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HIPAA NOTICE OF PRIVACY PRACTICES

Effective Date: 02/27/2026

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

At Midtown Pediatric Dentistry, we are committed to protecting the privacy and security of your child’s health information. This HIPAA Notice of Privacy Practices explains how we may use, disclose, and protect your child’s protected health information (PHI), as well as your rights regarding this information.

This notice applies to all records created, received, or maintained by Midtown Pediatric Dentistry related to your child’s dental care, including examinations, treatments, consultations, and other services provided by our practice.

OUR RESPONSIBILITIES UNDER HIPAA

Midtown Pediatric Dentistry is required to:

  • Protect the privacy of your child’s protected health information.
  • Provide this notice explaining our privacy practices.
  • Follow the privacy practices described in this notice.
  • Notify you when a breach occurs that may compromise the privacy or security of your child’s health information.
  • Use or disclose health information only as permitted by law or with your written authorization.

HOW WE MAY USE AND DISCLOSE YOUR CHILD’S HEALTH INFORMATION

We may use and disclose your child’s protected health information for treatment, payment, healthcare operations, and other purposes allowed by law.

TREATMENT, PAYMENT, AND HEALTHCARE OPERATIONS

Treatment

We may use and share your child’s health information to provide dental care, coordinate treatment, and communicate with other healthcare professionals involved in your child’s care when necessary.

Examples may include reviewing dental history, planning treatment, providing dental procedures, and coordinating referrals.

Payment

We may use and disclose health information to process payments, submit insurance claims, verify insurance benefits, and communicate with insurance companies or other parties responsible for payment.

Healthcare Operations

We may use health information for activities necessary to operate our dental practice, including:

  • Quality improvement activities.
  • Staff training.
  • Appointment scheduling.
  • Practice management.
  • Compliance reviews.
  • Administrative functions.

COMMUNICATIONS WITH PARENTS AND LEGAL GUARDIANS

Because Midtown Pediatric Dentistry provides care for children, we may communicate with parents, legal guardians, or individuals authorized to make healthcare decisions regarding your child.

We may discuss information related to:

  • Dental appointments.
  • Treatment recommendations.
  • Dental records.
  • Care instructions.
  • Follow-up information.

If you would like another person to receive information about your child’s dental care, written authorization may be required.

APPOINTMENT REMINDERS AND HEALTHCARE COMMUNICATIONS

We may contact you using the phone number, email address, or other contact information provided to our office.

Communications may include:

  • Appointment reminders.
  • Scheduling information.
  • Treatment follow-ups.
  • Practice updates.
  • Information related to your child’s dental care.

We may communicate through phone calls, voicemail, text messages, emails, or mail based on the contact preferences you provide.

USES AND DISCLOSURES REQUIRED BY LAW

We may use or disclose your child’s health information when required by federal, state, or local law.

Examples include:

  • Reporting suspected child abuse or neglect.
  • Responding to court orders or legal requests.
  • Supporting public health activities.
  • Assisting healthcare oversight agencies.
  • Preventing serious threats to health or safety.

We will only disclose the minimum necessary information required for the specific purpose.

USES AND DISCLOSURES WITHOUT YOUR AUTHORIZATION

In certain situations, Midtown Pediatric Dentistry may use or disclose your child’s health information without obtaining written authorization.

These situations may include:

  • Providing dental treatment.
  • Processing payments.
  • Managing healthcare operations.
  • Meeting legal requirements.
  • Supporting public health activities.
  • Preventing serious harm.

Any use or disclosure not described in this notice or permitted by law will require your written authorization.

USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

Certain uses and disclosures of your child’s health information require your written authorization.

You have the right to decide whether to provide authorization for these disclosures.

If you provide authorization, you may revoke it in writing at any time. Revoking authorization will not affect any actions already taken based on your previous authorization.

YOUR RIGHTS REGARDING YOUR CHILD’S HEALTH INFORMATION

Under HIPAA, you have important rights regarding your child’s protected health information.

Right to Access Health Information

You may request to review or receive copies of your child’s dental records and health information as permitted by law.

Right to Request Corrections

You may request corrections or updates if you believe information in your child’s records is incorrect or incomplete.

Right to Request Restrictions

You may request limits on certain uses or disclosures of your child’s health information. We will consider your request but may not be required to agree.

Right to Request Confidential Communications

You may request that we communicate with you about your child’s health information in a specific way or at a specific location.

Right to Receive a Copy of This Notice

You may request a paper or electronic copy of this HIPAA Notice of Privacy Practices at any time.

Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Midtown Pediatric Dentistry or the U.S. Department of Health & Human Services Office for Civil Rights.

You will not be penalized or treated differently for filing a complaint.

DATA BREACH NOTIFICATION

Midtown Pediatric Dentistry takes reasonable measures to protect your child’s health information from unauthorized access, use, or disclosure.

If a breach occurs that affects the privacy or security of protected health information, we will provide notification as required by applicable federal and state laws.

ELECTRONIC COMMUNICATIONS

We may use electronic communication methods, including emails, text messages, and online systems, to communicate with families regarding appointments and dental care.

While we take reasonable steps to protect your information, electronic communications may have certain privacy risks.

If you prefer another communication method, please contact our office.

CHANGES TO THIS HIPAA NOTICE OF PRIVACY PRACTICES

Midtown Pediatric Dentistry reserves the right to update this HIPAA Notice of Privacy Practices at any time.

Any changes will apply to all health information maintained by our practice. Updated versions will be available upon request and may be posted on our website.

COMPLAINTS

If you have questions, concerns, or complaints regarding our privacy practices, please contact Midtown Pediatric Dentistry.

You may also file a complaint with:

U.S. Department of Health & Human Services
Office for Civil Rights

Midtown Pediatric Dentistry will not retaliate against you for filing a complaint.

FOR MORE INFORMATION

If you have questions about this HIPAA Notice of Privacy Practices or would like additional information about how Midtown Pediatric Dentistry protects your child’s health information, please contact our office.

Midtown Pediatric Dentistry
Website: https://midtownpd.com/