NOTICE OF PRIVACY PRACTICES
 

Dental Specialists of Pahrump
Pahrump, Nevada

Effective Date: August , 2026
 

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

Your Rights

You have certain rights regarding your health information. These rights may include the right to:

• Obtain an electronic or paper copy of your dental and health records.

• Ask us to correct health information that you believe is incorrect or incomplete.

• Request that we communicate with you in a particular way or at a particular location. For example, you may ask us to contact you at a specific telephone number or address.

• Ask us to limit certain uses or disclosures of your health information. We are not required to agree to every request.

• If you pay for a service or healthcare item completely out of pocket, you may ask us not to disclose information about that service or item to your health plan for purposes of payment or healthcare operations when applicable law requires us to honor the request.

• Request an accounting of certain disclosures we have made of your health information.

• Obtain a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.

• Choose someone, such as a legal guardian or person acting under a valid healthcare power of attorney, to exercise your rights when legally authorized to do so.

• File a complaint if you believe your privacy rights have been violated.

Your Choices

For certain health information, you may tell us your preferences regarding what we share.

These situations may include:

• Sharing information with family members, friends, or others involved in your care.

• Sharing information in a disaster-relief situation.

• Certain communications regarding treatment alternatives or health-related services.

If you are unable to communicate your preference, we may use our professional judgment and applicable law to determine whether sharing information is in your best interest.

We will obtain your written authorization when required by law for uses or disclosures that are not otherwise permitted by applicable privacy laws.
 

We do not sell your protected health information.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your dental and healthcare treatment.

For example, we may share relevant information with your general dentist, dental specialist, physician, laboratory, pharmacy, imaging provider, or another healthcare professional involved in your care.

Payment

We may use and disclose your health information to bill and obtain payment for services provided to you.

For example, we may provide necessary information to your dental or medical insurance company to obtain benefits, determine eligibility, request authorization, submit claims, or receive payment.

Healthcare Operations

We may use and disclose your information for activities necessary to operate our dental practice.

These activities may include quality assessment, staff training, credentialing, compliance, auditing, business planning, patient service, and improvement of our clinical operations.

Appointment Reminders and Communications

We may use your contact information to communicate with you regarding appointments, treatment, referrals, follow-up care, billing, or other matters related to your care.

Depending on the contact information you provide and your communication preferences, these communications may occur by telephone, voicemail, text message, email, mail, or other permitted methods.

Business Associates

We may share protected health information with third-party service providers that perform services for our practice when permitted by law.

When required by HIPAA, these organizations are considered business associates and are contractually required to appropriately safeguard protected health information.

Public Health and Safety

We may disclose health information when permitted or required by law for certain public health and safety purposes, including preventing disease, reporting suspected abuse or neglect, preventing or reducing a serious threat to health or safety, and other legally authorized public health activities.

Legal and Government Requirements

We may disclose information when required or permitted by law, including certain disclosures involving:

• Health oversight agencies
• Workers' compensation matters
• Law enforcement
• Judicial or administrative proceedings
• Medical examiners or coroners
• Certain governmental functions
• Other disclosures required by applicable federal or state law

Substance Use Disorder Records

Certain substance use disorder treatment records may receive additional protections under federal law.

When Dental Specialists of Pahrump receives or maintains records protected by applicable federal substance use disorder confidentiality requirements, we will use and disclose those records only as permitted by applicable law.

Our Responsibilities

Dental Specialists of Pahrump is required by law to maintain the privacy and security of protected health information.

We will:

• Maintain appropriate safeguards designed to protect your health information.

• Notify you as required by law if a breach occurs that may have compromised the privacy or security of your protected health information.

• Follow the privacy practices described in the Notice currently in effect.

• Provide you with a copy of this Notice upon request.
 

We will not use or disclose your information for purposes not described in this Notice unless you provide written authorization or the use or disclosure is otherwise permitted or required by law.

If you provide authorization, you may revoke that authorization in writing as permitted by law. Revocation generally will not affect actions already taken in reliance on your authorization.

Changes to This Notice

We may change the terms of this Notice and our privacy practices as permitted by law.

Changes may apply to health information we already maintain as well as information we receive in the future.

When this Notice is materially revised, the current version will be available at our office and on our website.

Questions or Complaints

If you have questions about this Notice, want to exercise your privacy rights, or believe your privacy rights have been violated, please

Contact: Privacy Officer

Dental Specialists of Pahrump
1840 E Calvada Blvd, Suite 3
Pahrump, Nevada, 89048
 

Phone: 775 571 9977
Email: info@dspnevada.com

Effective Date:

This Notice is effective as of: [August 2026]