Deciding how to choose a dental accountant starts with the work your new practice needs before opening and every month afterward. Give candidates the same brief, verify relevant credentials, ask them to demonstrate their reporting process, and compare written responsibilities and total fees before signing an engagement.
A tax-return preparer, a bookkeeper, and an adviser who helps manage business decisions may perform different jobs. One firm can provide several services, but its dental focus or monthly price does not establish which ones are included.
Give each candidate the same practice brief
Prepare a one-page description of the planned location, owners, opening window, number of employees, funding arrangements, and whether this is a startup or acquisition. Describe any existing legal entity and decisions still awaiting advice. Share preliminary financial assumptions through an appropriate channel, without patient records or unnecessary personal identifiers.
List the specific work you need in three periods:
- Before opening: Accounting setup, opening balances, funding records, payroll coordination, and tax-deadline planning.
- During the first year: Regular bookkeeping or review, reconciliations, financial reports, tax estimates, and owner meetings.
- When something changes: A delayed opening, lender request, hiring decision, equipment purchase, ownership change, or notice from a tax agency.
Connect this scope to the startup cost checklist. Professional-service fees belong in the budget along with any software, payroll, implementation, and cleanup charges the candidate requires.
Verify the person who will do and review the work
Ask for the engagement leader's name, credentials, licensing jurisdiction, and role. Confirm the credential through the issuing authority and discuss who prepares routine work, who reviews it, and who answers your questions during busy periods.
The IRS distinguishes state-board-licensed CPAs from IRS-licensed enrolled agents and describes their representation rights. Those credentials answer professional-authority questions; they do not prove that a person has supported a dental startup or provides monthly management reporting. IRS guide to tax preparer credentials and qualifications
Ask about practices similar to your intended model. Useful evidence includes an explanation of the opening process, an anonymized sample report, and references offered with the clients' permission. Do not request another practice's identifiable financial information.
Have the candidate describe a difficult handoff in general terms: incomplete books, a late lender request, or conflicting figures between systems. Listen for how they identify the source, resolve the difference, and document the correction. A clear process is more useful than a claim that they “know dentistry.”
Use the interview to test practical fit
These questions make candidates discuss the work behind their proposals:
| Ask the candidate | Look for in the answer |
|---|---|
| How will you set up our books before the first patient? | A sequence, required inputs, owners, and an opening review |
| How do you compare practice-system receipts with bank deposits? | Defined sources, timing differences, adjustments, and reconciliation |
| What will I receive each month? | Named reports, preparation date, review meeting, and open-item list |
| How do you help an owner understand cash versus profit? | A plain explanation using the owner's actual decision |
| Who handles payroll questions and tax notices? | Named responsibilities, response route, and limits of the engagement |
| What happens if our opening is delayed? | Revised deliverables, deadlines, and any additional fees |
Ask for a sample monthly packet and walk through it together. It might include a profit-and-loss statement, balance sheet, reconciliations, and a concise explanation of unresolved or unusual items. Agree on what is actually included rather than assuming every packet contains the same reports.
Discuss whether the adviser will help prepare or review a 13-week cash forecast. Forecast support can require different inputs and work from preparing historical accounts. Clarify whether meetings include decision support or only a review of completed statements.
Set responsibilities across the adviser team
Create a responsibility list with a preparer, reviewer, due date, and completion evidence for each recurring task. Cover bank reconciliation, invoice entry, payroll inputs, tax deposits and filings, owner payments, and responses to agency notices.
For payroll, distinguish the accountant's role from the payroll provider's role. IRS guidance explains that using an ordinary payroll service provider does not remove the employer's federal tax responsibilities and recommends monitoring deposits. Ask how you will retain visibility into filing and payment evidence. IRS guidance on outsourcing payroll duties
Identify who coordinates with the attorney and lender. The business-structure discussion guide helps separate professional ownership rules, legal formation, and tax treatment. An accountant's tax recommendation should fit the lawful structure counsel confirms for your practice.
Avoid automatic authority to move money simply because the adviser prepares the books. Agree on which actions require owner approval and how approvals are recorded. Read-only access may meet a reporting need; payment or filing authority needs its own defined scope.
Compare complete first-year fees
Request one written price schedule covering setup, monthly services, business and owner returns, meetings, notices, cleanup, software, payroll coordination, extra employees or entities, and work outside scope. Ask what events allow a fee change and how additional work is approved.
Consider two hypothetical proposals with the same assumed deliverables:
| First-year component | Candidate A | Candidate B |
|---|---|---|
| Monthly service | $600 × 12 = $7,200 | $850 × 12 = $10,200 |
| Setup | $900 | $500 |
| Annual tax work | $2,400 | Included |
| Four quarterly meetings | $250 × 4 = $1,000 | Included |
| Total | $11,500 | $10,700 |
Under these fictional assumptions, B costs $800 less in the first year despite the higher monthly fee. These are not market prices. The comparison works only if return scope, meeting length, reporting, and other conditions truly match. Add any excluded work to both proposals before deciding.
Make security and the exit process concrete
Ask how the firm receives files, protects accounts, grants staff access, and handles an incident. The IRS states that professional tax preparers must create and enact security plans to protect client data. Ask the firm to explain its process without requesting sensitive security details. IRS guidance on protecting tax clients
Use individual accounts and appropriately limited permissions. Agree on secure document exchange, owner access to the accounting file, and who controls subscriptions. If patient-level information is requested, have the practice's privacy owner review the purpose, scope, and required arrangements before sharing it.
Finish by reading the engagement letter against the interview notes. Confirm deliverables, exclusions, deadlines, fees, approval rights, record access, termination terms, and the handoff of files. The right engagement gives you a named person, understandable financial information, and a clear next step when the business changes.
