HIPAA Notice of Privacy Practices
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 duties
Atlantic Smiles Dental LLC is required by law to maintain the privacy and security of your protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. We will not use or share your information other than as described here without your written permission, and you may revoke that permission in writing at any time.
How we may use and share your health information
Treatment
We use your health information to provide, coordinate and manage your dental care — for example to record findings and X-rays, to write a treatment plan, and to send a prescription or referral to another provider or dental laboratory.
Payment
We use and share your information to obtain payment for treatment — for example to verify benefits with your insurance carrier, to submit a claim, or to bill you or a responsible party.
Health care operations
We use information to run the practice — for example quality review, staff training, licensing and compliance audits, and arranging appointments.
Other permitted uses
- As required by law, including public health reporting, abuse or neglect reporting, and health oversight activities.
- To avert a serious threat to your health or safety or the health or safety of others.
- Judicial and administrative proceedings where a lawful order or subpoena is presented.
- Coroners, medical examiners and funeral directors, where the law allows.
- Organ and tissue donation organisations, where you are a donor.
- Business associates — vendors such as our billing service or the laboratory that makes your crown — who must protect your information under a written agreement.
- Appointment reminders and treatment alternatives: we may contact you by telephone, text message, email or post about your appointments and about treatment options we think may interest you.
Uses and disclosures not described in this notice — such as marketing, or the sale of your information — will be made only with your written authorisation. We do not sell your protected health information.
Your rights
- Get a copy of the health information we hold about you, in paper or electronic form. There may be a reasonable cost-based fee for copies.
- Ask us to correct information you believe is wrong or incomplete. We may say no, but we will tell you why in writing and explain how to have your statement added to your record.
- Ask us to limit what we use or share for treatment, payment and operations. We are not required to agree, except where the request relates to a service you have paid for in full yourself.
- Ask for confidential communication — for example that we contact you only by mobile phone or at a particular address.
- Get a list of the disclosures we have made of your information, other than for treatment, payment or health care operations.
- Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
- Choose someone to act for you — for example a health care proxy or a person with power of attorney.
Complaints
If you believe your privacy rights have been violated you may file a complaint with the practice by writing to the Privacy Officer at the address below, or with the US Department of Health and Human Services, Office for Civil Rights. You will not be penalised or denied treatment for filing a complaint.
- Privacy Officer, Atlantic Smiles Dental LLC, 741 S Atlantic Blvd, East Los Angeles, CA 90022
- Telephone: (323) 554-0072
- Email: atlantic@atlanticsmilesdental.net
- US Department of Health and Human Services, Office for Civil Rights — 200 Independence Avenue SW, Washington, DC 20201 · 1-877-696-6775 · hhs.gov/ocr/privacy
Changes to this notice
We may change this notice and make the new version apply to the information we already hold. The current version is always available at the front desk and on this page.
Effective date
Effective October 2026. This notice replaces all previous versions.