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Office Visit: Dr. Vijay Maheshwari

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Office Visit: Against the Current 

A rewarding but turbulent journey from associate to practice owner

by Kyle Patton, Editor
photography by Robin Lehrfeld-Subar

Dentists spend most of their working hours inside their own practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Dentaltown’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of how they practice.
Every year, Dentaltown asks clinicians to vote for their favorite products and services in the Townie Choice Awards, then publishes the results in our December issue. Out of all those who completed their ballots, we draw one at random to win a special prize: $1,000 and the chance to appear in an Office Visit cover profile.

This year’s winner is Dr. Vijay Maheshwari, who faced a wide range of obstacles and uncertainties when he took over a practice that focused heavily on Medicaid patients and molar endo treatments. In the first few months, he had to navigate a nightmare involving insurance credentialing. Following that, he learned to develop endodontic protocols while juggling the administrative nuances of a startup. Now, his Crown Point, Indiana, practice is on the upswing, and he’s settled into a groove.

In this exclusive Q&A, Maheshwari details the challenges he had to navigate in his first year— from flummoxed new hires to the maze of marketing, how he found his way by “rocking the boat” and much more.


Office Highlights
NAME:
Dr. Vijay Maheshwari

GRADUATED FROM:
Pacific Dental College (India); Howard University College of Dentistry

PRACTICE NAME:
Infuse Dental
Crown Point, Indiana

PRACTICE SIZE:
4,500 square feet; 7 ops

TEAM SIZE:
4
How did you get your start in dentistry?

From an early age, my parents instilled in me a deep appreciation for the health care field. My mom is a fitness aficionado while my dad is a physician, so maintaining an active lifestyle was a way of life growing up. I always envisioned a career that complemented this upbringing, and it came to fruition during adolescence when I had my teeth repositioned. This really sparked my interest in dental school.

During my two years of AEGD residency, I was fortunate to have great mentors like Drs. Gamble, Garcia and McIntosh at Howard University and Drs. Koday, Yurth and Eljack at the Northwest Dental Residency program. They helped shape and mold me into a general practitioner. Thanks to them, I can do routine work proficiently but also be comfortable enough to challenge myself in select cases. This has kept dentistry exciting and fresh for me.


You took over the practice in February 2023 from a retiring dentist who focused primarily on Medicaid and molar endo. What made this acquisition appealing to you?

After looking at a lot of practices in Chicago and the surrounding area, this practice was the one I could see myself working in each day. The location was in a professional building at an intersection of the main thoroughfare in Northwest Indiana. There are approximately 45,000 vehicles per day that pass my building on that main road. I may not have the best signage (something I will be working on), but you must like where you work. Out of all the practices I saw, this was the one that appealed to me. The existing buildout and equipment appeared to be in better shape than a lot of the other practices I came across. Additionally, the price of this project (including purchase price and working capital) made me very comfortable with the risk level. A comparatively sized startup would have cost three times more. It didn’t have the type of patients I wanted (PPO and FFS), but it checked off all the other boxes to warrant the purchase.

Tell us about your insurance and credentialing nightmare—and how other dentists might avoid a similar fiasco.

When I finally got the keys to the practice, the first thing I did was contact both the state insurance and private insurance credentialing. Private insurance was going to take some time negotiating fees, so in the meantime, I was essentially going to be out of network or continue seeing state insurance patients. The previous doctor said I could use his credentials to bill for treatments— but after reaching out to a state insurance liaison, she informed me that it was insurance fraud and that I needed to get credentialed. While that was going on, I could still see those patients and I would get paid retroactively. So, I ended up providing around $100,000 worth of treatment over the next few months.

When I finally got credentialed, I was informed that the major state insurance company is a closed-loop company where they don’t retro pay. They wanted me to write off all that treatment I did as a charity. I was not pleased. I ended up reaching out to another state organization that lobbied on my behalf to where I was able to get paid on most of those claims, but it left a really bad taste in my mouth. Thankfully I budgeted accordingly and was able to make it work, but that took almost six months to resolve. What a mess.


What specific changes would you have made sooner?

People have this tendency to not want to rock the boat too much. You want to continue what the previous owner did and maintain at minimum a level of practice that they did—aka the goodwill—that was purchased. But if something wasn’t working before, don’t be afraid to change it up radically. Looking back, it wouldn’t have been a bad idea to close the office for a few months, do some more work as a locum, wait until I got set up properly with insurance, found the right team members and then opened the office to a strong start. The income from those first few months was so inconsequential that if I had closed my office, it wouldn’t have affected me at all. I should have rocked the boat.


Now that you’ve had over a year as an owner, what have been the biggest lessons learned?

Being a practice owner is hard but extremely fun. My enjoyment comes from the challenge of creating a successful business. This starts with team members who succeed in their roles. As they are empowered to provide a well-crafted experience to our patients, it allows me to autopilot through the clinical side of providing treatment—focusing more on patient interactions and developing those relationships.

I also enjoy the admin side of the business: creating systems, auditing them and tracking marketing as the practice continues to grow. For each action in your business, tracking its health through different metrics will help ensure that your practice is growing properly.


What growth strategies have you implemented?

As a startup, the first things we implemented were to lower the barriers, expand the services offered and lengthen hours of operation. This helped to create a buzz of activity as people realized where we were located and started to see us as a general dental office and not just a niche office. We continued the previous doctor’s state insurance plans to ensure that we would have patient activity while we were getting credentialed with private insurance plans. We expanded services to include fillings, extractions, crown and bridge, Invisalign, implants, hygiene, etc. We also expanded hours of operation from the previous two days a week to five days with consistent hours. One of the things that I can provide is availability and same-day services, and that has helped convert a lot of patients.
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You’ve created a streamlined system for handling molar endo cases. Share more about that.

The challenge to endodontics is trying to create a system that is repeatable, predictable and efficient no matter which tooth you work on. This process starts with the patient’s information and the preoperative radiograph. I try to restrict my root canals to patients who are 40 or younger. There are times when I may push past, such as if it’s a single canal. If there is a long-standing infection, the tooth will react and create some sort of obstruction in one of the canals.

Try to avoid cases where you have a deep split at the middle third because even with loupes, you may still have a difficult time navigating. As you build confidence, utilizing the hand files to create a glide path before switching over to rotary can help you navigate significantly curved cases. Keeping track that your rotary files do not exceed three times usage helps keep broken file situations to a minimum. Finally, don’t be afraid to refer when things get tricky, such as in cases of complicated anatomy, calcified canals or retreatment cases.

It’s also been very helpful to have a sister who is an endodontist and is willing to take my calls sometimes mid-procedure to evaluate the cases I am tackling and continuously critique my work. It has allowed me to grow and tackle second molar cases where unique anatomy may have otherwise caused me to refer them out.


What do you enjoy most about smile design cases?

During my residency at Northwest Dental Residency program, my mentor, Dr. Yurth, now the program director, was very into documenting your work through photographs. I was able to do some anterior esthetic work and got to document it as well. Seeing the before and after and how emotional patients got was very rewarding.

I wish patients could see how beautiful a Class II filling looks on a molar, but nobody cares about that. So, we do things that keep us engaged and excited. They impact my practice because while we may not be doing the best in photographs just yet, it helps to create an album of work where patients can see before and after photos in the smile gallery. This creates a level of trust.


You examine your marketing from a three-month perspective. How has this approach helped you gauge what works for your practice?

As a new practice owner, I really enjoy testing different advertising mediums. What works well for us is giving a particular medium three months to achieve full effect. This ensures accountability so I don’t quit an advertisement too soon, but it keeps me from spending money on something unsuccessful.

During those three months, I tracked the results of the first campaign to see how effective it was. Depending on the results, I may modify the message or keep it the same. Finally, for the last campaign, I may tweak it again. After those three months, I track the return on investment to see if it’s worth continuing further. This gives me time for leads to come to fruition but also ensures cost savings. A lot of these advertising companies want to lock you into a long-term commitment with lots of “savings” but it’s hard for me to commit to that type of money without a round of trial and error first.

So far, Google Ads has been by far the most effective way to get patients. We have tried additional methods such as print, social media and SEO to various degrees of success but Google Ads has been rock solid for us.


You implement tests during onboarding for new hires. Run us through an example.

One day while watching a clip of Bill Belichick, I saw how he would utilize tests to make sure players did their homework for the upcoming match. I figured I could create a similar concept for my new hires. At the time, we were looking for a front staff team member, so after introducing them to the practice, we gave them an insurance breakdown to work on one of our most high-maintenance patients who ironically enough also had the toughest breakdown. It is astounding to see people who say they have worked in dental offices for decades, who have spent countless hours doing insurance verifications, breakdowns, claims, etc., get flummoxed. Sometimes after spending a couple hours on this test, they’ll just quit and say this is the best they can accomplish.

After seeing how impactful the results were for the front, we implemented something similar in the back and, as a result, we have filtered through the weeds with more purpose than before.


What has been the best budget investment you’ve made (under $500)?

For anyone who is not confident in extractions, Luxator periotomes are a great instrument when it comes to extracting teeth. I use them on almost all my extractions. It takes some getting used to, but man … what fantastic instruments.


What’s the next big investment you plan on making and why?

For 2025, I want to get credentialed to provide sedation services. That is one aspect of my practice I do currently refer out and I think it would be a great skill set to have in my toolbox. Also, a lot of patients have high dental anxiety and anti-anxiety oral medication is sometimes not sufficient to calm their nerves.


Give us a snapshot of your life outside of practice.

Life outside of the practice is pretty simple. I spend time on myself by going for long runs and working out in the interim. During those times I like to listen to various podcasts which helps motivate me even further to strive for even more success. The rest is spending time with my family members and being engaged in the present. 
 
Dentaltown Magazine
September 2025
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