HIPAA Notice of Privacy Practices
Effective date: September 3, 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.
This Notice of Privacy Practices applies to Cal Dental Group, its dental professionals, employees, staff, and other workforce members involved in providing and supporting care at the practice. It explains how we may use and disclose your protected health information (“PHI”), your rights regarding that information, and our legal responsibilities.
Your Rights
When it comes to your health information, you have certain rights. To exercise any of these rights, contact our Privacy Officer using the information below.
Get an electronic or paper copy of your record
- You may ask to inspect or receive an electronic or paper copy of your dental record and other health information we maintain about you.
- We generally will provide a copy or summary within the time required by law. We may charge a reasonable, cost-based fee where permitted.
Ask us to correct your record
- You may ask us to correct health information you believe is inaccurate or incomplete.
- We may deny the request in circumstances permitted by law, but we will explain the reason in writing within the legally required time.
Request confidential communications
You may ask us to contact you in a specific way, such as at a particular phone number, or to send mail to a different address. We will accommodate reasonable requests.
Ask us to limit what we use or share
- You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are not generally required to agree, but we will honor restrictions we accept except when disclosure is needed for emergency treatment or otherwise permitted by law.
- If you pay for a service or health care item completely out of pocket, you may ask us not to disclose information about that service or item to your health plan for payment or health care operations. We will agree unless disclosure is required by law.
Receive an accounting of disclosures
You may ask for a list of certain disclosures of your health information made during the six years before your request, including who received it and why. The accounting will not include disclosures for treatment, payment, or health care operations and certain other disclosures excluded by law. One accounting in a 12-month period is free; we may charge a reasonable, cost-based fee for additional requests.
Receive a copy of this notice
You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
Choose someone to act for you
If a person has legal authority to act as your personal representative, such as under a health care power of attorney or guardianship, that person may exercise your rights. We will verify that authority before taking action.
File a complaint
You may complain if you believe your privacy rights have been violated. Cal Dental Group will not retaliate against you for filing a complaint.
Your Choices
In certain situations, you may tell us your preferences about how we share your information, including sharing information with family members, close friends, or others involved in your care or payment for your care, and sharing information in a disaster-relief situation. If you cannot tell us your preference, we may share information when we believe it is in your best interest or when needed to lessen a serious and imminent threat to health or safety, as permitted by law.
We will obtain your written authorization before using or disclosing PHI for marketing when authorization is required, selling PHI, most uses and disclosures of psychotherapy notes if we maintain any, or other purposes not described in this notice. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
How We May Use and Disclose Health Information
Treatment
We may use your health information and share it with dentists, specialists, laboratories, pharmacies, or other professionals involved in your treatment. For example, we may share relevant information with a dental specialist to coordinate your care.
Payment
We may use and disclose your information to bill for services and obtain payment from you, a health or dental plan, or another responsible party. For example, we may provide treatment information to your dental benefit plan so it can process a claim.
Health care operations
We may use and disclose your information to operate the practice, improve care, train staff, conduct quality assessment, manage risk, perform audits, and carry out other health care operations permitted by law.
Business associates
We may share PHI with service providers that perform functions on our behalf when permitted by law. When required, we use written agreements that require those business associates to appropriately protect PHI.
Appointment reminders, treatment alternatives, and benefits
We may contact you with appointment reminders and information about treatment alternatives or health-related benefits and services that may interest you, as permitted by law.
Other uses and disclosures permitted or required by law
Subject to applicable legal conditions and safeguards, we may use or disclose PHI:
- For public health and safety activities, including disease prevention, product recalls, adverse-event reporting, and reports of suspected abuse, neglect, or domestic violence;
- To prevent or lessen a serious and imminent threat to health or safety;
- For health oversight activities authorized by law;
- For workers’ compensation claims;
- For certain law-enforcement purposes, judicial or administrative proceedings, court orders, or subpoenas;
- To coroners, medical examiners, or funeral directors when an individual dies;
- To organ-procurement organizations for donation and transplantation purposes;
- For research when all legal requirements have been met;
- For special government functions, including military, national-security, and presidential-protective-service activities; and
- When otherwise required by federal or state law, including disclosures to the U.S. Department of Health and Human Services to demonstrate compliance with federal privacy law.
Where California or another applicable law provides greater privacy protection than HIPAA, we will follow the stricter requirement.
To the extent we create or maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order accompanied by a subpoena, as required by law.
Our Responsibilities
- We are required by law to maintain the privacy and security of your PHI.
- We must provide you with this notice and follow the duties and privacy practices described in the notice currently in effect.
- We will notify affected individuals as required by law if a breach occurs that may have compromised the privacy or security of unsecured PHI.
- We will not use or disclose your information other than as described in this notice unless you authorize us in writing or the law permits or requires the use or disclosure.
Questions or Complaints
For questions, requests, or complaints, contact:
Privacy Officer
Cal Dental Group
936 Crenshaw Blvd., Suite 101
Los Angeles, CA 90019
Phone: 323-934-2804
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting the HHS health-information privacy complaint page, writing to 200 Independence Avenue SW, Washington, DC 20201, or calling 1-877-696-6775. Cal Dental Group will not retaliate against you for filing a complaint.
Changes to This Notice
We may change the terms of this notice, and the changes may apply to all PHI we maintain, including information created or received before the change. If we make a material change, the revised notice will be available upon request, at our office, and on this website.
Website Privacy
This HIPAA notice concerns health information handled by Cal Dental Group in its role as a health care provider. For information about data collected through this website, please review our Website Privacy Policy. Do not send sensitive medical or financial information through ordinary email or a general website contact form. Please call our office if you need to discuss confidential health information.