Rising Tide Dental Partners and Your Practice: What Owners Should Know in 2026

Most approach letters are signed by someone whose title contains the word “development.”

This one is signed by a dentist.

That is not a detail. It is the whole reason the name is worth ten minutes of your evening rather than a glance and a delete.

Because Rising Tide Dental Partners was not built by capital that then went looking for dentists.

It was built in February 2025 by seventeen practice owners. Each had received a letter much like the one now sitting on your desk.

Each decided to build something instead of answering it.

Whether that makes it the right home for your practice is a separate question. Here is the honest version of both.

Key takeaways

• Rising Tide buys existing practices, not new offices. It added six in July 2026 across Washington, Ohio, California, Illinois, New York and Florida, reaching 33 locations in 11 states.
• It is genuinely dentist-owned. The company states it has raised zero private equity, and its board and executive team are practising dentist-entrepreneurs. That is rare, and it is verifiable by the absence of any sponsor.
• The founders are your closest comparables. Seventeen owners who faced the same decision you face chose this instead. They can tell you what they turned down, which no ordinary reference call can.
• “No exit agenda” changes what equity is, not just when it pays. Without a planned liquidity event, paper pays through distributions rather than a future mark. Different shape, different risk.
• Buyer types are built for different sellers. Deciding what you are optimizing for comes before comparing prices, because the highest headline number frequently belongs to the worst-fitting structure.

Does Rising Tide Dental Partners buy dental practices? Yes. Rising Tide affiliates existing independent practices and added six in July 2026, taking it to 33 locations across 11 states.

It launched in February 2025 when 17 owner-dentists combined 27 practices, and it states it has raised no private equity.

Who Rising Tide Dental Partners actually is

The company launched on 11 February 2025. Seventeen founding dentists brought together twenty-seven operating practices spread from New York to Hawaii.

Leadership is Dr. Steven Albert as Executive Chairman and co-founder, Dr.

Anthony Leonetti as chief executive and co-founder, and Dr. Ced Lewis as co-founder and clinical director.

Brittany Dellagatta joined as chief operating officer in July 2026.

Two labels are worth defining before we go further, because the industry uses them loosely.

A DSO is a dental support organization: the management company owns the non-clinical side of a practice and handles everything outside the operatory, while a licensed dentist keeps ownership of the clinical entity.

Rising Tide calls itself a DPO, or dental partnership organization. The distinction it draws is that affiliating dentists hold ownership and governance of the parent, rather than simply selling into it.

That structure is not branding. Most states restrict who may own or control a dental practice under the corporate practice of dentistry doctrine, and support-organization models exist to operate inside those rules.

Today the network is 33 locations across 11 states: California, Florida, Georgia, Hawaii, Illinois, Minnesota, Missouri, New Jersey, New York, Ohio and Washington.

Does Rising Tide buy existing practices, or build new ones?

Buys. That is worth stating plainly, because several of the largest names an owner would think to Google do the opposite.

Aspen Dental and PDS Health grow primarily by opening new offices. Of the three largest, only Heartland Dental is substantially acquisition-led.

An owner who assumes every big name is bidding for existing practices is working from a false map.

Rising Tide is in the affiliating group, and recently. On 14 July 2026 it announced six practices joining at once, in Washington, Ohio, California, Illinois, New York and Florida.

The company put the effect at a fifteen percent increase in total revenue and a twenty-two percent expansion of its geographic footprint. Ohio entered the network for the first time.

Group Dentistry Now and Becker’s Dental Review both covered it independently, and the deal appears in the Group Dentistry Now roundup for that month alongside more than forty other acquiring organizations.

That is the test I apply to every buyer profile. Dated announcements, on the company’s own newsroom, corroborated by trade press that covers the whole sector.

The founding story is the diligence

Here is the part that makes this buyer genuinely unusual, and it has nothing to do with the balance sheet.

Nearly every other organization you will evaluate was assembled in the same sequence: capital arrived first, a management team was recruited to deploy it, and dentists were invited afterwards into a structure they had no hand in designing.

Sequence matters.

Rising Tide inverted that order.

Seventeen owner-dentists, each already running a practice, combined them at the same moment to create the parent. Nobody was recruited into someone else’s design.

They were the design.

Why does that matter to you specifically?

Because it means the founders are the only true comparables you will ever get access to.

Think about what an ordinary reference call yields. You ring two dentists who affiliated three years ago, they assure you integration went smoothly and the monthly reporting improved, and you hang up knowing roughly what you already knew.

Useful. Thin.

Now think about what these particular founders can tell you. Each of them held an approach letter.

Each of them ran the numbers on selling outright. Each of them decided against it, and can say precisely why.

That is not a testimonial. That is seventeen people who ran your exact decision to a conclusion and are willing to show their working.

I have sat in on a great many reference calls. The ones that genuinely shift an owner’s thinking are never about software platforms or benefits administration.

They are the ones where somebody says: here is what I gave up, here is what I got, and here is the thing I did not see coming.

So ask for that conversation, and ask for it early. Ask which offers they weighed.

Ask what the deciding factor was.

And ask the question that most owners are too polite to ask. Would you do it again.

The context that produced seventeen such dentists

None of this happened in a vacuum, and the background numbers explain a great deal.

Practice ownership in American dentistry has been falling for two decades. ADA Health Policy Institute research puts private-practice ownership at roughly 72.5 percent of dentists in 2023, down from about 84.7 percent in 2005.

The generational split is sharper still. Only around 21 percent of dentists who graduated between 2016 and 2020 owned a practice within five to nine years, against roughly a third of the 2011-2015 cohort and more than 60 percent of pre-2010 graduates.

Solo practice is thinning at the same rate. About 15 percent of dentists less than ten years out were in solo practice in 2024, compared with 48 percent of those at least twenty-five years out.

Read those together and you get the pressure that produced this platform. Owners in their fifties can see that the traditional buyer for their practice is a shrinking population.

That buyer was always a younger dentist willing to take on debt to go independent.

Selling to a support organization is the obvious answer. Building one with sixteen colleagues is the unusual one.

You need not admire the choice to find it informative. It tells you what this buyer is engineered to deliver.

What “no exit agenda” actually means for your money

Rising Tide’s owner-facing materials are direct about this. The company describes itself as dentist-funded with no private equity influence, and states plainly that it has no exit agenda.

Most owners read that as reassurance and move on. It deserves more attention than that, because it changes what rolled equity is.

Start with how the familiar version works.

In a sponsor-backed structure, rollover equity means keeping a slice of ownership in the buyer’s company instead of taking all cash at close.

Its value is realized at a recapitalization: the moment the sponsor sells or refinances and everyone’s paper gets marked at a fresh valuation.

That event is the engine. It is why rolled equity in those deals can be so valuable, and survey work reported by Becker’s has a large majority of DSOs anticipating a recap on a one-to-three-year horizon.

Now remove the event.

If no liquidity moment is planned, equity cannot pay you through a future mark. It must pay another way, which in practice means distributions of operating cash flow plus whatever internal redemption mechanism the operating agreement provides for buying a departing partner out.

Neither version is superior in the abstract. They are different instruments with different risks, and the honest framing is a trade rather than an upgrade.

The lump-sum version concentrates your outcome into one future date you do not control, with meaningful upside if the organization grows well and real downside if it does not.

The distribution version spreads it into predictable annual cash you can plan around, with less dramatic upside and a harder question about how you eventually exit.

So the questions change. Instead of asking when the recap is, you ask how the share price is set, who sets it, how often it is recalculated, and what happens to your stake when you retire.

Those answers should exist in writing. Ask to see the operating agreement provisions, not a summary of them.

The arithmetic, worked through

Abstractions about equity are useless. Numbers make it decidable, so let us do a practice.

Collections of $2.8 million. Overhead running at 60 percent, which is respectable but not exceptional.

The owner produces about 45 percent of total collections herself.

Now the bridge that most dentists never do properly.

Collections minus true operating overhead leaves roughly $1.12 million. Then subtract what it would cost to hire an associate at market rate to do the owner’s own production, call it $380,000.

What remains is about $740,000 of adjusted EBITDA: the operating profit after paying a market-rate dentist to do the work she currently does herself.

That number is what any buyer is valuing. Not collections.

Not production. And emphatically not a “percentage of collections” figure someone quoted at a study club.

Say two buyers arrive at the same headline. Neither Rising Tide nor anybody else publishes a price sheet, so treat what follows as generic structure rather than anyone’s terms.

At 8x, the headline is $5.92 million from both. Identical on the front page.

Not remotely identical underneath.

Shape one, the sponsor-backed offer. Seventy percent cash at close is $4.14 million. Thirty percent rolls into parent equity: $1.78 million of paper, realized at a recap expected in roughly four years.

If the organization grows and that recap lands at 1.8 times the valuation where you joined, your $1.78 million becomes something near $3.2 million. Excellent decision.

If it lands flat, you get your money back four years later, having carried the risk and lost the use of the cash. If liquidation preferences rank above you, common equity can return a fraction of its stated number.

Shape two, the no-planned-exit offer. Same $4.14 million cash, same $1.78 million of equity. But now the return arrives as distributions rather than a future mark.

Assume the network distributes 8 percent annually on that stake. That is roughly $142,000 a year, or about $568,000 across the same four years, arriving in instalments you can actually plan around.

I have made that 8 percent up for illustration. Nobody should accept an assumed distribution rate from an article, mine included.

Get the actual historical figure, and the formula sitting behind it.

But look at what the comparison exposes. One structure might pay $3.2 million in year four or might pay $1.78 million.

The other pays something closer to $568,000 across four years and leaves the stake itself outstanding.

Ask yourself which of those you would rather explain to your spouse.

There is no universally right answer. There is only the answer that fits what you are optimizing for, and almost nobody works that out before the offers arrive.

That is the mistake. Decide what you want first.

Then compare.

What kind of practice Rising Tide looks for

The company publishes no revenue threshold, no minimum patient count and no formal geographic screen, which is unremarkable, since almost nobody in this market publishes one and the handful who do tend to relocate the goalposts anyway.

The roster is more informative than a stated criterion.

Rising Tide’s practices are predominantly general and family dentistry. Names on the roster include 5 Star Family Dental, Adel Dental Associates and Twin Cities Family and Implant Dentistry.

Cosmetic and implant work sits inside those general practices rather than in standalone specialty groups.

The footprint tells you something else. Eleven states for 33 locations is deliberately spread rather than clustered, which is the opposite of the density strategy most regional platforms run.

A network built that way is not filling gaps on a map. It is adding owners it wants, wherever they happen to be.

Its owner-facing materials describe established practices, and they emphasise three commitments in particular: clinical independence, unchanged practice branding, and no forced staffing changes imposed on a team the seller spent decades assembling.

Underneath all of it sits the same test every buyer applies. Transferability.

A practice where patients come for the practice survives an owner’s departure; one where they come only for you is harder to underwrite, and buyers price that difference.

What an offer typically contains

Rising Tide does not publish a price sheet, and neither does anyone else in this market. What any buyer pays depends on the practice, the geography, their appetite, and above all on who else is bidding.

Any source quoting you a specific multiple for a named organization is generalizing from a handful of deals it half-remembers.

What holds broadly across the affiliating pool, rather than for any one buyer:

Cash at close is typically a portion of the headline figure, not all of it. Equity of some form usually makes up part of the balance.

An earnout may make up the rest. That is part of the price paid later, and only if the practice hits agreed targets after closing.

There is also a post-closing employment agreement, essentially always. Its length, its compensation formula and its restrictive covenants are terms, not formalities.

Two offers with identical headline numbers can be worth materially different amounts. I have watched an owner take the bigger headline and receive less money.

Diligence between signing and closing commonly runs several months. Plan your life around the closing date, not the letter of intent.

What changes after the sale

Start with what usually does not change.

Rising Tide’s stated position is that the practice name, culture and community reputation stay as they are, that treatment decisions remain with the clinician, and that there are no production quotas or mandated procedures.

Its own description of the model is that dentistry should remain in the hands of dentists, with the network supplying operational support rather than clinical direction.

Treat every such statement, from every buyer, as the opening of a conversation rather than the end of one. Not because anyone is being untruthful.

Because intentions and agreements are different documents.

What does change is the back office. Payroll, benefits administration, insurance contracting, purchasing, marketing, compliance and reporting all migrate to a central function.

For plenty of owners that migration is precisely the point, because vendor leverage and genuine financial visibility are the two things a solitary practice can almost never purchase for itself.

Economies of scale are real.

Your team feels it too. New benefits, a new payroll system, new reporting lines for some roles.

Worth knowing before you tell them, not after.

Questions worth asking Rising Tide specifically

Generic questions get generic answers. These are the ones I would put in front of this particular buyer.

“Can I speak with three of the founding dentists about the offers they turned down?” The single highest-value call available to you here, and unavailable at any sponsor-backed buyer. Ask for specific names rather than accepting whoever is offered.

“How is the equity valued, how often, and who performs the valuation?” Without a recap to set a price, something else must. Find out what.

“What is the mechanism if I want to sell my stake, and has anyone used it yet?” A young platform may not have been tested on this. That is not disqualifying, but you should know.

“Are distributions the expected return on equity, and what have they actually been?” Ask for the historical figure and the formula, not a projection.

“If the founders ever changed their mind about outside capital, what protects my position?” Asked neutrally, this is a fair governance question, and any serious organization has a documented answer.

“Which clinical decisions remain mine, in writing?” Materials, labs, hygiene protocols, scheduling templates, case acceptance. Name them individually rather than accepting a general assurance.

“Who is my day-to-day contact, and how many practices do they support?” This answer predicts your Monday mornings better than any org chart.

“What is the earnout measured on, and who controls those inputs?” An earnout measured on a number the buyer controls is not really an earnout.

Ask these of every buyer, not just this one. Answers are only comparable when the questions are identical.

How to know whether the offer is competitive

Here is what actually decides your outcome, and it is not which organization is on the letterhead.

A buyer who approaches you directly is competing with nobody. Their offer reflects that.

It would be strange if it did not.

That same organization, bidding against three rivals who also want your practice, behaves altogether differently. Not because the opening number was dishonest.

The leverage simply changed.

The pool is deep enough for that to be real. Becker’s Dental Review tracked more than 200 DSO affiliations in 2025, and 69 percent of DSOs reported in 2026 that their sponsors expect increased acquisition activity.

The ADSO alone counts more than 80 member companies supporting thousands of practices. Roughly 30 to 35 organizations acquire independent general practices at meaningful scale.

Most owners have heard of four.

And here the fit argument and the competition argument converge, which is the thing worth taking away.

Running a competitive process is not only about price. It is the only reliable way to see several shapes of deal side by side.

Cash-heavy against equity-heavy. Planned exit against no planned exit.

That comparison is how you discover which one you actually want.

You cannot decide what you are optimizing for from a single offer. There is nothing to optimize against.

Creating that comparison is what the Elite Selling System exists to do. We hand-select and vet every buyer who gets to bid on your practice, the way a doorman with a velvet rope lets in only the right people.

Then we run a private competitive window inside that group. The point is not to squeeze anyone.

It is that you cannot know whether a number is good, or whether a structure suits you, until a second serious buyer has told you what they think.

What to do next

If a Rising Tide approach is on your desk, the first job is not to compare it against your expectations. It is to make it comparable to anything at all.

Get your adjusted EBITDA documented properly, with the owner-production adjustment done honestly rather than optimistically. Separate cash at close from equity from earnout.

Read the employment agreement as carefully as the price.

Then do the thing this particular buyer makes possible and nobody else does. Talk to the founders about the offers they declined.

And work out, in writing, what you are actually optimizing for. Maximum cash on the day.

Predictable income into retirement. Keeping your name on the door.

Protecting the team who built the place with you.

Those goals point at different buyers. A dentist-owned network with no planned liquidity event is a serious and unusual option, and for the right owner it is an excellent one.

For an owner who wants to be finished and paid, it may not be.

The point is to choose on structure and fit rather than on the warmth of a letter from a colleague.

We will give you that assessment free and in confidence. That includes telling you to wait eighteen months and fix two things first, when that is the honest answer.

It starts with a free, confidential practice value estimate.

Our fee varies depending on the value of the practice and is entirely success-based. If we do not get you a result, we do not get paid.

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Frequently asked questions

Does Rising Tide Dental Partners buy dental practices?

Yes. Rising Tide affiliates existing independent practices rather than opening new offices.

It announced six practices joining in July 2026 across Washington, Ohio, California, Illinois, New York and Florida, taking the network to 33 locations in 11 states.

Who owns Rising Tide Dental Partners?

Practising dentists. The company launched in February 2025 with 17 founding dentists and states that it has raised no private equity.

Its board and executive team are dentist-entrepreneurs. That is uncommon at this scale, and checkable by the absence of any sponsor.

What is a DPO, and how is it different from a DSO?

A DSO is a dental support organization, which owns the non-clinical side of a practice while a licensed dentist keeps the clinical entity. A DPO, or dental partnership organization, describes a model where affiliating dentists also hold ownership and governance of the parent company.

What does “no exit agenda” mean for my rollover equity?

It changes how equity pays. Without a planned recapitalization, value tends to arrive as distributions of operating cash flow rather than a lump sum at a future valuation event.

Ask how the share price is set, how often, and how a partner is bought out.

Will my practice keep its name if I join Rising Tide?

Its owner-facing materials state that the practice name, culture and community reputation remain unchanged, and the current roster shows practices operating under their own local names. Get the specific commitment written into the agreement rather than relying on the general pattern.

What does Rising Tide Dental Partners pay for a practice?

There is no published price sheet, and any specific multiple attached to a named buyer is generalized from limited data. What any organization pays depends on the practice, the market, their appetite and who else is bidding.

How do I compare a dentist-owned buyer against a private-equity-backed one?

Not on the headline number, because identical headlines can hide very different structures. Compare cash at close, the form and liquidity of any equity, earnout terms and the employment agreement, then weigh them against what you personally want from the sale.

Should I accept a direct offer from Rising Tide?

Not before other qualified buyers have had the chance to bid. A single offer tells you what one organization will pay when nobody is competing.

It tells you nothing about whether the structure is the right one for you.

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Sources

Rising Tide Dental Partners scale, ownership and activity

1. Rising Tide Dental Partners. “Rising Tide Dental Partners Launches Multi-State Doctor-Owned Dental Platform,” 11 February 2025. risingtidedental.com
2. Rising Tide Dental Partners. “Rising Tide Dental Partners Expands with Acquisition of Six New Practices, Adds to Leadership Team with New COO,” 14 July 2026. risingtidedental.com
3. Rising Tide Dental Partners. “For Practice Owners.” risingtidedental.com
4. Rising Tide Dental Partners. “Home.” risingtidedental.com
5. Rising Tide Dental Partners. “Locations.” risingtidedental.com
6. Group Dentistry Now. “Rising Tide Dental Partners Expands with Acquisition of 6 New Practices, Adds to Leadership Team with New COO.” groupdentistrynow.com
7. Group Dentistry Now. “DSO Deal Roundup – July 2026.” groupdentistrynow.com
8. Becker’s Dental Review. “Rising Tide Dental Partners expands network by 22%.” beckersdental.com

Buyer pool, deal activity and market structure

9. Association of Dental Support Organizations. “About ADSO.” theadso.org
10. Becker’s Dental Review. “200+ DSO affiliations in 2025: State-by-state breakdown.” beckersdental.com
11. Becker’s Dental Review. “69% of DSOs plan to boost acquisitions in 2026: Report.” beckersdental.com
12. Becker’s Dental Review. “The big trends driving DSO growth in 2026.” beckersdental.com
13. Becker’s Dental Review. “What the 3 largest DSOs have been up to.” beckersdental.com

Practice ownership trends and dental economics

14. ADA Health Policy Institute. “Practice Ownership Trends in Dentistry: A New Look at Old Data.” ada.org
15. ADA Health Policy Institute. “Practice Ownership Among Dentists Continues to Decline.” ada.org
16. ADA Health Policy Institute. “The State of the U.S. Dental Economy, Q1 2026 Update.” ada.org
17. DrBicuspid. “Practice ownership fades as the face of dentistry changes.” drbicuspid.com

Deal structure, process and regulation

18. Mandelbaum Barrett PC. “The Four-Phase DSO Transaction Process.” mblawfirm.com
19. Cranfill Sumner LLP. “Selling Your Dental Practice to a DSO.” cshlaw.com
20. Holland & Knight. “Q1 Recap on Proposed Legislation Affecting Healthcare Consolidation.” hklaw.com
21. US House Committee on Oversight. “Survey of State Laws Governing the Corporate Practice of Dentistry.” oversight.house.gov