Notice of Privacy Practices

Our commitment

We are required by law to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices, notify you following a breach of unsecured PHI, and follow the terms of the notice currently in effect.

How we may use and disclose your health information

• Treatment — sharing information with specialists, dental labs or other providers involved in your care.
• Payment — billing you, your insurance company or a financing provider for services.
• Health care operations — quality reviews, training, scheduling and business management.
• Appointment reminders and information about treatment alternatives or health-related services.
• As required by law, for public health activities, health oversight, legal proceedings, law enforcement, or to avert a serious threat to health or safety.
• To family members or others involved in your care, unless you object.

Uses requiring your written authorization

Most uses for marketing, the sale of PHI, and other uses not described in this notice require your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Your rights

• Get an electronic or paper copy of your dental record.
• Ask us to correct your record if you believe it is incorrect or incomplete.
• Request confidential communications (for example, at a different phone number or address).
• Ask us to limit what we use or share. If you pay out-of-pocket in full, you may ask us not to share that information with your health plan.
• Get a list of those with whom we have shared your information (an accounting of disclosures).
• Get a paper copy of this notice at any time.
• Choose someone to act for you, such as a medical power of attorney or legal guardian.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on this website.