HIPAA Notice of Privacy Practices

Effective Date: August 12, 2026

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Ablantis Dental is committed to protecting the privacy and confidentiality of your health information. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), along with other applicable federal and state privacy laws, establishes standards for how your protected health information may be used, disclosed, and safeguarded.

When you receive care from Ablantis Dental, we create and maintain records containing information about your dental health, treatment, services, and related healthcare matters. We may use or disclose this information as permitted or required by law for treatment, payment, healthcare operations, and other purposes described in this Notice.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your protected health information to provide, coordinate, or manage your dental care.

For example, we may share relevant information with dentists, physicians, specialists, dental laboratories, pharmacies, or other healthcare professionals involved in your care. This may include making referrals, coordinating treatment, ordering laboratory services, or issuing prescriptions.

Payment

We may use and disclose your health information as necessary to obtain payment for services provided to you.

For example, we may provide information to your dental or health insurance plan to determine eligibility or benefits, obtain authorization, submit claims, or receive reimbursement for treatment.

If you pay for a healthcare item or service in full out-of-pocket, you may request that we not disclose information regarding that item or service to your health plan for payment or healthcare operations, where required by law.

Healthcare Operations

We may use and disclose your health information for activities necessary to operate our dental practice and improve the quality of care we provide.

These activities may include:

Reviewing the quality and effectiveness of treatment and services;
Evaluating the performance of our dentists, team members, and other healthcare professionals;
Staff training and education;
Business planning and administrative activities;
Compliance, auditing, and quality-improvement activities; and
Working with professional advisors and business associates.

Other Permitted Uses and Disclosures

We may also use or disclose your protected health information under the following circumstances, as permitted or required by law:

Other Healthcare Providers: We may disclose information to dentists, physicians, specialists, nurses, dental laboratories, pharmacies, or other healthcare professionals involved in your treatment.
Health Plans: We may provide information to your dental or health insurance plan for claims processing, benefit determination, authorization, reimbursement, and other permitted payment activities.
Business Associates: We may disclose information to companies or individuals who perform services on our behalf, such as billing companies, technology providers, consultants, laboratories, or other vendors. Business associates that receive protected health information are generally required to appropriately safeguard that information.
Family Members and Others Involved in Your Care: With your permission, or when otherwise permitted by law, we may share relevant information with a family member, personal representative, caregiver, or another person involved in your healthcare or payment for your care.In an emergency or when you are unable to provide permission, we may disclose information when we determine that doing so is in your best interest and is permitted by law.
Treatment Alternatives and Health-Related Services: We may contact you regarding treatment alternatives, appointment information, or other health-related products or services that may be of interest to you, as permitted by law.
Coroners, Medical Examiners, and Funeral Directors: We may disclose health information when necessary to identify a deceased individual, determine a cause of death, perform legally authorized duties, or facilitate organ or tissue donation.
Military and Veterans Activities: If you are a member of the armed forces or a veteran, we may disclose health information as required by appropriate military authorities or other applicable laws.
Public Health Activities: We may disclose information to authorized public health agencies for purposes such as preventing or controlling disease, injury, or disability, or performing other legally authorized public health activities.
Health Oversight and Product Safety: We may disclose information to government agencies, including the U.S. Food and Drug Administration or other authorized agencies, for activities such as reporting adverse events, product defects, recalls, or safety concerns.
Workers’ Compensation: We may disclose health information as authorized or required by workers’ compensation laws or similar programs.
Legal and Administrative Proceedings: We may disclose your health information in response to a valid court order, administrative order, subpoena, discovery request, or other lawful process when permitted or required by law.
Law Enforcement: We may disclose information to law enforcement officials when authorized or required by law, including in response to certain court orders, warrants, subpoenas, or other legal requirements.
Preventing Serious Threats to Health or Safety: We may disclose health information when necessary to prevent or reduce a serious and imminent threat to your health or safety or the health or safety of another person, when permitted by law.
Fundraising: We may contact you regarding fundraising activities associated with our practice when permitted by law. You have the right to opt out of receiving fundraising communications.
Marketing and Sale of Protected Health Information: Certain uses or disclosures of your health information for marketing purposes, or disclosures that constitute a sale of protected health information, may require your written authorization.
Other Uses and Disclosures: For uses and disclosures not described in this Notice and not otherwise permitted or required by law, we will obtain your written authorization before using or disclosing your protected health information.

If you provide written authorization, you may generally revoke that authorization at any time by submitting a written request. Revocation will not affect disclosures already made in reliance on your authorization.

Required by Law: We may use or disclose your protected health information when required by federal, state, or local law. When another applicable law provides greater privacy protection than HIPAA, we will follow the more protective requirement when applicable.

Our Responsibilities

Ablantis Dental is required to:

Maintain the privacy and security of your protected health information.
Provide you with this Notice describing our legal duties and privacy practices.
Follow the terms of the Notice currently in effect.
Notify you following a breach of your unsecured protected health information when notification is required by law.
Notify you if we are unable to agree to certain privacy-related requests when required.
Accommodate reasonable requests concerning how we communicate health information with you when required by law.

Changes to This Notice

We reserve the right to change our privacy practices and the terms of this Notice as permitted by law.

Any revised Notice may apply to health information we already maintain as well as information we receive in the future.

The current version of this Notice will be available upon request and may also be made available through our website or office.

Your Privacy Rights

As a patient of Ablantis Dental, you have certain rights regarding your protected health information.

1. Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your protected health information for treatment, payment, or healthcare operations.

We are generally not required to agree to every requested restriction.

However, when required by law, we must agree to your request not to disclose information to a health plan for payment or healthcare operations when the information relates solely to a healthcare item or service that you, or someone on your behalf other than the health plan, paid for in full.

Requests for restrictions should be submitted in writing and should identify:

The information you want restricted;
Whether you want to restrict our use, disclosure, or both; and
The person or organization to whom the restriction should apply.

2. Right to Receive Breach Notification

You have the right to be notified following a breach of your unsecured protected health information when notification is required by applicable law.

3. Right to Request Confidential Communications

You may request that we communicate with you about your health information in a particular way or at a particular location.

For example, you may ask that we contact you only at a specific phone number or mailing address.

Reasonable requests will be accommodated as required by law.

4. Right to Access Your Health Information

You have the right to inspect and obtain a copy of protected health information maintained about you in a designated record set, subject to certain limitations permitted by law.

You may request records in paper or electronic form when available.

Reasonable fees may apply where permitted by law.

5. Right to Request an Amendment

If you believe information contained in your health record is incorrect or incomplete, you may request that we amend the information.

Your request should be submitted in writing and explain why you believe the information should be changed.

We may deny your request under circumstances permitted by law, including when we determine that the existing information is accurate and complete.

If your request is denied, you may have additional rights to submit a written statement of disagreement.

6. Right to an Accounting of Disclosures

You may request a list of certain disclosures we have made of your protected health information during the period permitted by law.

The accounting generally does not include disclosures made for treatment, payment, healthcare operations, disclosures authorized by you, or certain other disclosures excluded by law.

7. Right to a Paper Copy of This Notice

You have the right to request a paper copy of this Notice at any time, even if you previously received or agreed to receive it electronically.

Questions or Complaints

If you have questions about this Notice, our privacy practices, or believe your privacy rights may have been violated, please contact:

Ablantis Dental
351 Santa Fe Dr., Suite 110
Encinitas, CA 92024
Phone: 760-334-0128

You may also submit a complaint to the U.S. Department of Health and Human Services, Office for Civil Rights.

Ablantis Dental will not retaliate against you for filing a privacy complaint or exercising any of your rights under HIPAA.