Privacy Policy

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date

February 17, 2026

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’ve 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

Important SUD (Part 2) Notice:
To the extent that we have any substance use disorder (SUD) patient records that are 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.

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) 571-0222

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.

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.

Examples: 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.

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 (for example, 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 for certain situations such as:

• Preventing disease

• Reporting suspected abuse, neglect, or domestic violence

• 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’re 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

• 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’ll 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’ve 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 our website.