Hawaii’s rules come from HRS chapter 448 and Board of Dentistry rules. Check the legislation tracker for pending changes.
1. CPOD status
Tier: Strict. Four layers apply. The proprietor clause: under HRS § 448-1, a person practices dentistry by owning, maintaining, or operating an office for the practice of dentistry. The licensee-side ban: § 448-14.5(a) provides that no licensed dentist may permit a person or entity other than a licensed dentist “to directly or indirectly own, direct, control, or interfere with” the licensee’s practice, subject to stated exceptions. The entity-side ban: § 448-15 prohibits a corporation from practicing dentistry, holding itself out as entitled to practice, “furnish[ing] dental services or dentists,” advertising that it owns a dental office or can furnish dental service, or soliciting dental patronage. Fines run 500 per offense, with each day treated as a separate offense. The Board rule: HAR § 16-79-4 separately provides that no unlicensed person may own, maintain, operate, manage, or conduct a place where dental operations are performed, subject to statutory exceptions. Section 448-3(a) also fines a manager or proprietor of a dental place who employs an unlicensed operator.2. Other professions
This page covers dentistry only. Medicine, optometry, veterinary practice, and other professions are governed by different statutes and boards, even within the same state. For medical-practice sources, use the MSO-PC Wiki.3. Professional entity forms
Permitted forms: professional corporations under HRS ch. 415A are expressly excepted from the § 448-15 corporate-practice ban, as are dental service corporations under HRS ch. 423 (nonprofit dental service plans). Hygienists and physicians: Section 448-14.5(a) permits only “a dentist licensed pursuant to this chapter” to own, direct, or control a dental practice. A hygienist, physician, or lay investor does not qualify. Also confirm before filing:- Naming rules, designator requirements, and any limits tied to licensed owners’ names; several states regulate dental trade names separately
- Board pre-approval or certificates, whether the dental board must act before (or after) the secretary of state will file
- Officer and director licensure, including states that restrict these roles as well as ownership to licensees
4. Fee structure
Hawaii disciplines fee splitting. Dividing or splitting fees for dental services “with any person for bringing or referring a patient” is a ground for suspension or revocation (§ 448-17(b)(5)), and § 448-17(b)(9) reaches professional association with a person or entity holding itself out contrary to the chapter. Section 448-15 provides an exception for corporations “furnishing information or clerical services which can be furnished by persons not licensed to practice dentistry,” with the dentist assuming full responsibility. That limited scope should inform both the service schedule and the fee. Verify the arrangement with counsel. For the MSA, test whether a percentage-of-collections fee is permitted under the state’s dental, fee-splitting, referral, tax, and contract rules. Several states expressly restrict revenue-linked dental management fees, and the Aspen Dental settlements imposed related party-specific terms. Flat and cost-plus formulas are not automatic safe harbors; the services, calculation, amount, control rights, and actual payments still matter. See Fee-splitting rules and Set the management fee.5. Noncompetes
No dental-specific noncompete statute was identified for this page. Verify current Hawaii law with counsel before including one. Federal noncompete policy changed substantially in 2025 and 2026. The FTC’s Non-Compete Rule was vacated, the agency dismissed its appeals in September 2025, and the rule was removed from 16 C.F.R. pt. 910 effective February 12, 2026. State law remains central. Dental enforcement resolutions in New York and California have also restricted noncompetes for the settling parties as a corporate-practice remedy. Verify the current rule, worker, agreement type, transaction context, effective date, and remedy in this state. See the legislation tracker.6. DSO-specific law and registration
Hawaii has no DSO registration statute, but § 448-14.5(b) lists what a licensed dentist may not permit a non-dentist to do: (1) direct or interfere with the licensee’s clinical judgment and competent practice; (2) select a course of treatment, procedures, materials, or the manner of treatment; (3) control patient records; or (4) prohibit or limit access to the office, facilities, and equipment needed to serve patients. The measure originated as H.B. 2301 (2008 Regular Session), but the exact Session Laws act number was not verified for this page. Section 448-16 adds a disclosure mechanism. On the board secretary’s written demand, anyone practicing dentistry must provide within 15 days the names of everyone practicing or assisting in the office and the authority under which the practice operates. See Register a DSO for states with filing regimes.7. Death and transition
Under HRS § 448-1, exemption (6), the executor or administrator of a dentist’s estate, or the legal guardian or authorized representative of an incapacitated dentist, may own and manage the practice to wind down, transfer, or sell it for up to one year from death or the declaration of incapacity. Licensed dentists must perform all other aspects of the practice of dentistry.8. Practical structuring notes
- Hawaii’s express support exception covers “information or clerical services” for which the dentist remains fully responsible. Draft the DSO’s service scope to that exception and the § 448-14.5(b) control list.
- Section 448-14.5(b)(4) makes access important. Default remedies, including a landlord lockout for unpaid fees, should not limit the dentist’s access to the office, facilities, or equipment needed to serve patients.
- Section 448-16 gives the board a 15-day disclosure mechanism. Structure the arrangement on the assumption that the board can review all participating people and entities.
- No 2023–2026 Hawaii DSO legislation was identified in this research; verify with counsel.
9. The standing checklist
- Confirmed the permitted entity form for dentistry in this state
- Confirmed whether dental board pre-approval or a certificate is required before filing
- Confirmed whether officers and directors must be licensed dentists
- Confirmed the management fee structure is lawful here, including any restriction on revenue-linked fees
- Clinical carve-out drafted against this state’s current statutory language, including any enumerated control prohibitions
- Transfer restriction and succession documents checked against this state’s death-transition window
- Noncompete provisions checked against current state law
- DSO foreign-qualified before it has employees here
- Any DSO registration, licensure, or disclosure obligation identified and calendared
- Trade-name and advertising-disclosure rules for dental practices checked
10. Sources and where to verify
For the cases and statutes referenced above, see DSO & dental case law and the 51-jurisdiction table. For enacted and pending legislation, see the dental legislation tracker.