The Largest Dental DSOs
in the US
A ranked list of the biggest Dental Service Organizations in the United States — by office count, with headquarters and focus. Updated for 2026.
Heartland Dental
Aspen Dental (The Aspen Group)
PDS Health (Pacific Dental Services)
Top 10 dental DSOs, ranked by office count
Approximate figures compiled from public sources (early 2026). Counts change often — verify with each organization.
| # | DSO | Offices | States | Headquarters | Focus |
|---|---|---|---|---|---|
| 1 | Heartland Dental | 1,900+ | 39 + DC | Effingham, IL | General dentistry |
| 2 | Aspen Dental (The Aspen Group) | 1,100+ | Nationwide | Chicago, IL | General dentistry |
| 3 | PDS Health (Pacific Dental Services) | 1,000+ | 25 | Henderson, NV | General dentistry |
| 4 | MB2 Dental | 800+ | 45 | Carrollton, TX | Doctor-owned / general |
| 5 | Smile Brands | 600+ | 29 | Irvine, CA | General & multi-specialty |
| 6 | Smile Doctors | 580+ | 36 | Dallas, TX | Orthodontics |
| 7 | Sonrava Health (Western Dental) | 400+ | 20 | Orange, CA | General & multi-specialty |
| 8 | Dental Care Alliance | ~400 | 24 | Sarasota, FL | Multi-specialty |
| 9 | Affordable Care | 380+ | 39 | Morrisville, NC | Tooth replacement & implants |
| 10 | Great Expressions Dental Centers | 246 | 9 | Southfield, MI | General & specialty |
Sources: Becker's Dental Review “53 DSOs to Know 2026,” Medix Dental, and company websites (early 2026). Office and state counts change often through acquisitions and openings — verify with each organization directly.
What is a dental DSO?
A Dental Service Organization (DSO) is a company that provides the non-clinical business support behind a group of dental practices — recruiting and HR, marketing, billing and insurance, procurement, scheduling, IT, and compliance. That lets dentists focus on patient care instead of back-office operations.
In most states, the DSO does not own the clinical practice itself; the dentist (or a dentist-owned professional entity) does. The DSO owns the management company and delivers support under a services agreement. DSO-affiliated practices now make up a large and fast-growing share of US dentistry — from national platforms with well over a thousand offices down to small regional groups.
How the biggest DSOs run the front desk at scale
Every location on this list shares one challenge: answering every patient call and booking it consistently across dozens — or thousands — of front desks. That is exactly what an AI receptionist for DSOs does — one platform that answers 24/7, books into any PMS, and reports group-wide, whether a location runs Dentrix, Open Dental, or Denticon.
Dental DSOs: frequently asked questions
What is a DSO in dentistry?
A Dental Service Organization (DSO) provides the non-clinical business support — HR, marketing, billing, procurement, scheduling, IT, and compliance — to affiliated dental practices, so dentists can focus on patient care while keeping clinical autonomy.
What is the largest dental DSO in the US?
Heartland Dental is the largest US DSO by office count, with roughly 1,900 affiliated locations across 39+ states as of early 2026, followed by Aspen Dental and PDS Health (Pacific Dental Services).
How many DSOs are there in the US?
There are hundreds of DSOs in the US, ranging from large national platforms with 1,000+ offices to small regional groups of a handful of locations. DSO-affiliated practices now make up a large and growing share of US dentistry.
Do DSOs own the dental practices?
In most states, the DSO does not own the clinical practice — the dentist or a dentist-owned professional entity does. The DSO owns the management company and provides business support under a services agreement.
Are these DSO office counts exact?
No — DSO location counts change frequently through acquisitions and new openings. The figures here are approximate, compiled from public sources in early 2026, and should be verified with each organization directly.