What is the IT onboarding checklist for a dental startup?

Key facts

Who is this checklist for?

It's written for the MSP or IT lead taking on a brand-new dental practice. The doctor-facing version is the dental office IT setup checklist. A startup is different from a takeover: there's no legacy mess, but there's also no history, no admin accounts and no one at the practice who knows what a VLAN is. Every decision you make in the first month becomes their default for a decade.

The order matters. Accounts created under your firm's name in week one are the ones a doctor fights to get back in year five, and drops missed before drywall cost far more to add later. Treat the five phases below as gates: don't start the next one until the current one is signed off by the practice owner.

Phase 1: Contract, BAA and scope

• Sign the BAA before touching anything. HHS lists IT contractors and managed service providers that support systems holding ePHI as business associates (HHS).
• Put ownership in the service agreement. Practice owns accounts, data and documentation; turnover on request (IT contract clauses).
• Define who does what. CISA tells MSP customers to make sure contracts "transparently identify ownership of ICT security roles and responsibilities" (CISA AA22-131A).
• Split project and recurring scope. Build-out work and monthly support are priced differently; see pricing IT for new builds.

Phase 2: Owner-held accounts

• Domain registered to the practice as registrant (ICANN).
• Microsoft 365 or Google Workspace tenant in the practice's name, with two emergency admin accounts not tied to any individual, at least one held by the owner (Microsoft Learn).
• PMS, imaging, backup, phone and camera accounts registered to the practice, billed to the practice.
• Vault set up and owned by the practice; your technicians get named access.
• Name the HIPAA security official at the practice. The rule requires one person with security responsibility (45 CFR 164.308).

Phase 3: Network and device plan (before framing)

• Pick the PMS and imaging software first. Hardware specs follow from them. Dentrix lists supported server OS versions from Windows Server 2016 to current, and notes Server 2016 extended support ends in January 2027 (Henry Schein One). Open Dental publishes its own requirements (Open Dental).
• Decide server vs. cloud (server vs. cloud).
• Check every device against the PMS. Sensors, pano, CBCT and scanners need supported drivers or bridges (sensor compatibility).
• Drop schedule per room, including spares (network drops per operatory).
• Rack location, power and cooling on the drawings, behind a locked door. HHS 405(d) says to keep network closets locked (HICP Technical Volume 1).
• Segment the network: clinical, imaging, phones, cameras, guest (network design).
• Order internet early, with a failover path (internet speed).

Phase 4: Security baseline

• No new Windows 10 machines. Microsoft ended Windows 10 support on October 14, 2025 (Microsoft), and Henry Schein One stopped supporting new Dentrix installs on Windows 10 after June 30, 2026 (Henry Schein One).
• Phishing-resistant MFA on email, remote access and admin accounts (CISA).
• No RDP exposed to the internet (CISA).
• Change every default admin username and password on the firewall, switches, NVR, printers and access points (CISA).
• Firewall with current support and IPS. See choosing a firewall for a dental office.
• Offline, off-site, encrypted backups, which HHS 405(d) says practices should require of an MSP (HICP Technical Volume 1; backup guide).
• Risk analysis documented with the practice (45 CFR 164.308; HIPAA IT checklist).

Phase 5: Go-live tests and handover

• Imaging test in every operatory: capture and open from another room.
• Restore test: restore a file and the PMS database.
• Failover test: pull the primary internet; confirm PMS, phones and card terminals.
• Power test: UPS carries the rack long enough to shut down cleanly.
• Documentation delivered: asset inventory, network map, credential register (how to document a dental client's network).
• Owner logs in to each critical system with their own account while you watch.

Which free tools help with this?

The network & IT plan generator (free tool, coming soon) is planned to turn a floor plan into a network, drop and rack plan. The credential ownership checklist (free tool, coming soon) is planned to list every login, license and account the practice should own, with a "password hostage" letter template. The device compatibility checker (free tool, coming soon) is planned to check sensors, imaging units and bridges against your practice software. FloorStack Studio (live, free plan) places every device on your floor plan and gives you a device schedule with rooms, ports and cable lengths (FloorStack FAQ).

How FloorStack helps

FloorStack is a dental build-out platform that gives the MSP and the doctor one shared plan. Studio (live, free to start) turns a floor plan into a device schedule, drop map and rack layout the low-voltage contractor can price (FloorStack). The free Network & IT plan generator (coming soon) will draft Phase 3 from the floor plan, the free Credential ownership checklist (coming soon) covers Phase 2, and the free Device compatibility checker (coming soon) will check sensors and imaging against the chosen PMS. After opening, the practice's vault lets the owner grant or revoke your access with every view logged (FloorStack). Visit the Dental Office IT Setup hub.

Free tools for this step

• Network & IT plan generator: drops, rack and segments from the floor plan (free tool, coming soon).
• Credential ownership checklist: owner-held accounts audit (free tool, coming soon).
• Device compatibility checker: sensors and imaging vs. PMS (free tool, coming soon).
• Studio: device schedule and drop map (live).