What a 3,000–8,000 sf dental or medical practice in DFW actually costs to build right now — and the three drivers that move that number most. Includes a real value-engineering example from KVC Pediatric Dentistry.
All cost figures are directional planning ranges, researched May 2026, subject to final preconstruction review. Pereff is not a lender. [DFW cost benchmarks, 2026; DFW medical/dental vertical knowledge base, 2026].
Every week we get the same question: 'What's a realistic number for my dental office in Plano?' The answer is always a range — the drivers that push a medical build up or down are real and project-specific.
The headline range
Medical and dental tenant improvements in the DFW suburbs run roughly $175–$450 per square foot for construction, directional. The wide range is honest: a basic primary-care practice is very different from an oral surgery suite with cone-beam CT. The worked examples are more useful than the full range:
$175–$225/SF
Basic dental TI (3–4 ops, no imaging room), directional, May 2026 [DFW cost benchmarks, 2026]
$225–$300/SF
Mid-complexity dental (4–6 ops, one pan/perio X-ray room), directional, May 2026 [DFW cost benchmarks, 2026]
$300–$450/SF
Specialty dental or medical with imaging suite (CT, cone-beam), directional, May 2026 [DFW cost benchmarks, 2026]
For a 5,000 sf dental practice in Plano at mid-complexity, the all-in construction budget commonly runs $1.0M–$1.4M. That figure should guide your feasibility thinking — not your contractor bid.
DFW commercial construction costs rose roughly 12–18% from 2023 to 2026, with growth slowing to ~3–4% in 2026. Lock material orders early — waiting costs money. [construction cost trend data, 2026]
Real example: KVC Pediatric Dentistry
KVC Pediatric Dentistry — Dr. Velasquez and Dr. Chen — needed a 3,000 sf pediatric dental office in Little Elm, Texas. The project came in at $423,000 — roughly $141/SF — achieved through true value engineering in the design-build process. The doctors had previously hired a dental consulting firm that was failing to produce a competitive priced architect or builder. Pereff replaced the consulting firm entirely at no charge, compressed the permit to 1 month against an 8-month city backlog, and delivered the project in 3 months.
The $141/SF figure for KVC is below the typical range because the scope was tightly defined at the design stage — no imaging room, modest operatory count, value-engineered casework. The point is not that this is a typical number; it is that true design-build can find the budget-meeting configuration before you sign a general contract, not after. [Pereff project data, KVC Pediatric Dentistry]
Three cost drivers that matter most
In every medical and dental project we've priced, three line items separate the low end of the range from the high end. Everything else is secondary.
1. Imaging and radiation shielding
Lead-lined rooms for X-ray, panoramic, or cone-beam CT are the single biggest cost driver in order of magnitude. Shielding isn't just a materials line — it involves structural coordination (sometimes floor-slab framing modifications), a separate radiation shielding report, and city plan review. A single shielded X-ray room can add $40K–$100K+ depending on the imaging modality and room size. If your plan includes CT, budget the higher end and get a shielding design early in design development. [DFW medical/dental vertical knowledge base, 2026]
2. Plumbing density (operatories)
Each operatory requires dedicated plumbing — water supply, vacuum lines, compressed air, and drain. A 6-operatory buildout has substantially more rough-in than a 3-op suite. The cost compounds further if your shell already has concrete-slab plumbing that doesn't match your layout, requiring saw-cutting. Count your operatories and confirm whether you're in a TI space with existing slab rough-in or a raw shell. [DFW medical/dental vertical knowledge base, 2026]
3. Sterile-environment HVAC
Medical and surgical spaces require dedicated HVAC zoning, higher air-change rates, and in some cases negative or positive pressure differentials. Standard office HVAC is not sufficient. Sterile-environment HVAC can cost two to three times a comparable square footage in standard office TI. For dental practices, this is usually the third-largest line item after imaging and plumbing. [DFW medical/dental vertical knowledge base, 2026]
What's not in the per-SF number
The per-SF figure covers hard construction costs. Three categories sit on top — together adding 25–45% to total project cost:
- Soft costs (design, permits, engineering, inspections, insurance) — typically 15–30% of hard costs.
- FF&E and equipment — dental chairs, imaging units, sterilizers, casework — often $200K–$400K for a mid-size practice, budgeted separately.
- Contingency — plan 8–12% on a new medical TI; more if renovating an occupied space or the shell has unknown conditions.
Most common budget mistake: planning for the construction number without FF&E, soft costs, and contingency. A project that looks feasible at $1.1M in hard costs can run $1.6M–$1.8M total.
The question Pereff asks first
Before we quote anything, five questions determine where a project lands in the range — and which design decisions will move it most:
- What type of practice? Clinical workflow drives room counts and MEP requirements.
- How many operatories or exam rooms? Each adds plumbing and air/vacuum infrastructure.
- What imaging? X-ray, panoramic, or cone-beam CT — each step up adds shielding cost.
- Ground-up shell or existing TI space? If TI, what's the slab condition?
- What's your target open date? A compressed schedule costs more — budget for it.
These answers let us give you a directional range within 10–15% of what preconstruction will confirm — a number you can take to the bank for feasibility, not a bid that surprises you later.
Want a project-specific directional range for your medical or dental buildout? Start a brief — no commitment, no fee. If we can't help, we'll tell you who can.
Want a project-specific take?
Every number in this post is directional and dated. A 30-minute preconstruction conversation with Pereff gives you a project-specific range you can actually use for budgeting, financing, and scheduling.