Notice of Privacy Practices

Effective Date: June 1, 2026

Our duty to protect your health information

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, and follow the terms of the notice currently in effect. We reserve the right to change the terms of this notice and make new provisions effective for all PHI we maintain. If we make a material change, we will make the revised notice available in our office and on our website.

How we may use and disclose your health information

We may use and disclose your health information for the following purposes without your written authorization:

• Treatment: To provide, coordinate, or manage your dental care. For example, sharing information with a specialist to whom we refer you, or with a dental laboratory fabricating a prosthesis.
• Payment: To bill and collect payment for your dental care. For example, submitting claims to your dental insurance plan, sending information to a collection agency, or contacting you about outstanding balances.
• Health Care Operations: To support our business activities, such as quality improvement, training, compliance reviews, audits, and general administrative functions.

We may also use or disclose your information without authorization for the following purposes as permitted or required by law:

• As required by federal, state, or local law.
• For public health activities, such as reporting communicable diseases.
• To report suspected abuse, neglect, or domestic violence.
• For health oversight activities by government agencies.
• In response to a court order, subpoena, or other lawful process.
• For law enforcement purposes, as specifically required or permitted by law.
• To coroners, funeral directors, and organ donation organizations.
• For certain research purposes, with appropriate protections.
• To prevent or lessen a serious and imminent threat to health or safety.
• For workers compensation as required by law.
• To the U.S. Department of Health and Human Services for compliance investigations.

All other uses and disclosures of your health information require your written authorization. You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on it.

Your rights regarding your health information

• Right to Access: You have the right to inspect and obtain a copy of your health information. Submit a written request to our Privacy Officer. We will respond within 30 days. A reasonable cost based fee may apply.
• Right to Request Amendment: You may request in writing that we amend information in your record that you believe is incorrect or incomplete. We will respond within 60 days. We may deny the request under certain circumstances and will provide a written explanation.
• Right to an Accounting of Disclosures: You have the right to receive a list of certain disclosures we have made of your health information for the prior six years (excluding disclosures for treatment, payment, operations, and certain other categories). Submit a written request to our Privacy Officer.
• Right to Request Restrictions: You may request restrictions on how we use or disclose your information for treatment, payment, or operations. We are not required to agree to most restrictions. However, we must agree to restrict disclosures to a health plan for services you have paid for in full out of pocket.
• Right to Confidential Communications: You may request that we communicate with you at a specific phone number, address, or by a specific method. We will accommodate reasonable requests.
• Right to a Paper Copy of This Notice: You have the right to receive a paper copy of this notice at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights. You may file a complaint at www.hhs.gov/ocr/complaints or by calling (800) 368-1019. You will not be penalized or retaliated against for filing a complaint.

Contact information

This Notice of Privacy Practices is provided pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Part 164, Subpart E. For our general website privacy policy, see our Privacy Policy.