Context
Niche: dental network (4 clinics).
Region: Russia (home market) + US market entry.
Starting point: RU site worked stably, no US domain. Goal — within a year, reach organic visibility in Google US for local dentistry queries in a target state.
Strategy
Split architecture: RU-site serves the main business, a separate subdomain handles US-market with localized content and hreflang. Goal — not "Russian dentistry in the States" but full-fledged local SEO for the English-speaking audience.
What we did
1. Multilingual site architecture
Set up hreflang: ru-RU (primary), en-US (Florida targeting), x-default → RU. Unified canonical, eliminated duplicates.
2. Content localization, not translation
Wrote the English site from scratch for US medical UX: ADA certifications, insurance plans (PPO, HMO), separate landings for popular procedures (Invisalign, veneers, dental implants).
3. US Entity SEO
Registered Google Business Profile, BrightLocal directories, Healthgrades, Zocdoc, Yelp Business. Knowledge Graph for the brand built in 4 months.
4. Local link building
PR in local state media, school sponsorships, Chamber of Commerce mentions. 38 local backlinks in 8 months.
5. Dual review pipeline
Google + Healthgrades. 160 reviews on the US side in 6 months, average 4.8.
Results
| Metric | RU | US |
|---|---|---|
| Organic/mo | 9,800 | 3,700 |
| Total | 13,500/mo | |
| Top-10 keywords (local) | 140 | 62 |
| Google Business rating | 4.9 | 4.8 |
| Online inquiries/mo | ~280 | ~95 |
Timeline & budget
12 months. Team: senior SEO strategist (international), native US editor, technical specialist, local US outreach manager.
What was tough
First 3 months in the US Google didn't index much of the content — new domain in a YMYL niche. Fix: backlinks from authoritative medical sites via digital PR + sameAs for all professional accounts. Indexation sped up 4× after that.