Primary source: Ryan McCostlin, LinkedIn, November 5, 2026, 11:05 p.m. CT
On November 5, 2026, Ryan McCostlin posted that Tailwater Dental Partners has joined forces with Innovate 32, and he described the group as a $25 million business supporting 15 practices across multiple states. If you run dental revenue cycle, a DSO combination at that scale puts payer participation, fee schedules, and insurance verification on the table for every supported practice. The post disclosed neither a price nor a structure, and it did not say who bills.
McCostlin's figure, in the November 5 post, for the business Tailwater has become: 15 practices across multiple states, five years after a single practice in East Tennessee. That number is his. The deal price was not disclosed, and this article does not estimate one.
The post is timestamped 11:05 p.m. Central Time. He called Innovate 32 a Shore Capital-backed dental support organization, also based in Nashville. Healthcare DealHub logged the same combination on November 11 and restated his $25 million as revenue. The page showed the post as edited when this article was filed. What the edit changed is not in the text we have.
The post is a founder announcement. It is the primary account of the combination. There is no company press release in the sources for this event.
| Item | What the November 5 post states |
|---|---|
| The combination | Tailwater Dental Partners "has joined forces with Innovate 32, a Shore Capital-backed dental support organization also based in Nashville." |
| What he says Tailwater is | He founded it five years ago. It started with a single practice in East Tennessee. "Today, Tailwater has grown into a $25 million business supporting 15 practices across multiple states." The $25 million and the 15 are his figures. |
| Investors he named | The Nashton Company, "particularly Jay Davis and Caroline Murphy DiMatteo." He thanked them for five years of confidence, partnership, and friendship. |
| His next seat | "I've joined Innovate32 as Chief Strategy Officer, working alongside CEO Josh Johnson and the broader leadership team." He wrote that he has known Johnson since 2023. That line is a detail of this combination. |
| Left blank | Price, deal structure, closing date, Innovate 32's location count after the deal, and whether Nashton kept a stake. None of those is estimated here. The post does not name the other states. |
"I'm proud to share that Tailwater Dental Partners has joined forces with Innovate 32, a Shore Capital-backed dental support organization also based in Nashville. Five years ago, I founded Tailwater with a simple idea: build a dental group that puts people first, supports great dentists, and creates exceptional careers in dentistry. We started with a single practice in East Tennessee. Today, Tailwater has grown into a $25 million business supporting 15 practices across multiple states."
"I've joined Innovate32 as Chief Strategy Officer, working alongside CEO Josh Johnson and the broader leadership team. I've known Josh since 2023, and we share a conviction that great dental organizations are built by investing in great people and empowering dentists to do what they do best."
He thanked the team, the dentists who trusted Tailwater with their practices, and the Nashton investors. The chief strategy officer sentence tells you where the founder is going. It does not tell you what transferred.
tailwaterdental.com says Tailwater buys a majority stake in dental practices and then provides non-clinical management services: "Marketing, HR, IT, Accounting, and more." It tells doctors to "Choose your lab and insurance participation." The address on the site is 10 Burton Hills Blvd, Ste 400, Nashville, TN 37215.
Those sentences are how Tailwater has described itself. They are the revenue-cycle facts on the page. Insurance participation is a doctor-level choice, in Tailwater's own words. Accounting is a named service. Billing, credentialing, and insurance verification are not on that list. The November 5 post does not say any of those lines changed when the group joined forces with Innovate 32.
Healthcare DealHub, November 11, 2026, headlined the item "Tailwater Dental Partners joins forces with Innovate 32." The item says Tailwater was founded five years ago, supports 15 practices across multiple states, and is generating $25 million in revenue. Segment: Professional Services. The URL lists the buyer as undisclosed. Terms were not disclosed.
Read the $25 million once. McCostlin called Tailwater a $25 million business. DealHub called that revenue. The figure is the founder's. DealHub is the trade log, six days later, and it adds a segment label and an undisclosed buyer. It does not add a price.
On November 11, Innovate 32's own wire announced a partnership with Post Oak Dental, a single practice in Houston's Uptown. RevCycleAI already published that as a separate event: Innovate 32 partners with Post Oak, and the release does not say who bills. Dr. Chris Gowan keeps clinical direction. That wire has no price, no location count, and no practice count. It is not this combination. Tailwater's 15 practices do not include Post Oak, and this article does not add them together.
The same November 11 wire is where Innovate 32 describes itself as a Nashville-based, partner-driven dental services organization, names Josh Johnson as CEO, and says it is expanding across the Southeast, Midwest, and Texas, backed by Shore Capital. McCostlin independently called the platform Nashville-based and Shore Capital-backed. The Southeast, Midwest, and Texas line is the company's, from the other wire. It is not a list of Tailwater's states. His post says multiple states and names East Tennessee as the start.
If one DSO's supported practices move onto another's central services, the revenue-cycle work is the migration: payer participation, credentialing, fee schedules, billing, and insurance verification. These sources raise that question. They do not say the migration happened.
Tailwater has told doctors they choose their own insurance participation, and it has described its work as non-clinical management, with accounting on the list and billing off it. Innovate 32, on the Post Oak wire the same week, offers what that release calls essential management resources and leaves the billing owner unnamed. Set those two pages next to each other and the operating question is whose paper the 15 practices bill on after the combination. A centralized payer panel and a doctor-chosen panel are different workflows. The post does not pick one.
Scale is the other blank that matters. Fifteen is Tailwater's supported-practice count, from the founder. Innovate 32's location count after the deal was not disclosed, so this article does not print a combined count. Shore Capital is the backer McCostlin names for Innovate 32. The post gives Shore no check size for this combination, and DealHub's URL lists the buyer as undisclosed. Nashton is the investor he thanks. Whether Nashton kept a stake is one of the blanks.
Price, structure, and a closing date sit in the same blank. A $25 million business is a founder's description of revenue scale. It is the number you can take to a staff meeting as his. It is not consideration, and it is not a multiple.
Tailwater's founder says the Nashville group has joined forces with Shore Capital-backed Innovate 32: 15 practices, and a $25 million business by his count. Price, structure, and the billing owner were not disclosed. The revenue-cycle item still open is whether those practices keep doctor-chosen insurance participation or move onto one platform fee schedule and one verification workflow.
Read November 5 as the founder's account and November 11 as the trade log of one combination. Fifteen practices across multiple states, a $25 million business in his words, Shore Capital named behind Innovate 32, Nashton named behind Tailwater. He is joining Innovate 32 as chief strategy officer alongside Josh Johnson. DealHub lists the buyer as undisclosed and prints no terms. Price, structure, closing date, the post-deal location count, and any retained Nashton stake were not disclosed.
If you run revenue cycle for a dental group, the fact is a 15-practice support organization joining a Nashville DSO that already put another partnership on the wire this week. Our read is that the work in front of you, if the practices share one administrative platform, is payer participation, credentialing, fee schedules, and insurance verification. Tailwater's site still says doctors choose their plans, and it still lists accounting rather than billing. The documents do not say that choice moved. Leave the price blank. Post Oak is the other Innovate 32 page from this week, and it leaves the same billing line empty.
Who keeps payer participation, and who runs the verification queue.
Sources: Ryan McCostlin, LinkedIn, timestamped November 5, 2026, 11:05 p.m. CT (2026-11-06 05:05:55 UTC). The joined-forces sentence, the five-year founding, the single East Tennessee practice, the "$25 million business supporting 15 practices across multiple states," the Nashton thanks naming Jay Davis and Caroline Murphy DiMatteo, and the chief strategy officer sentence naming Josh Johnson and "since 2023" are his. "Innovate32" as one word appears in that chief strategy officer sentence. The post was marked edited as of November 12. LinkedIn mention spacing in the raw post is normalized in the quotations above. The employee and advisor thank-you list in the post is not repeated here. Healthcare DealHub, November 11, 2026, "Tailwater Dental Partners joins forces with Innovate 32": five years, 15 practices, "generating $25 million in revenue," segment Professional Services, buyer listed as undisclosed in the URL, terms not disclosed. The revenue label is DealHub's restatement of the founder's figure. tailwaterdental.com: majority stake, non-clinical services "Marketing, HR, IT, Accounting, and more," doctors "Choose your lab and insurance participation," address 10 Burton Hills Blvd, Ste 400, Nashville, TN 37215. Innovate 32's Nashville base, partner-driven description, CEO Josh Johnson, Southeast / Midwest / Texas expansion, and Shore Capital backing are also in the November 11, 2026 Business Wire on the separate Post Oak Dental partnership, covered at Innovate 32 partners with Post Oak. That partnership is a different event. Price, structure, closing date, post-deal location count, and any retained Nashton stake were not disclosed, and none is estimated. The RevCycleAI analysis section is our read.