Effective Date: April 16th, 2026
This Notice explains how your health information may be used and disclosed and how you may access this information. Please read it carefully.
Dental Therapy is committed to protecting your privacy. We are required by federal law (HIPAA) and by applicable Arizona State laws to safeguard the confidentiality and security of your Protected Health Information (PHI), provide this Notice describing our legal duties and privacy practices, and inform you if a breach occurs involving your unsecured PHI.
We are obligated to follow the terms of this Notice while it remains in effect. We may modify or update this Notice as permitted by law. If changes are made, the revised version will be available in our office, and copies will be provided upon request.
How We May Use and Disclose Your Health Information
We may use or disclose your PHI for the following purposes:
- Treatment
We may use or share your PHI to provide, coordinate, or manage your dental care. This includes communication with specialists, dental laboratories, pharmacies, or other healthcare providers involved in treating you.
- Payment
Your PHI may be used for billing and payment‑related tasks, including:
- Submitting insurance claims
- Eligibility verification
- Claims processing
- Collections activities
- Healthcare Operations
We may use your information to support the routine operations of our practice, including:
- Quality assessment and improvement
- Credentialing and staff training
- Licensing, audits, and compliance activities
- Internal administration
Other Uses and Disclosures Permitted or Required by Law
Individuals Involved in Your Care
Information may be shared with family members or others involved in your care as allowed by law or as authorized by you.
Disaster Relief
PHI may be disclosed to assist with disaster or emergency response efforts.
Public Health and Safety
We may disclose PHI to public health authorities for purposes such as:
- Preventing or controlling disease
- Reporting abuse or neglect
- Reporting adverse events or product defects
- Exposure notifications
Law Enforcement
PHI may be disclosed for law enforcement purposes when required by HIPAA or Arizona law.
Health Oversight
We may disclose PHI to oversight agencies for audits, inspections, or investigations.
Judicial or Administrative Proceedings
We may disclose PHI in response to court orders, subpoenas, or authorized requests.
Research
Limited PHI may be shared for approved research studies with appropriate privacy safeguards.
Coroners, Medical Examiners, and Funeral Directors
Your information may be provided to assist such professionals in carrying out their duties.
National Security & Military
PHI may be disclosed to authorized federal officials or military authorities when lawfully required.
Fundraising
We may contact you regarding practice‑related fundraising activities. You may opt out at any time.
Uses Requiring Written Authorization
Certain uses of PHI require your written permission, including:
- Psychotherapy notes (if applicable)
- Certain marketing communications
- Sale of PHI
You may revoke your authorization at any time in writing.
Your Rights Regarding Your Health Information
- Right to Access
You may request to view or obtain copies of your PHI. Electronic copies are available when feasible. Reasonable, cost‑based fees may apply.
- Right to Request Restrictions
You may ask us to limit how your PHI is used or disclosed.
We are not required to agree, except when you pay for a service fully out‑of‑pocket and request that we not share that information with your insurer.
- Right to Confidential Communications
You may request communications through alternative addresses, phone numbers, or methods.
- Right to Amend
If you believe your PHI is incomplete or incorrect, you may request an amendment. If denied, we will provide a written explanation.
- Right to Accounting of Disclosures
You may request a list of certain disclosures made during the past six years, excluding those related to treatment, payment, operations, and other legally exempt categories.
- Right to Notification of Breach
We will notify you in writing if a breach occurs involving your unsecured PHI.
- Right to Paper Copy
You may request a paper copy of this Notice at any time.
State‑Specific Information: Arizona
Arizona generally follows federal HIPAA standards but provides additional protections for certain types of sensitive health information, including:
- HIV/AIDS‑related information
- Communicable disease information
- Mental health records
- Substance use treatment information
- Genetic testing information
When Arizona law requires stricter confidentiality standards, Dental Therapy will comply with the stricter rule.
Questions, Requests, or Complaints
If you have questions, want to exercise your privacy rights, or wish to file a complaint, please contact:
Dental Therapy – Privacy Officer
1150 E Glendale Ave, Phoenix, AZ 85020, United States
Phone: 602-944-4123
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
We will not retaliate against you for filing a complaint.