Notice of Privacy Practices

Effective date: February 17, 2026 · Village Dental — Olde Raleigh, North Raleigh, Brier Creek and Wake Forest.

Your Information. Your Rights. Our Responsibilities.

Your rights. When it comes to your health information, you have certain rights. You have the right to:

• Get a copy of your paper or electronic dental record
• Correct your paper or electronic dental record
• Request confidential communications (how and where we contact you)
• Ask us to limit the information we share
• Get a list (accounting) of certain disclosures we have made
• Get a copy of this privacy notice
• Choose someone to act for you (power of attorney, legal guardian, etc.)
• File a complaint if you believe your privacy rights have been violated

Your choices. You have some choices in the way that we use and share information as we:

• Communicate with family and friends involved in your care
• Contact you with appointment reminders
• Tell you about treatment options or services that may benefit you
• Conduct fundraising communications (if applicable)
• Use your information for marketing — we need your written permission in most cases

Our uses and disclosures. We may use and share your health information as we:

• Treat you
• Run our practice
• Bill for your services
• Help with public health and safety issues
• Comply with the law
• Respond to lawsuits and legal actions
• Address workers’ compensation, law enforcement, and certain government requests

Substance use disorder (42 CFR Part 2) notice. To the extent that we have any substance use disorder (SUD) patient records protected by 42 CFR Part 2, we will not use or disclose that information for civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your written consent or (2) a court order and a subpoena, as required by law.

I. Who This Notice Applies To

This Notice describes the privacy practices of Village Dental (“we,” “us,” or “our”). It applies to the dental services we provide and the records we maintain about you in our practice, at all of our offices.

II. How to Contact Us — Privacy Official

If you have questions about this Notice or want to exercise your rights, contact our Privacy Official:

Village Dental — Privacy Official
3101 Edwards Mill Road #103
Raleigh, NC 27612
(919) 914-9607

III. Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of the Notice currently in effect
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information

We will not use or share your information other than as described in this Notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time — let us know in writing if you change your mind.

IV. How We Typically Use or Share Your Health Information

1) Treat you. We can use your health information and share it with other professionals who are treating you. For example, we share x-rays or clinical notes with a specialist you are referred to.

2) Run our practice. We can use and share your health information to run our practice, improve your care, and contact you when necessary — quality improvement, training, care coordination, internal audits, legal compliance and business operations.

3) Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. For example, we submit information to your dental plan so it can pay for your treatment.

V. Appointment Reminders and Practice Communications

We may contact you to remind you about appointments or follow-up care. We may contact you by phone, voicemail, text message, email or mail unless you tell us you prefer another method.

VI. How Else We Can Use or Share Your Health Information

We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and safety. We must meet conditions in the law before we can share your information for these purposes.

Public health and safety. We can share health information about you in certain situations, such as preventing disease, reporting suspected abuse, neglect or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.

Comply with the law. We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Law enforcement and government requests. We may disclose health information as permitted by law for law enforcement purposes, health oversight activities, national security and protective services, and workers’ compensation claims.

Lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena or lawful process as permitted by law.

VII. Uses and Disclosures That Require Your Written Authorization

We will obtain your written permission (authorization) before using or disclosing your information for purposes not described in this Notice, unless otherwise permitted or required by law. In particular, we generally need your written authorization for:

• Most marketing communications not otherwise permitted by HIPAA
• Sale of protected health information (PHI)
• Most sharing of psychotherapy notes, if applicable

You may revoke your authorization at any time in writing, except to the extent we have already acted in reliance on it.

VIII. Your Rights in Detail

Get a copy of your medical/dental record. You can ask to see or get an electronic or paper copy of your dental record and other health information we have about you — ask us how to do this. We will provide a copy or a summary, usually within 30 days. We may charge a reasonable, cost-based fee.

Ask us to correct your record. You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we will tell you why in writing within 60 days.

Request confidential communications. You can ask us to contact you in a specific way (for example, only by cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment or operations. We are not required to agree, and we may say “no” if it could affect your care. If you pay out-of-pocket in full for a service, you can ask us not to share that information with your health insurer for payment or our operations — we will say “yes” unless a law requires us to share it.

Get a list of those with whom we have shared information. You can ask for a list (accounting) of certain disclosures of your health information for six years prior to the date you ask, who we shared it with, and why. We will provide one accounting per 12 months for free; we may charge a reasonable, cost-based fee for additional requests.

Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide you a copy promptly.

Choose someone to act for you. If someone has legal authority to act for you (legal guardian, medical power of attorney), that person can exercise your rights and make choices about your health information. We will verify authority before taking action.

IX. Special Protections for Certain Types of Information

Certain federal and state laws may provide additional protections for sensitive health information — for example, certain mental health information, genetic information, or substance use disorder records. If additional protections apply, we will follow the more stringent requirements.

X. File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information above. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). We will not retaliate against you for filing a complaint.

XI. Changes to This Notice

We can change the terms of this Notice, and the changes will apply to all information we have about you. The updated Notice will be available upon request, in our office, and on this website.

XII. Website Privacy

This section covers information collected through villagedentalraleigh.com. It is separate from the HIPAA notice above, which governs the dental records we keep about you as a patient.

What we collect. When you use this site we may collect the information you enter into a form (name, phone number, email address, preferred office and anything you write in a message field), and basic technical information your browser sends automatically — IP address, device and browser type, the pages you visit, and the site or ad that referred you.

Cookies and analytics. We use cookies and similar technologies to keep the site working, to measure how it is used, and to understand which marketing brings patients to us. This includes Google Analytics and Google Ads conversion measurement. You can block or delete cookies in your browser settings, and you can opt out of Google Analytics with the Google Analytics opt-out browser add-on. Blocking cookies may affect how parts of this site behave.

Calls and forms. Phone numbers shown on this site may be tracking numbers that route to the office you are calling. Calls may be recorded or transcribed for quality assurance and staff training, and appointment requests submitted through our online forms are delivered to the office you selected. We use these tools to answer you faster and to know which marketing is working — not to sell your information.

Advertising. We advertise on Google and on social platforms, and those platforms may use cookies to show our ads to people who have visited this site. We do not sell your personal information, and we do not use protected health information for advertising.

Third-party services. Some parts of this site are provided by third parties — online scheduling, patient forms, maps and video. Those services have their own privacy policies, and information you submit through them is handled under their terms as well as ours.

Children. This website is not directed at children under 13, and we do not knowingly collect personal information from children online. Parents and guardians provide the information we need for a child’s dental care.

Security. We use reasonable administrative, technical and physical safeguards to protect the information we hold. No method of transmission over the internet is completely secure, so please do not send detailed medical information through a website form or by email — call the office instead.

Questions about this site. Contact our Privacy Official at (919) 914-9607 or write to the address in Section II.