Center Stage – DSO Influencer, Alessandro “Alex” A. Giannini, D.D.S.

For the past seven years, Group Dentistry Now has been committed to the success of emerging dental groups & DSOs and the people who work for them. 

In January 2019, we began recognizing DSO influencers with our annual ‘DSO Influencers To Watch’ list. We are now pivoting from an annual list to a regular featured article, Center Stage, which will highlight an individual DSO influencer. 

Who is a DSO influencer? Someone who impacts and influences not just their dental group, but the DSO industry at large. With well-honed leadership skills, they inspire positivity, exhibit vision, and display entrepreneurial energy. Outside-the-box thinkers, they have extraordinary business acumen and philanthropic interest.  

Our latest DSO Influencer is Alessandro “Alex” A. Giannini, D.D.S. Here is our interview with him:

GDN: You became a dentist in 1988 and have had an incredible career since then. You have either founded or been a CEO at many DSOs like Comfortable Care Dental, Dynamic Dental Partners Group, Blackford Dental Management, and Affiliated Dental Support. How did you get involved in DSOs?  

Dr. G.: Post‐graduation from dental school, I was blessed to have great business (financial/operational) and clinical mentors along my professional career path. Having acquired my first office in May 1989 with revenue of $224,000 annually, I grew it to $3.3 million within nine years. I learned a great deal from that which I then applied to my future endeavors. I had boundless opportunities to assist/change and rehabilitate the lives of many dentists, on a national basis, who were not able to keep or grow their practices for many reasons, including what I call the five “Deadly D’s” (Death, Drugs, Divorce, Disability, “Dumbness”).

GDN: Who has influenced you?

Dr. G.: The three most influential people in my professional life were Don Clay of Vantage Institute, Walter Hailey of Dental Boot Kamp, and Dr. Rick Workman (with Pat Bauer) during my tenure as a partner/shareholder in Heartland Dental Care (today, the largest and most successful DSO for many reasons). Between these mentors, my strong entrepreneurial drive/passion and my professional experience, in and out of the dental field, I have learned the philosophy, the policies, the systems, the structure, the protocols, the procedures and formulas which take the guess work out of growing a DSO platform or large dental group exponentially and professionally.

GDN: What are some of your most significant professional accomplishments in the industry?

Dr. G.:

  • I rescued a dental group that was losing $600,000/month with $10M in annual revenue and turned into a national DSO with $50 Million in annual revenue and $11.5 Million of four‐wall EBITDA.
  • Built and managed 21 Dental offices for Heartland in 2004 with annual budget of $20 Million and EBITDA of 21%.
  • My second DSO, Dynamic Dental Partners Group, was founded in the middle of the Great Recession with no capital. I pioneered a new DSO model now being duplicated across the nation. Every office that we managed or acquired, we were able to double or even triple annual revenue. With this track record, this company was named the 14th fastest private growing company in Inc. 500 – 2014 edition. The company was sold to private equity firm Huron Capital.
  • Grew Pennsylvania Dental Partners from $10.2 M in 2014 to $15.7M in 2015 while also merging and right-sizing 21 offices to 14 offices. In addition, I rescued $16M loss for investor.
  • I founded Blackford Dental Management and grew same store revenue 60% in Year 1. I then grew revenue 196% and 70% thereafter. For example T‐F Dental, which is a group in Georgia that Blackford and I acquired, went from $13M in revenue to $21M in 18 months with organic growth only. The group was led by Dr. Frank Nia and Dr. Alex Toub. Under my coaching and wing we grew and then we sold them to North American Dental Group. Grew EBITDA 239% in one year with organic growth only. Sold company in three parts in 2017. Today Dr. Nia is the Chief Clinical Officer of NADG.

GDN: You were past president of and currently sit on the board of directors for the American Academy of Dental Group Practice (AADGP). What is the AADGP?

Dr. G.: They are dedicated to providing members with an environment that encourages collaboration, engagement, and the pursuit of best practices for dental group practices. Whether you are already part of a dental group practice or just want to know more about the benefits of this dynamic approach to delivering dental care, AADGP is the place to be. The organization is dedicated to promoting the group concept and providing educational resources to group dentists and managers/administrators through meetings, networks and publications. I look forward to attending the upcoming 2022 AADGP Dental Group Practice Expo February 3-5 at the Bally’s Las Vegas.

GDN: What do you see as the future of the dental industry (trends, opportunities, etc.)?

Dr. G.: Consolidation is here to stay and the benefits for dentists working in group practice is all part of new way of socializing collaboratively. Economically speaking if you compare a dentist with the same clinical and leadership skills in a solo versus a group practice we find fewer solo dentists being able to make the same money as dentists in group practice and the quality of life for a group dentist is much higher.

There are failures in dental groups and DSOs, but its usually because of lack of experience and fundamental understanding of what is required to build an such organization (you actually have to go out of your way to plunge the business). The reality is that once when you get past a certain number of locations, revenue and EBITDA, like the top 20 DSOs, it’s a numbers game of growing with continuous and never ending improvement.

Mergers of dental groups will turn into mergers of DSOs (as we see already this year) and as the capital markets change we will see the return of publicly traded DSOs. We are most likely half way up the consolidation effort and I would not be surprised to see over 60% of dentists practicing in a group or DSO within the next 10-20 years.

GDN: Your CV is quite impressive. What are you doing now?

Dr. G.: I am with Aligned Dental Partners, a dental consulting and advisory company to growing entrepreneurial dentists, dental groups and DSOs. We help them build the structure, infrastructure and platforms required to grow and scale a dental group to either buy and build dental offices/groups or hold as a legacy company or transition to a strategic buyer. We also help them source capital via debt or private equity raises. We have two divisions to our company. One is strategic consulting and the other is operational consulting, which includes clinical coaching with hygiene. On the strategic consulting side, we coordinate with our clients attorney’s to build the ideal legal and operational structure while also helping form Finance/Accounting department, HR, Procurement, IT, Marketing, Revenue Cycle and Operations. The operational consulting helps our clients increase revenue with tried and tested methodologies while also increasing operational efficiencies.

Previous DSO Influencers:

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