HIPAA Notice of Privacy Practices
How we may use and disclose your protected health information, and your rights regarding that information.
Effective date: 2026.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our commitment to your privacy
American Dental Health Providers (“ADHP”, “we”, “us”) is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this notice of our legal duties and privacy practices with respect to PHI, and to notify affected individuals following a breach of unsecured PHI. We are required to abide by the terms of this notice while it is in effect.
How we may use and disclose your health information
We may use and disclose your PHI for the following purposes without your written authorization:
- Treatment. To provide, coordinate or manage your dental care and related services, including consulting with other treating providers, our in-house dental lab, oral surgeons and specialists involved in your care.
- Payment. To bill and collect payment for services, including verifying insurance eligibility and benefits, submitting claims, and coordinating with financing providers you have chosen.
- Health care operations. For activities such as quality assessment, staff training, licensing, and normal business operations of the practice.
- Appointment reminders and treatment options. To contact you about appointments or to tell you about treatment alternatives or health-related benefits and services that may interest you.
- As required by law. Including public health, health oversight, law enforcement, and in response to court orders or subpoenas.
Other uses and disclosures not described in this notice will be made only with your written authorization, which you may revoke at any time in writing.
Your rights regarding your health information
- Right to inspect and copy. You may request access to your dental records to inspect and request copies of them.
- Right to request amendment. You may ask us to amend health information you believe is incorrect or incomplete, for as long as we maintain it.
- Right to an accounting of disclosures. You may request a list of certain disclosures of your PHI we have made.
- Right to request restrictions. You may ask us to restrict certain uses or disclosures of your PHI; we are not required to agree, except in certain circumstances involving payment in full out-of-pocket.
- Right to request confidential communications. You may ask that we contact you at a specific location or by a specific method.
- Right to a paper copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be retaliated against for filing a complaint.
Changes to this notice
We reserve the right to change this notice and to make the revised notice effective for PHI we already maintain, as well as any information we receive in the future. The current notice is available at our offices and on this page.
Contact us
To exercise any of the rights described above, or if you have questions about this notice, contact our Privacy Officer at any of our office locations or call (562) 923-0038.
This notice describes our HIPAA privacy practices and is separate from our website Privacy Policy, which covers information submitted through this site rather than information created in the course of your dental care.