Scaling Up From 1 to 3 Practices: A Candid Q&A with TLN Family Dental’s Founder, Dr. Tammeka Nickleberry

Emerging Dental Group Spotlight: TLN Family Dental

Dr. Tammeka L. Nickleberry, a dynamic dental entrepreneur based in Houston, Texas, is the founder of TLN Family Dental and two additional de novo locations operating under the TLN Family & Cosmetic Dentistry brand.

Since launching her de novo strategy in 2009, Dr. Nickleberry has steadily expanded her footprint across the Greater Houston Area, building a thriving, community-focused organization rooted in long-term patient relationships and leadership development. She has grown the organization from just two team members to a team of over 20, with a strong emphasis on developing leaders. Her teams take great pride in the collaborative, values-driven culture they’ve built together.

Group Dentistry Now sat down with Dr. Nickleberry to learn more about her journey, growth strategy, and the core values that drive her practices.

GDN: Tell us a little about yourself.

Dr. Nickleberry: I reside in Houston, Texas, and I am the founder of TLN Family Dental, TLN Family & Cosmetic Dentistry, Pearland Parkway, and TLN Family & Cosmetic Dentistry, Meyer Park.

I earned my Bachelor of Science degree in Biology with a minor in Chemistry from Prairie View A&M University in 2001. In 2005, I received my Doctor of Dental Surgery degree from Texas A&M School of Dentistry.

I’m originally from a small town in the northeast corner of Texas. I grew up in a community where healthcare providers built long-term relationships with their patients and were deeply connected to the communities they served. That experience shaped the foundation for how I would grow my own organization.

GDN: Can you share the story behind launching your first dental practice and what inspired you to expand to multiple locations?

Dr. Nickleberry: My first dental office was inspired by community. That location was built in what I consider to be an underserved area. It is home to multigenerational families headed by retirees. I loved the idea of intertwining my dental practice and later my entire brand in the communities that I serviced. It reminded me so much of the small town feel that I grew up in. It’s just nestled inside of a major metropolitan city.

GDN: What were some of the biggest challenges you faced when scaling from one to three practices, and how did you overcome them?

Dr. Nickleberry: The biggest issue early on was finding a doctor to be in relationship with the patients. There were many excellent clinicians. However, building a real relationship with the patients was a little more difficult to navigate. I found that was the bedrock of my practice. I learned to hire for that specific quality in a provider and to make sure our values aligned there. The rest of the “indoctrination” was cultivated over time, and I got better at scaling that portion of the practice.

GDN: How do you maintain a consistent patient experience and clinical standard across all three locations?

Dr. Nickleberry: I train, retrain, reinforce, retrain some more, and measure to keep consistent standards. I have learned the value of blocking off clinical time to train people individually, by department, as an entire team, and together as an organization to make sure our standards are high, the quality of care is exceptional and the experience is amazing. I want patients to feel the same experience regardless of the location or provider. That requires teaching, training, modeling, and keeping an eye on the systems and how they play out in the patient experience. I also look at every single review and internal feedback. This lets me know whether or not my patients can feel what we teach.

GDN: What do you look for when hiring dentists and staff to ensure they align with your group’s vision and culture?

Dr. Nickleberry: I look for servant leaders, empathetic individuals, cheerleaders, and team players. I want someone that is truly passionate about patient care. It can be difficult to know if new team members have all of these qualities and align with the core values, mission, and vision of the organization. Through the first 30 or so days I am intentional about looking to see if they embody the values that the organization believes in. They may not necessarily have all of the skills that I require. It’s more of can they model my heart for patient care.

GDN: What systems or technologies have been most instrumental in supporting your growth and operations?

Dr. Nickleberry: Getting my systems and training material recorded in small digestible doses has been instrumental in standardizing my locations. Now with AI I can update these faster and streamline them even more when needed. Getting information in a format that can be easily disseminated has done wonders for allowing the organization to take team members from where they are and get them to where we need them to be to facilitate delivering dentistry at a high level.

GDN: How has your role evolved as the group has expanded, and what does a typical day look like for you now?

Dr. Nickleberry: I spend less time sitting in the chair these days.  I have 2 days a week where I am chairside and that is typically all I do that day. The other 3 days are spent looking at key metrics, analyzing how we can influence them to continue moving in the right direction, developing the strategies around that as well as training modules for the team. I also spend a great deal of time from office to office supporting relationship building with our patients.

One of the components I am enjoying more and more is walking alongside my doctors with their treatment to get the best clinical outcomes. It is a fascinating and rewarding thing to watch them utilize the tools I’ve given them to go from good to great. And of course, I spend time working on the next expansion opportunities. I guess the short of that is I am spending more time working on the business instead of actually in it. I’m not sure which is the most challenging of the two. I guess each component brings its own unique challenges as well as rewards.

GDN: How do you balance the clinical and business aspects of running a dental group?

Dr. Nickleberry: It has been easier to balance because I have a phenomenal leadership team that handles a lot of the intricate day to day business whether I am in or out of the chair. They have spent a great deal of time with me. They know my heart for service and the patient experience.

Most of the time they are able to execute that flawlessly. Everyone knows that when I have a clinical schedule that is what I am doing for the day. My patients deserve my undivided attention and they get it. My team and patients know that I am always in one of the offices working and I am very accessible so I think that alleviates the anxiety of not being able to get an answer when they are stuck or needing to speak to me about a treatment plan.

GDN: In what ways do you engage with and support your team to foster retention and growth?

Dr. Nickleberry: I won’t kid you. I think retention and staff is the worst I’ve seen in my career. I am intentional about getting into every office every week to check in with team members as well as connect. There are systems in place such as 30,60,90 days, 6 months, and annual evaluations that allow candid conversation about their experience here and work-life balance. It allows an opportunity to give them praise for a job well done as well as feedback on any needed areas of improvement. I also want to know what we as an organization can do to improve their experience working with us.

GDN: What advice would you give to other dentists who are considering expanding beyond a single location?

Dr. Nickleberry: My advice would be to make sure you have systems for every single piece of your practice and the WHYs behind it. Then make sure those systems are recorded in a format that can be used to train teams that you may not be sitting next to.

Also make sure you know your own WHY and what you want your brand to represent. That becomes really important when you start thinking about expansion. You want to be sure of your purpose and mission and to be able to duplicate that in every location. I also encourage sorting out upfront what your goals and your future exit will look like. It will help navigate the ship while you are expanding.

GDN: Looking ahead, what’s next for your group—any plans for further expansion or new service offerings?

Dr. Nickleberry: I do have hopes of adding additional locations. I have my eye on a few other communities that I would really like to be a part of what’s happening in them. I have also become laser focused on increasing same store growth. I aim to do that by making sure my providers are highly trained, very proficient and efficient in all phases of dentistry. Beyond their clinical skills I am actively creating space in the brand to bring on different specialists to ensure that our patients are being treated comprehensively with little to no need for referral.

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