Dental Startup IT: The New Dental Office Technology Guide, From Lease to Day 90

You have a letter of intent on a space, a lender asking for a "technology" line, and a contractor's bid that mentions low-voltage once. Nobody on the team owns the new dental office IT setup yet.

This guide follows that journey from the first site visit to the end of the third month after opening. It is built around tables you can hand to your architect, contractor and staff: a journey map, a lease-stage check, a responsibility matrix for ten parties, a milestone-by-milestone timeline, a decision log, an account-ownership register, a handover pack, a mock-patient-day acceptance sheet and a first-90-days plan. Legend Networking counts 1,500+ dental startup buildouts and has served over 3,500 practices since 2004, and the projects named below are real openings you can look up on our project pages. If you want a team to carry this for you, see our dental startup IT services. If you are buying an existing practice rather than building one, the work is different; start with buying an existing practice instead.

What does dental startup IT cover, from the lease to day 90?

Dental practice startup IT covers every technology task between choosing a space and the end of your third month open: site checks, drawings, cabling, the network closet, internet, phones, software, imaging connections, security, testing, handover and early support. It runs alongside the business milestones (lease, financing, permits, hiring), and each technology step unlocks the next business step. Early support after opening usually becomes a monthly arrangement, so it helps to understand how managed IT works for dentists before the build ends.

Most guides start when the space is already chosen and stop when the doors open. Both ends matter. Before the lease, a few questions about the building decide how hard the rest of the job will be. After opening, the first weeks show whether the network, phones and software were built for the way your team actually works. The table below puts the two tracks side by side. The business column is there only as a frame; your broker, attorney, lender and practice consultant own that advice.

Table A. The opening journey, with technology as the spine

How long each row takes depends on the market, the building, the carrier and the city. We do not print durations here because they vary too much to be useful from a national page. Ask each party for its own interval at your address and keep the answer with your project file. The city guides linked in the by-market section below carry local timing where it can be sourced.

What should you check about the technology before you sign the lease?

Before you sign, find out whether carriers already serve the suite, whether the building's electrical panel and cable paths can take a dental office, whether a room can become the network closet, and what the landlord allows. These answers do not decide the lease, but they tell you which problems you are buying.

A space that looks right for patients can be expensive for technology. A second-floor suite with no conduit to the building's telecom room, a panel with no spare capacity for imaging, or a landlord who only allows one contractor to run cable can each add cost and delay that nobody planned for. None of this is legal advice and none of it replaces your broker or attorney. It is a list of technology questions to put to them, and to the landlord, while you still have leverage.

Table B. Lease-stage technology checks

Treat each row as a question, not a verdict. A red flag rarely kills a space on its own, but three of them together usually mean the technology budget and schedule need a second look before you commit. Hand the list to your broker and attorney as questions they can raise with the landlord. They decide what goes into the lease; this table only makes sure the technology questions get asked at the one point when the answers are cheap.

Who does what on a startup team, and which decisions does each one own?

A startup team usually has ten parties: the dentist, architect, general contractor, electrician, low-voltage contractor, equipment dealer, software and imaging vendors, carrier, IT partner, and at the edges the insurer, accountant and lender. Each deliverable needs one party who leads it, one who approves it, and the others kept informed. If you are still choosing the IT partner, our list of top dental IT companies notes which ones publish a startup service.

The matrix below names a lead for each of fourteen deliverables. Print it, write the actual names into the column headers, and bring it to the first meeting where everyone is in the room.

Table C. Responsibility matrix (L = leads · A = approves · I = needs to be informed · — = not involved)

Two rows show two leads on purpose. On the closet, the architect draws it and the contractor builds it; the IT partner approves both. On staff accounts and the opening test, the practice decides who gets what and runs the day, while the IT partner builds the accounts and fixes what the test finds.

Three hand-offs fail more than the rest. Put each one on the kickoff agenda as a question:

1. 1. Architect to low-voltage contractor. Who turns the device locations on the drawings into a numbered cable schedule, and who checks it before cable is pulled?
2. 1. Equipment dealer to electrician. On what date will each imaging unit's site-prep sheet reach the electrician, and who confirms it matches the installed circuit?
3. 1. Carrier to IT partner. Who receives the carrier's install notice, who is on site to meet the technician, and who tests the circuit before the closet is closed up?

How long does a new dental office IT setup take, milestone by milestone?

How long the technology setup for dental startups takes depends on your building, carrier and city, so plan by milestone rather than by month. Each construction milestone needs certain technology work finished before it, and each one unlocks the next. The eleven steps below are the sequence to plan around, with what must already be true at each.

The steps line up with the construction and business milestones in Table A. Use them as the agenda for your weekly site meeting: at each meeting, check whether the "must already be true" items for the next milestone are done.

1. Sign the lease with the technology questions answered

Before signing, run the ten checks in Table B and keep the answers in your project file. What must already be true: you have a short list of spaces and a broker who knows you need technology answers, not just square footage. What it unlocks: a space whose limits you know, and a first draft of the questions your architect will need to design around. If two spaces are otherwise equal, the one with an existing carrier and a clear cable path is usually the easier build.

2. Put the technology on the drawings

While the architect is drawing, mark every device location: chairside workstations, monitors, sensors, phones, cameras, access points, printers, payment terminals and screens. Mark the closet, its dedicated circuit and the paths cable will take. What must already be true: you have a shortlist of practice software and imaging units, so their site-prep sheets can reach the architect. What it unlocks: a permit set that carries the technology, rather than a set that has to be revised later. The detail of where each item sits in each room belongs to technology decisions during office design.

3. Use the permit wait to order long-lead items

The permit review is the quiet window to start everything that has a lead time outside your control. Order the internet circuit, ask the carrier for a site survey, decide whether you are keeping or getting new phone numbers, and confirm software and imaging choices. What must already be true: the suite address is final and the closet location is fixed on the drawings, because the carrier needs to know where its line ends. What it unlocks: carrier engineering and approvals that run in parallel with the city's review instead of after it.

4. Check rough-in against the drawings

During demolition and rough-in, walk the space with the electrician and confirm that the dedicated circuits for imaging and the closet are where the drawings put them, and that conduit and backboxes for low-voltage are in place. What must already be true: the imaging units are chosen and their site-prep sheets are with the electrician. What it unlocks: framing that can carry cable along the planned paths. A circuit in the wrong place is cheap to move now and costly to move after the walls close.

5. Pull, label and test cable while the framing is open

This is the milestone that decides most of the network's future. The low-voltage contractor pulls every run on the cable schedule, labels both ends, and tests each run. What must already be true: a numbered cable schedule exists and the closet location is built out enough to receive the runs. What it unlocks: walls that can close with every planned connection inside them, including spare runs and the runs for operatories you will equip later. Excelsior Orthodontics in Purcellville, Virginia, shows why phasing matters: our project page follows "phase one" of Dr. Minh Nguyen's practice and "its completion in October 2023".

6. Close the walls and finish the closet

While drywall and finishes go in, the contractor finishes the closet: its dedicated power, cooling or ventilation, a lockable door, and space for the rack. Cable ends are protected from dust and paint. What must already be true: every cable run has passed its test and the results are filed. What it unlocks: a clean, secure room where network equipment can be installed without sharing the space with construction debris. Ask the contractor who signs off the closet as finished, and add that sign-off to your handover file.

7. Receive equipment against the site-prep sheets

When chairs, cabinetry, imaging units and screens arrive, check each item against its site-prep sheet: power, mounting and connection points. Mount screens and wireless access points at the locations on the drawings. What must already be true: the closet is finished and the cable runs are labeled so the dealer and the IT partner can find the right jack. What it unlocks: a room where devices can be connected and powered. Joie Pediatric Dentistry in Ramsey, New Jersey, is a useful picture of this point: its project page covers the final stages of the technology buildout "once the walls, flooring and dental equipment were in".

8. Install and stage the systems

The IT partner installs the firewall, switching, Wi-Fi, workstations, server or cloud connections, practice software, imaging connections, phones, printers and backup, then stages each system so it can be tested. What must already be true: the internet circuit is live, licences are purchased, and accounts are registered in the practice's name (Table M). What it unlocks: a working system staff can train on. At Anchor Periodontics in Stevensville, Maryland, our project page records Legend "wrapping up the technology infrastructure" for Dr. Elizabeth Polak's new practice.

9. Train on the real system and pass inspection

Around the Certificate of Occupancy, create each staff member's own accounts, turn on multifactor sign-in, and train on the installed software and imaging, not on a demo. What must already be true: the systems are staged and the access rules (who sees what) are agreed with the owner. What it unlocks: a team that has already done a full patient flow on the real system. Training on the live configuration is also when gaps show up, such as a missing printer, a label template that prints wrong, or a sensor that only works in one room.

10. Run opening week with a daily issues log

During opening week, keep one shared log of every problem, who reported it and who fixed it. Have the IT partner reachable throughout, with on-site cover arranged where needed. What must already be true: the role-by-role tests in Table K have passed and staff know who to call. What it unlocks: a short list of real problems, ranked by how much they slow the schedule, instead of a vague feeling that "the computers are slow". Close the log each day with a note of what is still open.

11. Hand over and run the first 90 days

After opening, take the handover pack (Table L), confirm every account sits in the practice's name (Table M), and follow the first-90-days plan (Table N). What must already be true: the build is finished and the issues log is shrinking. What it unlocks: a practice that runs without the build team, with documents that let any future IT partner, contractor or new office manager understand what was built. End the 90 days with a review against your decision log.

Table D. Milestone readiness

If you would rather have one team keep this sequence moving with your contractor, plan your build-out with Legend.

Which technology decisions should be made, and logged, before construction?

Ten decisions shape what gets built: practice software in the cloud or on site, imaging types, phone platform, Wi-Fi coverage, cameras, patient screens, backup, email and identity, payment terminals and specialty software. Make each one by a named milestone and file the evidence. A dated log protects you when a vendor or plan changes mid-build.

The order you decide these in matters less than the fact that each decision has a date, an owner and a paper trail. Builds change: a vendor discontinues a model, a partner joins and prefers different software, a lender trims the budget. When that happens, the log shows exactly what the change touches downstream and which milestone it now threatens. Copy the table into a shared spreadsheet and add a column for the date each row was decided.

Table E. Decision log (copy this template)

Why a log, and not just a list? Because decisions get re-opened by people who were not in the room. When a new office manager asks why the practice runs a server, or a contractor asks why there are spare runs in an empty operatory, the log answers in one line with the date and the reason. It also gives a new vendor everything it needs to quote accurately.

For the first row, the evidence is the vendor's own requirements page, saved with the date you read it. As one example of what those documents say, Open Dental's computer requirements page recommends "having a dedicated server to protect data", warns that Home editions of Windows can fall short on connection and networking, and states that "Windows 11 S is not supported" (Open Dental, read 2026-10-16). Every platform publishes its own version of this page, and the details differ. Our guide to software system requirements covers how to read them, and our comparison of a cloud or on-site server covers the trade-offs behind row 1.

Legend supports the IT environment of Dentrix, Eaglesoft, Open Dental and Archy, and of the imaging systems DEXIS, Vatech, Carestream, Planmeca/Romexis and Dolphin Imaging. Each has its own page: Dentrix, Eaglesoft, Open Dental, Archy, DEXIS, Vatech and Dolphin Imaging. For the platform side as a whole, see practice-software and imaging support. If you use Curve, Denticon or CareStack, the same logging approach applies; record the vendor's current requirements document with its date.

What does each operatory need?

Each operatory needs a connection for every device that will sit in it, plus spares: the chairside workstation, doctor-side and patient-facing monitors, any ceiling screen, a phone if staff do not use softphones, and strong Wi-Fi for scanners and tablets. Count devices room by room, and wire the operatories you will equip later now.

Sensors and intraoral cameras usually plug into the workstation by USB rather than into the wall, so they add to the workstation's needs, not the cable count. Scanners on carts often run on Wi-Fi and need a strong signal at the chair. Screens need power and a video path, which may be a cable in the wall or a network connection depending on the system.

Table F. Operatory device count

The working rule is simple: count the devices you know about, add spares for the ones you do not, and wire every operatory on the plan even if some will stay empty at opening. Pulling a run later means opening a finished wall, and phased practices like Excelsior Orthodontics show that the second phase does come. We are not printing a universal number of connections per room, because the right count depends on your devices and layout; your IT partner should produce a room-by-room count from your drawings.

Room-by-room design while the floor plan is still open is covered in technology decisions during office design. Cable types, testing and labeling are covered in our network and low-voltage cabling plan.

What belongs in the network closet?

The network closet holds the internet handoff, firewall, switches, any server, the backup device and a battery unit. It needs its own circuit, a battery backup, a way to remove heat, a lock, a clear path to where the carrier's line enters, grounding, and labeling so every port can be traced to a room.

Treat the closet as the room every other room depends on. That room is where the internet arrives, where every wall jack ends up, and where the equipment that keeps the office online sits. Put it on the drawings with the same care as an operatory.

Table G. Closet spec at a glance

Two closet mistakes cost the most to fix: a closet with no cooling in a building that shuts off air at night, and a closet with no spare circuit when a server or second battery unit is added later. Both are cheap to prevent on the drawings. For how the network inside the closet is designed, see dental network design and our full guide to dental office network setup.

How do you plan internet and phones for an office that does not exist yet?

Start the internet order as soon as the suite address and closet location are fixed, because carrier timing is outside your control. Ask for a site survey, approve any construction quote quickly, and plan a second path. Decide early whether to keep existing phone numbers, and confirm how the phone system handles 911.

The carrier cannot install service in a suite that has no address in its system, and it cannot tell you a date until it knows whether its line already reaches the building. That is why the order goes in during the permit wait, not after the walls close. Keep every email from the carrier, and note the name of the person who gave each date.

Table H. Carrier planner

For the second path, ask each carrier where its line enters the building and which street it comes from. If both answers match, a cellular backup adds more independence than a second wired service.

Number plan. Decide early whether the practice will use new numbers or bring numbers from a previous practice or a personal line. Porting needs the account details exactly as the losing provider has them, so collect the latest bill and the account holder's name now. If the numbers are new, register them in the practice's name, not an individual's, and add them to the account register (Table M). Our guides to phone systems for dental offices and our VoIP services page cover features and setup.

911 on a new multi-line phone system

A new office phone system with several lines or extensions falls under the FCC's multi-line telephone system rules, the rules that carry out Kari's Law and section 506 of RAY BAUM'S Act. Under 47 CFR § 9.15, they apply to systems first sold, leased or installed after February 16, 2020, which covers any system installed in a new office today.

47 CFR § 9.16 sets three obligations for whoever installs, manages or operates such a system. In plain terms: a caller must be able to dial 911 directly from any phone without first dialing a prefix such as 9; the system must notify a central point in the office, where someone is likely to see or hear it, when a 911 call is placed, if the system can do so without hardware or software improvements; and the system must send a dispatchable location with the call. We are stating the rule by title, not interpreting it. Ask your phone vendor three questions and keep the answers with your project file: how does your system meet each obligation, where will the notification appear in our office, and what location will a 911 call from each room send? File the answer with your decision log, and include a 911 notification test in opening week following the vendor's own procedure.

How does the plan change by specialty?

The core plan is the same for every specialty, but layout and devices change it. Pediatric offices often use open bays and ceiling screens; orthodontic offices add imaging and records software; oral surgery adds CBCT and sedation-room devices; endodontic offices add microscope cameras; multi-specialty offices combine several. Plan those differences into the drawings from the start.

The technology-difference column below is general planning knowledge for that specialty, not a description of what Legend installed in the named project. The project column states only what each project page says.

Table I. Specialty matrix

The practical step is to give your architect and IT partner the specialty mix on day one. A pediatric open bay changes where access points and cameras go; an orthodontic records room changes storage and imaging; a surgical suite changes power and backup. These are decisions for the drawings, not for the install week.

What changes when a group opens a new location from the ground up?

When a group builds a new location from scratch, the main difference is the standard. Use the same drawing template, device list, account structure and naming as your other offices, so the new site matches from day one. The group's IT partner should review the drawings against that standard before the permit set goes out.

Four standards, written down before the architect starts, make the new site match the others:

• • A drawing template. The closet, operatory device count and front desk layout are drawn the same way at every site, adjusted only for the building.
• • A device list. The same workstation models, screens, access points and phones, so spares and support are shared.
• • An account structure. New users, mailboxes and phone extensions are created under the group's existing tenant and naming rules, and the location's carrier and licence accounts are added to the group register.
• • Naming. Rooms, devices, ports and network segments follow one convention across sites, so a support call about "Op 3" means the same thing everywhere.

Texas Tiny Teeth of Greenville shows the scale this can reach: our project page describes "an 18,000-square-foot pediatric dental practice in Greenville, Texas, Dr. James Slaughter's 12th location", with Legend's team on site setting up the office. For groups planning several openings, see IT for multi-location dental groups.

How should a startup budget its technology?

Budget by category, not by a single number: one-time build costs, recurring monthly costs, and replacement cycles. Each category is quoted by a different party. At Legend, startups are custom quoted; hardware procurement, major cabling projects and software licensing are quoted separately; and backup protection is from $39.99 per month (storage-dependent).

Your lender will ask for one technology line, but a single number hides what drives it. Split the budget into the categories below, note who quotes each one, and compare quotes line by line. When two quotes differ, the difference is usually in what is included, not in the price of the same thing.

Table J. Budget categories

Three things move a technology budget more than anything else: the number of operatories wired and equipped, the imaging mix (a CBCT changes storage and workstation needs), and whether the carrier needs construction to reach your suite. Ask every bidder to price the same room list so the quotes can be compared.

The full method, including how to compare two startup quotes, is in budgeting technology for a dental startup. For monthly support costs once you are open, see what dental IT support costs after opening.

What protects patient data from the first day?

Before the first patient, every staff member should have a unique account with multifactor sign-in and only the access their role needs. Vendors that handle patient data should have signed business associate agreements, a documented risk analysis should exist, and the backup should have passed a restore test. These are the minimum baseline for opening.

A new office has one advantage an older office lacks: nothing has to be undone. There are no shared logins to retire and no old accounts to find. Set the baseline at install and it stays the baseline.

The HIPAA Security Rule is published in 45 CFR Part 164, Subpart C, with sections for administrative, physical and technical safeguards and for organizational requirements such as business associate contracts. We name it by title; how it applies to your practice is a question for your compliance adviser or attorney.

The opening baseline

• • Unique accounts. One sign-in per person, with no shared front-desk login.
• • Multifactor sign-in. CISA describes multifactor authentication as adding "an extra layer of protection" by requiring two or more ways to verify a user's identity (CISA, read 2026-10-16). Turn it on for email, remote access and the practice software where supported.
• • Least privilege. Front desk, clinical and billing roles see what they need; admin rights stay with named people.
• • Business associate agreements. List every vendor that will store, receive or transmit patient data (practice software host, imaging cloud, backup, IT partner, phone system with recordings) and file the signed agreement for each.
• • A documented risk analysis. Done for the environment you built, and kept with the handover pack.
• • A tested backup. CISA advises testing the backup procedure so your team "can rapidly restore data both fully and partially" (CISA, read 2026-10-16). Record the first restore test before opening.

Legend provides 24/7 monitoring once systems are live. For the services behind this section, see dental cybersecurity, backup and recovery and HIPAA compliance readiness support.

What should be tested before the first patient, and by whom?

Each role should run its own real tasks on the installed system and pass them before opening: the front desk checks a patient in and out, clinical staff capture an image in every operatory, billing sends a claim, and the owner restores a file from backup. Each test has a pass condition, and failures go on the issues log.

Testing by role finds problems a general walk-through misses, because each person knows which step they cannot afford to fail. Give each person a printed copy of their rows, have them initial each pass, and keep the sheet with the handover pack.

Table K. Opening-week test by role

If a row fails, record it in the issues log with the person who will fix it and the date it will be retested. Do not open on a failed imaging or check-in test if you can avoid it; those two failures slow every appointment.

To test the hand-offs between roles in one continuous patient flow, run the mock patient day in the next section: it adds a timed script, an acceptance sheet, go/no-go rules for opening day and a first 10 days issues log.

How do you run a mock patient day before opening?

A mock patient day is a full rehearsal on the installed system, with test patients instead of real ones. The team runs each visit from check-in to checkout, captures an image in every operatory, sends a text reminder and confirms the night's backup. Each step has an owner and a pass condition, and the owner dentist decides go or no-go.

Table K checks each role on its own. A mock patient day checks what happens between roles: the check-in has to appear in the hygienist's operatory, the doctor's treatment plan has to reach the front desk, and the payment has to post to the ledger. A hand-off can fail even when every single-role test passes, and the rehearsal finds it while there is still time to fix it.

It is also not a soft opening with friends and family, which puts real people and real patient information into the system. Run the rehearsal on test records first, so the first real chart goes into a system that has already passed, with the baseline from what protects patient data from the first day in place. That is a sequencing choice, not a legal reading; your compliance adviser decides what your practice needs.

What has to be ready before the rehearsal?

Hold the rehearsal once the systems are staged (milestone 8) and every staff member has an account (milestone 9). Set these up the week before:

• • Three test patients. Names nobody could mistake for a real person ("ZZTEST Adult", "ZZTEST Child", "ZZTEST Emergency") and a test insurance plan. Ask your software vendor how to mark test records and whether to inactivate or remove them after opening.
• • Each person's own sign-in. Every participant uses a personal account with multifactor sign-in. A rehearsal on one shared login tests nothing about access.
• • The eligibility path. Electronic eligibility needs the clearinghouse set up first. The Open Dental manual, for example, says to register with the vendor and "make sure Real Time Eligibility or real time services are enabled" (Open Dental manual v24.3, read 2026-10-22). Check your own platform's documentation.
• • A test payment. Ask your processor how to run and void a test transaction.
• • Text messaging registration. Business texts go through carrier registration. The Campaign Registry calls itself "the backbone support for the 10DLC messaging ecosystem" and notes that "direct registration with TCR is not available for Brands" (The Campaign Registry, read 2026-10-22), so your reminder platform registers for you. Ask it for the status.
• • A 911 test, arranged in advance. Tennessee's 911 guidance, for example, notes that "prior to placing a test call, PSAPs appreciate advance notice" and asks callers to contact the local 911 center on its non-emergency line first (Tennessee Department of Commerce & Insurance, read 2026-10-22). Follow your local center's instructions and your phone vendor's procedure.
• • The people. Everyone who works opening week, in their real roles; one scribe who holds the acceptance sheet and runs no step; your IT partner, on site or reachable; and your software or imaging vendor's go-live trainer, if one is offered.
• • A date with room after it. Leave enough time to fix a failed row and run it again. Ask each vendor how long its usual fixes take and set the date from the longest answer, then book a shorter second session for the failed rows only.

The mock patient day script

The times are an example for a morning start; move them to your hours. Run every step in the real rooms, on the devices patients will see. The scribe records each result as it happens.

Table O. Mock patient day script (example times)

Three notes on the script. The same Open Dental page warns that "Most carriers still send very sparse data", so the eligibility step tests your fallback as much as the connection. The outage drill belongs to the IT partner, because a wrong cable pulled in a new closet causes the very problem being tested. The restore follows the HIPAA Security Rule's wording on a data backup plan to "create and maintain retrievable exact copies" and "periodic testing and revision of contingency plans" (45 CFR 164.308(a)(7), read 2026-10-22); we name the text, and how it applies to you is for your compliance adviser.

When a step fails, record it and keep going, so one failure does not hide the next. If an image lands in the wrong chart, see our imaging integration troubleshooting guide. Caller ID, screen pops and call-flow tests are covered in integrating your phone system with your dental software. Outage gaps are covered in what to do when the dental office internet goes down.

The mock-patient-day acceptance sheet

The sheet turns the script into a record. The person who ran each step marks it, not the IT partner, and every fail gets a name and a fix-by date before the team goes home.

Table P. Mock-patient-day acceptance sheet (copy this template)

File the signed sheet with the handover pack (Table L).

What are the go/no-go rules for opening day?

The owner dentist makes the call from the acceptance sheet; the IT partner reports each open row but does not decide. Every failed row falls into one of three groups: it stops opening, it allows opening with a tested workaround, or it can be fixed after opening. Agree the groups before the rehearsal.

Table Q. Go/no-go rules for opening day

Write the decision down: date, time, open rows, the workaround for each, and the signature of whoever made the call. If a no-go row that affects the whole office is still open after the re-run, move the opening date rather than clearing it with patients in the chairs.

How do you keep the first 10 days issues log?

For the first ten working days, every problem goes into one shared log, however small: the time, who reported it, the room or device, and what happened in that person's words. Rank each item by its effect on patients, review the log at the end of each day, and close it with a day-10 review.

Some problems only appear with a full schedule, such as a printer that jams on the thirtieth label. The log turns "the computers are acting up" into a list your IT partner can work through.

Table R. First 10 days issues log (template; the rows are examples, not a real opening)

Three habits keep the log useful:

• • End-of-day review. Sort by impact. Every A item gets an owner and a next step before anyone leaves; B and C items get an owner and a target day.
• • Watch for repeats. Three reports of the same problem become one root-cause item for the IT partner. A repeat that turns out to be a habit is a training item, fixed with a short refresher rather than a ticket.
• • Day-10 review. With the office manager and IT partner, sort every row into technology or training, and carry open rows into the first-90-days plan (Table N). To compare how quickly items closed with what your agreement says, see how to read a dental IT support SLA.

The aim of the rehearsal, the sheet and the log is what our project page for Smile Craft Orthodontics in Jessup, Maryland, describes: "a reliable, secure technology foundation designed for smooth day-one operations".

Questions to ask your IT partner about the rehearsal

• • Who from your side will be on site or reachable during the rehearsal?
• • Which rows on the sheet will you run, and which should our staff run?
• • How will you run the outage drill without disrupting the carrier's service?
• • How do we hand you items from the issues log, and how will you report back?

If you want help planning the rehearsal for your own office, start with our dental startup IT services for new practices.

What should you receive at handover, and who should own each account?

At handover you should receive the as-built cable map, the test results for every run, a patch-panel map, a network diagram, a password vault transfer, warranty and licence lists, vendor contacts, a restore-test record, the signed agreements and your decision log. Every account should sit in the practice's name, with the IT partner as a delegated admin.

A handover pack is what lets the practice change contractors, add an operatory or bring in a new office manager without starting from scratch. Ask for it at the kickoff meeting, so each party knows what it owes at the end.

Table L. Handover pack

The principle behind the next table is simple: the practice owns, and the IT partner is a delegated admin. If an account is registered to a contractor or a staff member personally, the practice can lose access when that relationship ends.

Table M. Account-ownership register (copy this template)

Fill in the register as accounts are opened, not at the end. The best time to put a domain or a phone number in the right name is the day it is created.

What happens in the first 90 days after opening?

The first 90 days turn a finished build into a working practice. Keep a daily issues log in week one, complete the first patch cycle and a post-opening restore test, walk the office for Wi-Fi complaints, set up a new-hire account process, light up any phased operatories, and close with a day-90 review against your decision log.

Table N. First 90 days

Once you are open, Legend's support runs through a staffed 24/7 helpdesk at 1-800-794-1588, with 24/7 monitoring. Legend has in-house engineers; no outsourced first-level triage, and onsite dispatch by appointment across served dental markets; remote-first nationwide. For what ongoing support looks like, see dental IT support after opening and managed IT services.

What do real startup openings look like?

Real openings are uneven: some are phased, some are a group's twelfth site, some open as multi-specialty practices. The projects below are Legend startup and new-location projects in seven states, each described only in the words of its own project page, so you can see the range before you plan your own.

• • Joie Pediatric Dentistry, Ramsey, New Jersey. The final stages of the technology buildout, "once the walls, flooring and dental equipment were in".
• • Anchor Periodontics, Stevensville, Maryland. Legend "wrapping up the technology infrastructure" for Dr. Elizabeth Polak's new practice.
• • Smile Craft Orthodontics, Jessup, Maryland. Now open; Legend "supported the startup launch".
• • Excelsior Orthodontics, Purcellville, Virginia. "Phase one" of Dr. Minh Nguyen's practice and "its completion in October 2023", with a look back at the full IT install.
• • Clayton Family Dental, Clayton, North Carolina. From technology installation to the practice's grand opening.
• • EOM Dental Center, Sequim, Washington. Legend's team "completing the technology infrastructure" for Dr. Joseph Churchill's practice; the update documents "computers, networking, Wi-Fi, dental software, imaging integration and security planning ahead of opening".
• • Little Roots Pediatric Dentistry, Bartlett, Illinois. Legend's team on-site "installing and configuring technology" as the practice approached opening.
• • Texas Tiny Teeth of Greenville, Greenville, Texas. "An 18,000-square-foot pediatric dental practice", Dr. James Slaughter's 12th location.

More projects, with photos, are on our project pages. Legend Networking has 22+ years in dental IT (since 2004) and a 4.8 rating · 173 Google reviews. Ian Lynch — 22 years in dental IT; oversees the NOC, onsite dispatch and client technology roadmaps.

Opening in a specific market?

Yes, local conditions change the plan: which carriers serve the area, how the local utility and weather affect power, and how permitting runs. If you are opening in one of these markets, the local guide adds the timing, utilities and nearby projects that this national page cannot.

• • Dallas–Fort Worth: opening in Dallas–Fort Worth.
• • Houston: the Houston technology timeline.
• • Austin: opening in Austin.
• • San Antonio: the San Antonio technology timeline.
• • Tampa Bay: opening in Tampa Bay.
• • Denver: the Denver technology timeline.
• • Charlotte: opening in Charlotte.
• • Philadelphia: the Philadelphia technology timeline.
• • Boston: the Boston dental startup IT plan.
• • Phoenix: the Phoenix dental startup IT plan.

Deeper guides in this series

• • Our network and low-voltage cabling plan covers cable types, the closet build, switching, Wi-Fi, testing and labeling.
• • The technology a new office runs on covers the systems and how they connect.
• • Budgeting technology for a dental startup covers categories, cost drivers and comparing quotes.
• • Technology decisions during office design covers what goes where in each room while the floor plan is open.

The new dental office technology checklist

Copy this checklist into your project file. It follows the journey from lease to day 90 in eight groups; tick each line as it is done and note the date.

1. Lease

• • [ ] Carriers serving the suite identified, with the rep's name
• • [ ] Cable path from the building entry to the suite confirmed
• • [ ] Panel capacity checked by an electrician
• • [ ] A closet room identified, away from water
• • [ ] Landlord rules on contractors, access and roof work read
• • [ ] Technology items raised with the broker and attorney for the work letter

2. Design and drawings

• • [ ] Every device location marked, room by room
• • [ ] Closet location, size and dedicated circuit on the drawings
• • [ ] Imaging site-prep sheets delivered to the architect and electrician
• • [ ] Specialty mix given to the architect and IT partner
• • [ ] Decision log started with dates

3. Cabling and closet

• • [ ] Numbered cable schedule issued before cable is pulled
• • [ ] Spare runs and phased-operatory runs included
• • [ ] Every run labeled at both ends and tested
• • [ ] Test results filed
• • [ ] Closet power, cooling, lock and grounding signed off

4. Internet and phones

• • [ ] Circuit ordered during the permit wait
• • [ ] Site survey done; any construction quote approved
• • [ ] Second path planned (different carrier, different entry, or cellular)
• • [ ] Number plan decided; porting details collected
• • [ ] 911 direct dialing, notification and location confirmed with the phone vendor

5. Systems and software

• • [ ] Practice software and imaging requirements filed with their dates
• • [ ] Licences bought in the practice's name
• • [ ] Workstations, network and Wi-Fi installed and staged
• • [ ] Imaging working in every operatory
• • [ ] Printers, label printers and payment terminals connected

6. Security and data

• • [ ] Unique accounts for every staff member
• • [ ] Multifactor sign-in on email, remote access and software
• • [ ] Business associate agreements signed and filed
• • [ ] Risk analysis documented
• • [ ] First restore test recorded

7. Opening week

• • [ ] Role-by-role tests passed (Table K)
• • [ ] Daily issues log running
• • [ ] Staff know who to call and how
• • [ ] 911 notification test completed

8. Handover and first 90 days

• • [ ] Handover pack received (Table L)
• • [ ] Account register complete, all in the practice's name (Table M)
• • [ ] First patch cycle and post-opening restore test done
• • [ ] New-hire and leaver process set
• • [ ] Day-90 review held against the decision log

What to ask your IT partner at the kickoff meeting

Bring these ten questions to the first meeting with your IT partner, before cable is pulled. The answers tell you whether the partner plans for the whole journey or only for install week.

For Legend, the answers to questions 3 and 10 start with the registry facts above: support for the IT environment of Dentrix, Eaglesoft, Open Dental and Archy, and of DEXIS, Vatech, Carestream, Planmeca/Romexis and Dolphin Imaging; and a staffed 24/7 helpdesk at 1-800-794-1588.