HIPAA Notice of Privacy Practices

Who this notice covers

Centre Dental NYC, located at 139 Centre St, Suite 306, New York, NY 10013, is a dental practice and a covered entity under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing rules. This notice describes how we may use and disclose your Protected Health Information (PHI) and the rights you have over that information. For website-specific data handling, see our Privacy Policy.

We are required by law to keep your PHI private, to give you this notice of our legal duties and privacy practices, to follow the terms of the notice that is currently in effect, and to let you know if a breach exposes unsecured PHI about you.

How we may use and disclose your PHI without your written authorization

Uses and disclosures that require your written authorization

We will ask for your written authorization before we use or disclose your PHI for any purpose not described in this notice. This includes:

• Most marketing communications
• Any sale of your PHI
• Most uses and disclosures of psychotherapy notes
• Uses and disclosures for reproductive health care outside the permitted categories
• Uses and disclosures of substance use disorder records protected under 42 CFR Part 2

You can revoke an authorization at any time in writing. The revocation applies going forward — it does not cover information we already shared while the authorization was in effect.

Your rights regarding your PHI

• Right to inspect and copy. You can ask to look at or get a copy of your dental and billing records. We will respond within 30 days of a written request. A reasonable, cost-based fee may apply to copies.
• Right to amend. You can ask us to correct information you believe is wrong or incomplete. We may deny the request in limited cases and will explain any denial in writing.
• Right to an accounting of disclosures. You can ask for a list of certain disclosures we made in the last six years. This list does not include disclosures for treatment, payment, operations, or disclosures you authorized.
• Right to request restrictions. You can ask us to limit how we use or disclose your PHI. We are not required to agree, except that we must honor a request to not disclose information to a health plan for a service you paid for in full out of pocket.
• Right to confidential communications. You can ask us to contact you at a specific phone number, address, or by a specific method (for example, text only). We will accommodate reasonable requests.
• Right to a paper copy. You can ask for a paper copy of this notice at any time, even if you already received it electronically.
• Right to be notified of a breach. We will notify you if a breach compromises your unsecured PHI.
• Right to choose someone to act for you. A person with medical power of attorney or a legal guardian can exercise these rights on your behalf. We will verify their authority before sharing information.

Our duties

We are required by law to keep your PHI private, to give you this notice of our duties and privacy practices, and to follow the terms of the notice that is currently in effect.

We reserve the right to change this notice. If we change it in a material way, the new notice will apply to all PHI we maintain, including information we collected before the change. The current notice is always posted in our office and at centredent.com/hipaa-notice. You can ask the front desk for a paper copy at any time.

How to file a complaint

If you believe your privacy rights have been violated, you can file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint. If you are a new patient and have questions before your first visit, our new patient guide has what you need.

To file with us: contact our privacy contact using the details below.

To file with HHS OCR: hhs.gov/hipaa/filing-a-complaint, or call the OCR at 1-800-368-1019.