HIPAA Notice of Privacy Practices

Our responsibilities

We are required by law to maintain the privacy and security of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

How we may use and disclose your information

Treatment: we may use your information and share it with other professionals who are treating you, such as a specialist, dental laboratory or your physician.

Payment: we may use and share your information to bill and get payment from health plans, dental insurers or other entities.

Health care operations: we may use and share your information to run our practice, improve your care and contact you when necessary, including appointment reminders.

Other permitted uses: as required by law; for public health and safety; to comply with workers' compensation, law enforcement or other government requests; to respond to lawsuits and legal actions; and for health oversight activities.

Uses that require your written authorization

We will not use or share your information for marketing purposes or sell your information unless you give us written permission. You may revoke an authorization at any time in writing.

Your rights

Get a copy of your dental record: you can ask to see or get an electronic or paper copy of your record. We will provide it, usually within 30 days, and may charge a reasonable cost-based fee.

Ask us to correct your record if you think it is incorrect or incomplete.

Request confidential communications, such as contacting you at a different phone number or address.

Ask us to limit what we use or share. If you pay for a service out-of-pocket in full, you can ask us not to share that information with your health insurer.

Get a list of those with whom we have shared your information, an accounting of disclosures for up to six years prior.

Get a paper copy of this notice at any time, and choose someone to act for you, such as a legal guardian.

Website, forms and AI concierge

Our website AI assistant is designed for general questions and scheduling help only. Please do not share detailed health history, insurance member IDs or other sensitive identifiers in the chat. Appointment requests submitted through our secure Jotform forms are handled under this notice.

File a complaint

If you feel we have violated your rights, you can complain to our Privacy Officer by calling any office, or file a complaint 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.