying to choose between buying an existing practice with cash flow or building a modern, scalable space designed for long-term growth.Topics include:●       Acquisition vs. startup: key factors that make each option optimal●       Why many older dental spaces limit growth and modern workflow●       How lease length, square footage, and expansion potential influence success●       Strategic advantages of merging an acquired patient base into a new startup●       How DSOs changed the acquisition landscape—and what it means for solo owners●       Hidden costs of retrofitting outdated dental offices●       Why the “best practice owners” often start first, then acquire later

In this episode of How to Open a Dental Practice, banking expert Lori Riley breaks down the financial realities of acquiring a dental practice versus launching a startup. With 18 years of lending experience and deep expertise in dental acquisitions, Lori explains how banks evaluate risk, cash flow, borrower production history, practice profitability, and transition readiness. New dentists looking to buy their first practice will gain a clear understanding of what lenders look for—and how to avoid financing mistakes that can derail an acquisition.Listeners will learn how practice valuation truly works, why two $1M practices can have completely different profitability, and how lenders determine whether a buyer has the production capacity to maintain or grow the business.Topics include:●       How banks evaluate dental practice acquisitions and lending risk●       Why profitability—not collections—determines true practice value●       Common financing challenges new dentists face●       How lender conditions work (seller stay-on periods, production history, etc.)●       Startup vs. acquisition lending: what banks see differently●       What happens if a seller can’t complete their transition period●       How to prepare financially before approaching a lender

In this episode, Arminco CEO Artin Safarian and Sara Reichenbach, Senior Consultant, speak with Dr. Madeleine Goodman of Harmony Pediatric Dentistry & Orthodontics in Bethesda. She is an orthodontist, entrepreneur, and the heart and soul behind Tiny Changes, a dental plastics recycling and sustainability initiative.Dr. Goodman shares not only her passion for creating sustainable change in the dental industry but also her firsthand experience opening her own practice and navigating the challenges that come with practice ownership. Her work through Tiny Changes offers dentists a practical way to reduce the significant amount of single-use plastics generated in daily operations—keeping them out of landfills and moving the profession toward a more responsible future.This episode is an excellent opportunity for dental professionals to learn how sustainability and practice success can go hand in hand.To learn more about the process, visit Tiny Changes.Interested in joining the initiative? Contact [email protected] to receive a discounted recycling box and complimentary advisory services as a thank-you for your participation.Arminco is the full-suite professional partner behind over 1,000 successful healthcare buildouts nationwide. We integrate strategy, design, and execution into one seamless process, delivering certainty where others deliver complexity. Arminco Inc. is a full-suite professional services partner helping healthcare professionals open and expand with confidence. With 20+ years, we deliver certainty through integrated, custom solutions, not cookie-cutter templates. From concept to care, our hands-on team turns complexity into clarity so you can focus on what matters most: your practice.At Arminco, we believe great spaces start with great partnerships. For over 20 years, we've helped healthcare professionals across the country bring their vision to life with clarity, confidence, and certainty. As a vertically integrated professional services partner, we connect every phase of your project into one seamless experience. We don't hand off responsibilities. We take ownership from the first idea to your first patient, ensuring a custom, non-cookie-cutter solution built around your goals. With over 1,000 projects delivered nationwide, our proven process transforms complexity into confidence every time.

When contractor bids come back higher than expected, the issue often starts with what’s missing from the landlord’s work letter. In this episode, Art and Hailee break down a real situation where a healthcare tenant discovered major gaps in the landlord’s delivery—including no HVAC, no electrical panel, no drywall, and even no concrete slab.For dental offices, these items can dramatically inflate construction costs and create unexpected budget stress.This episode covers:• Why bidding construction from design-only drawings leads to inaccurate pricing• How missing core infrastructure can add $100K+ to your dental build-out• What your landlord’s work letter must include before you sign a lease• How to negotiate TI money when key elements aren’t delivered• Why working with an experienced healthcare realtor mattersA must-listen for any dentist preparing to lease a new space and wanting to protect their construction budget.

Renovations can fall apart long before construction begins — and in this case study, a 3,500 sq. ft. dental expansion in Arizona shows exactly how. What looked like a “full” drawing set turned out to be missing critical engineering details, complete specifications, clear phasing, and even basic contract protections. The result? Four wildly different bids, unclear scope, and a project headed toward major cost overruns.In this episode, Art and Hailee break down how vague drawings, incomplete contracts, and early contractor involvement can derail a renovation before it ever starts — and what every doctor should verify before signing anything.Topics include:• Why incomplete drawings lead to inconsistent bids and surprise costs• How missing MEPs, open specs, and vague details create disputes• The risk of starting a phased project without a defined shutdown plan• What every dental contract must include (timelines, penalties, warranties, lien waivers, etc.)• Why spending more on design and planning can save hundreds of thousands later

In this “Whoops, It Can Happen to You” episode, Art and Antonis break down a real-world situation that every dentist should understand before expanding their practice. A doctor attempted to renegotiate a sublease on an adjoining space—only to discover he was unintentionally renegotiating his entire lease without professional guidance.Antonis walks through the hidden risks, overlooked opportunities, and the financial leverage most dentists don’t realize they have when adding square footage. From tenant improvement allowances to updating outdated floor plans, to protecting your future exit strategy, this episode outlines exactly what can go wrong—and how to prevent it by involving the right professionals before speaking to your landlord.

Many dentists assume that taking over a former medical office will save time and money — but as Art and Sara reveal, that’s often far from the truth. In this episode, they break down what really goes into converting a medical space into a functional dental practice. From occupancy codes and power upgrades to compressor rooms, plumbing, and fire-rated nitrous closets, every detail matters.Tune in to learn: Why “medical-ready” doesn’t mean “dental-ready” How to evaluate conversion costs versus starting from scratch The biggest hidden expenses and compliance pitfalls What to look for before signing that lease Whether you’re eyeing a second-generation space or weighing your build-out options, this episode will help you make an informed, cost-effective decision.

Second-generation dental spaces can look like a shortcut — faster to open, cheaper to build, and already “set up.” But in reality, many doctors discover hidden challenges, unexpected costs, and long-term compromises they didn’t anticipate.In this episode, Sara and Art walk through the critical steps to evaluate an existing dental office before you lease or purchase it. They explain why simply inheriting someone else’s layout, infrastructure, or equipment can work against your vision, efficiency, and budget — and how to determine whether a space truly supports your long-term goals.Topics include:• Defining your clinical and business plan before shopping spaces• Understanding when a second-gen office actually saves money• Navigating code compliance, outdated systems, and redesign needs• The importance of inspections, due diligence, and cost analysis• Real examples of doctors who regretted or benefited from second-gen decisions

Banks, contractors, and doctors don’t always speak the same language—and that confusion can cost you. In this episode, Art and Antonis explain what lenders actually mean when they ask for a “construction bid,” how to tell the difference between an estimate and a bid, and why contingencies can lead to unnecessary costs. If you’re financing a dental build-out or renovation, this discussion will help you avoid common pitfalls and protect your investment.

From the look of your office to the technology you invest in, every choice you make as a practice owner impacts your return on investment. In this episode, Hailee sits down with Art and Antonis to explore what truly drives ROI for dental practices. Is it your design aesthetic, your equipment lineup, or the patient experience you deliver? The team breaks down how each factor influences patient perception, long-term retention, and profitability — and how to find the right balance for your next build or renovation.

In this episode of How to Open a Dental Practice, Art, Antonis, and Hailee explore three real-world case studies from Art’s recent visits to dental offices, each highlighting a unique ownership or operational challenge.They break down:A dentist navigating the tension between leasing and owning her condo space — and how seller financing could reshape the outcome.A practice owner is weighing renovation costs against prepayment penalties while trying to expand her operatory count and efficiency.An established dentist nearing retirement, facing underused space — with options like subleasing, bringing in specialists, or downsizing.Each scenario offers practical lessons on negotiation, financing, and maximizing your practice’s long-term value.

In this Whoops, It Can Happen to You episode of How to Open a Dental Practice, Sara shares a cautionary tale about what happens when dentists try to cut corners by hiring contractors below budget. While saving money up front might seem appealing, the hidden risks and long-term costs can be devastating. Through real-life examples, this episode explores the pitfalls of penny-pinching—ranging from poor workmanship to ethical dilemmas—and highlights how those choices can derail your project and cost you more in the end. Learn why investing in the right team from the start is one of the smartest financial decisions you can make for your practice.

Choosing the right location is one of the biggest factors in your practice’s success. In this episode of How to Open a Dental Practice, we dive into the essential questions every dentist should ask their realtor before signing a lease. From navigating zoning regulations and understanding lease terms to evaluating long-term growth potential, you’ll get practical tips to ensure your space supports both your vision and your future. Whether you’re opening your very first office or expanding into a new one, this episode will help you approach the process with clarity and confidence.

In this episode of How to Open a Dental Practice, we unpack one of the most important relationships in your startup journey: the one with your general contractor. Knowing the right questions to ask can save you from costly mistakes and delays. From evaluating past project experience to understanding how a GC handles challenges, you’ll learn what to listen for in their answers—and which red flags to avoid. By the end, you’ll have a clear picture of the contractor’s true role in bringing your vision to life, and the confidence to approach your build with the right partner on your side.

For dentists starting a new practice, timing can be everything. Should you lock in a lease before securing financing, or line up your loan before committing to a space? In this episode, we break down the pros and cons of each path, share common pitfalls, and give you the clarity you need to make the right first move for your dental startup.

HVAC problems can quickly undermine patient experience in a dental practice, even in a brand-new space. This episode examines how overlooked mechanical details, like missing dampers or repurposed ductwork, create comfort issues and unnecessary expenses. We share strategies for ensuring mechanical systems are designed, specified, and installed correctly, plus tips for avoiding the trap of “value-engineered” bids that cut out essential components. Learn how to safeguard your renovation or build from these avoidable setbacks.

Finding the right space for your dental practice goes beyond looks. We discuss the critical factors to assess during property tours, including ADA compliance, restroom requirements, and egress points. You’ll learn how space shape and layout impact operational efficiency, why early involvement from your design team prevents costly adjustments, and how building type — retail, medical office, or standalone — affects your budget and build. We also explore the trade-offs of first- vs. second-generation spaces and why location quality should never be sacrificed for a lower rent.

Refreshing a dental office can boost patient perception and improve functionality, but timing and planning are everything. This episode covers how to choose the right moment to renovate, whether you’re refreshing aesthetics, upgrading systems, or reconfiguring for a better workflow. We discuss budgeting with both design priorities and functional needs in mind, how to avoid code-triggered scope creep, and ways to minimize downtime during construction. You’ll also learn how to weigh the costs and benefits of phased renovations versus full shutdowns.

A last-minute decision to bring on an associate dentist caused a major redesign for one oral surgeon. Sara and Art walk through how a missing compressor line disrupted the entire project, costing time, money, and momentum. Learn how business plan shifts impact construction, and why aligning your clinical vision and build scope early is crucial to staying on track.

Is it really possible to build a dental practice without using any of your own money? Sara and Art unpack a real-world example where poor budgeting, a vague LOI, and a misleading test fit led to financial strain. They explain what TI allowances actually cover, why design always comes before demolition, and how early planning prevents costly surprises.

Sara and Art share the story of a ventilation and HVAC failure that delayed a new dental practice from passing inspection. What seemed like a contractor issue revealed a deeper design flaw—caused by a lack of coordination between the mechanical engineer and build team. They explain how to avoid these expensive missteps with better oversight, smarter mechanical design, and early alignment with your project team.

In this episode of How to Open a Dental Practice, Sara and Art talk about all things trade shows. From tips on how to make the most of your time at the event to the value that lives beyond CE credits, this episode breaks down how to approach trade show season with purpose. Whether you're attending to learn, network, or explore new vendors, this conversation offers practical advice for doctors at any stage of their journey.

In this episode of How to Open a Dental Practice, we dive into the critical role of architectural drawings in the planning and development of your dental office. Artin Safarian breaks down why these drawings are more than just blueprints—they’re the foundation for compliance, functionality, and long-term success. We’ll discuss common mistakes to avoid, how detailed drawings impact permitting and construction, and why investing in the right architectural team can save you time and money. Whether you’re starting from scratch or renovating an existing space, this episode will give you key insights into building a practice that works for you.

In this inaugural episode of How to Open a Dental Practice, Senior Integrated Practice Specialist Sara Reichenbach and President of Arminco Inc. Artin Safarian kick off the series with an engaging discussion on what it takes to successfully plan and launch a dental practice.From defining your vision to selecting the right location and navigating design and construction, Sara and Artin draw on their extensive experience to provide actionable insights for aspiring and current dental practice owners. Whether you’re in the early stages of planning or looking to refine your existing business, this episode lays the groundwork for building a thriving practice.Tune in for expert advice, real-world examples, and a fresh perspective on the essential steps to make your dental practice dreams a reality.