Dental CPA Insights 

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs An orthodontic practice can generate $2 million in annual collections and still have significant opportunities to improve profitability. The problem is that collections don't tell the entire story. Treatment can extend for months beyond the original estimate, laboratory costs vary considerably, and today's collections often reflect cases started a year or two earlier. When I evaluate an ortho

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs An oral surgery practice can collect $3 million a year, run a full surgical schedule, and still leave a considerable amount of profit on the table. I see it more often than you would think. Oral surgeons run a different business from general dentists. You depend heavily on referrals, invest in expensive surgical equipment, employ specialized staff, and perform procedures with widely varying c

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs A dental practice can collect $1.5 million annually, have a full schedule, and still watch profitability decline. When this happens, most dentists look at payroll, dental supplies, or laboratory expenses. Those are worth reviewing, but what if the bigger problem is that the practice isn't getting paid enough for the procedures it's performing? You know what you charge for a crown. You probabl

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs As of October 4, 2026. Tax law changes frequently, and the rules, limits and deadlines described below may not be in effect when you read this. Every December I get the same phone call. A practice owner has just looked at a tax projection for the first time all year, the number is bigger than expected, and he wants to know what he can still do about it. The answer is always the same. Less tha

By Spiro Leunes, CPA | CEO, MRL Advisory Group, New Jersey and New York Dental CPAs Ask a dentist what their daily production goal is and I usually get one of three answers: a round number that sounds good, a number a consultant gave them four years ago, or a blank stare. When I ask where the number came from, the conversation is over. A daily production goal is arithmetic. It comes from what the practice has to bring in over the next 12 months, spread across the days you'll

By Spiro Leunes, CPA | CEO, MRL Advisory Group, New Jersey and New York Dental CPAs A DSO has made an offer for your practice, and the number on the first page is bigger than anything you expected. Six times EBITDA, maybe seven. Total value well above what you assumed the practice was worth. Before you get attached to that number, understand what it is made of. In my experience the headline is the least informative number in the whole package. What matters is how much of it i

By Spiro Leunes, CPA | CEO, MRL Advisory Group, New Jersey and New York Dental CPAs Reviewed September 2026. Worker classification rules change frequently, and the rules described below may not be the rules in effect when you read this. This is one of the questions I am asked most often, by practice owners and by associates. Should the associate be a 1099 contractor or a W-2 employee? The honest answer is that it is not a choice either party gets to make. Classification is de

By Spiro Leunes, CPA | CEO, MRL Advisory Group, New Jersey and New York Dental CPAs Payroll is the largest expense in most dental practices, and it is also the expense owners are most likely to manage by feel. A hygienist asks for a raise and gets one. An assistant who has been with the practice ten years discovers that the assistant hired six months ago is making almost the same money. December comes around, everyone gets a check, and within a few years that check is no long

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs A buyer sits down with three years of a seller’s financials, works out what the practice earns, and decides what he can pay for it. That is the right exercise. The trouble is that he almost always runs it on the seller’s numbers, and nobody in the room stops to ask whether those numbers travel. Some of them do not. The one that catches buyers most often is the rate the practice actually gets

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs When I analyze a dental practice that's busy but not profitable, the issue is rarely clinical, it's at the front desk. The desk is where production either becomes collections or quietly evaporates, where the hygiene schedule either stays full or develops holes, and where a new patient either books or hangs up and calls the office down the street. I've written about how practices lose profit t

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs Hygiene drives the dental practice. That's why the conversations I keep having with practice owners across New York and New Jersey are so concerning. It's no longer simply, "How do I keep my hygiene schedule full?" It's: "I can't find a hygienist to run the column." An empty hygiene column isn't just a staffing problem. It's a production, collections, and practice-growth problem. This Isn't a

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs Every dental practice diagnoses more treatment than it completes. The exam is thorough, the diagnosis is sound, and the patient nods, schedules a cleaning, and walks out the door. The crown, the implant, or the periodontal work that was clearly indicated never gets scheduled. That gap has a name. It is called case acceptance, and after more than two decades working with dental practices, I h

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs At some point in nearly every practice owner's career, the same question arrives. Keep paying rent, or buy the building the practice operates in? Sometimes a landlord hints that he would sell. Sometimes a lease renewal arrives with a difficult escalation clause. Sometimes a colleague at a study club has just purchased his own unit and cannot stop talking about it. However it arrives, most den

By Spiro Leunes, CPA | CEO, MRL Advisory Group, New Jersey and New York Dental CPAs Ask ten dentists what their practice is worth and most of them land on the same answer. Somewhere around 70 to 80 percent of collections. That rule has been floating around study clubs for decades, and it still gets repeated at every dinner meeting. The trouble is that it answers a question buyers stopped asking a long time ago. Two offices that both collect $1.5 million can sell for numbers t

By Spiro Leunes, CPA | CEO, MRL Advisory Group – New Jersey and New York Dental CPAs Most dentists only think about taxes in April. That’s exactly why they overpay. By filing time, the game is over. Every decision that could have cut your tax bill has already been made. You’re no longer planning—you’re just reporting history. The most profitable dental practices treat July like a strategic reset. With six months left, you still have time to move the needle on collections, pr