David Janash, Founder & CEO of Underbite Dental, built a
13-location DSO from the ground up in one of the most brutally competitive markets in the country: New York City. He's made every expensive mistake in the book — and turned those mistakes into a data-driven operation that actually tells him what's going to happen before it does.

Key Revelations:

• Most DSO leaders are obsessing over last month's report — the operators winning right now are looking at next week

• Running multiple offices on different practice management softwares isn't flexibility — it's chaos disguised as convenience

• Special contracts, different hours, outlier comp plans — when things go wrong, you'll wish you'd standardized your DSO sooner

The Gap Between Intention and Actuality

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"Does my EBITDA look strong, but I still feel broke every month?"

Ken's answer: A few things hide from EBITDA that devour your cash — debt service, capital expenditures, and cash vs. accrual distortion. Strong EBITDA and empty pockets aren't a contradiction. They're a signal. Here's how to read it.

The "Ask Ken" Question:

Top 3 Episodes Of The Dental Truth Project. Listen Now!

(E.25) The PMS Data Gatekeeping Scandal in Dentistry: Jake Larsen & Clint Berry, Kolla
(E.20) Fake Codes, Hidden Fraud & The Accounting Nightmare: Paul Lowry, Dental Menu
(E.5) The DSO Valuation Crash No One Talks About: Gareth Petsch, pH Partners

David used to log into every single office manually, every single night, just to know how his business was doing. Then he spent hundreds of thousands of dollars building a custom data warehouse and hiring software engineers to solve the problem. He eventually scrapped all of it for a monthly software subscription that does it better.The lesson isn't just about wasted money — it's about what happens to your strategy when you're operating without real insight.

David coined it himself: "The map to that gap is your data"

Ask Ken

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