NOTICE OF PRIVACY PRACTICES
Notice of Privacy Practices Effective Date: 01/01/2026
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 LEGAL DUTY
We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice, and follow the terms of the Notice currently in effect.
HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
- For Treatment: We may use or disclose your health information to provide, coordinate, or manage your dental care (e.g., sharing information with specialists or labs).
- For Payment: We may use or disclose your information to obtain payment from insurance companies or other third parties.
- For Health Care Operations: We may use or disclose information for office operations such as quality assessment, staff training, licensing, and audits.
- As Required by Law: We may disclose your information when required to do so by federal, state, or local law.
- Public Health and Safety: We may disclose information to prevent or lessen a serious threat to health or safety or for public health activities.
- Business Associates: We may share information with third parties who perform services on our behalf (billing, IT support), who are required to protect your information.
YOUR RIGHTS
You have the right to:
- Get a copy of your dental and billing records
- Request corrections to your records
- Request confidential communications
- Ask us to limit what we use or share (we are not required to agree)
- Get a list of certain disclosures we’ve made
- Get a copy of this Notice at any time
- File a complaint if you believe your privacy rights have been violated
You will not be retaliated against for filing a complaint.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
Practice Privacy Officer:
- Name/Title: Kelly – Office Manager
- Phone: 713-598-0727
- Email: manager@thedsimplantcenter.com
- Or with the U.S. Department of Health and Human Services.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain. Updated Notices will be posted in our office and available upon request. Practice Address: 21911 Gosling Rd. Spring TX 77388
Acknowledgment of Receipt of Notice of Privacy Practices
I acknowledge that I have received a copy of The Dental Studio Notice of Privacy Practices.