Notice of Privacy Practices

Our Commitment to Your Privacy

Smile Creators Dental is required by law to protect the privacy of your protected health information ("PHI"). PHI is information that identifies you and relates to your past, present, or future health, the dental care we provide, or payment for that care. We are required to give you this Notice of our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify you if a breach of your unsecured PHI occurs.

How We May Use and Disclose Your Information

We may use and disclose your PHI without your written authorization for the following purposes:

• Treatment. To provide, coordinate, or manage your dental care. For example, we may share your records or x-rays with a specialist, dental laboratory, or pharmacy involved in your care.
• Payment. To bill and collect payment from you, your insurance company, or another third party. For example, we may send treatment details to your dental plan to confirm coverage or submit a claim.
• Health care operations. To run our practice, such as reviewing the quality of care, training staff, conducting audits, and handling business planning and administration.
• Appointment reminders and communication. To contact you by phone, text message, email, or mail about appointments, treatment follow-up, or recall visits. You may ask us to contact you a different way.
• Treatment alternatives and health-related services. To tell you about treatment options or services we offer that may interest you.
• Business associates. To companies that perform services for us, such as billing, scheduling software, IT support, or practice management. They must sign an agreement to protect your information.

Other Uses and Disclosures Permitted or Required by Law

• Family and friends. To a family member, friend, or other person involved in your care or payment, if you agree or do not object, or if we believe it is in your best interest in an emergency.
• As required by law. When federal, state, or local law requires it.
• Public health. To report disease, injury, adverse reactions to products, or suspected abuse, neglect, or domestic violence, as permitted or required by law.
• Health oversight. To agencies for audits, investigations, inspections, and licensure.
• Legal proceedings. In response to a court order, subpoena, or other lawful process.
• Law enforcement. For certain law enforcement purposes permitted by law.
• Serious threat to health or safety. To prevent or lessen a serious and imminent threat to a person or the public.
• Coroners, medical examiners, and funeral directors. As needed to carry out their duties, including identification using dental records.
• Organ and tissue donation. To organizations that handle organ, eye, or tissue donation.
• Specialized government functions. For military, national security, and similar purposes as permitted by law.
• Workers' compensation. As authorized by workers' compensation laws.

Uses That Require Your Written Authorization

We will not use or disclose your PHI for the following without your written authorization: most uses of psychotherapy notes (if any), marketing communications (other than face-to-face communications and promotional gifts of nominal value), and the sale of your PHI. Any other use or disclosure not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Special Protections Under New York Law

New York law may give certain information greater protection than federal law, including HIV/AIDS-related information, genetic test results, mental health information, and alcohol or substance use treatment information. We will follow the more protective law and will obtain any special written consent the law requires before disclosing this information.

Your Rights Regarding Your Information

• Right to inspect and get a copy. You may ask to see or get a paper or electronic copy of your dental and billing records. We will respond within 30 days and may charge a reasonable, cost-based fee.
• Right to request a correction. If you believe information in your record is incorrect or incomplete, you may ask us in writing to amend it. We may deny your request, and if so we will tell you why in writing.
• Right to an accounting of disclosures. You may request a list of certain disclosures we made of your PHI in the six years before your request, other than for treatment, payment, operations, and certain other purposes. The first list in any 12-month period is free.
• Right to request restrictions. You may ask us to limit how we use or share your PHI. We are not required to agree, except that we must agree not to share information with your health plan about a service you paid for in full out of pocket, unless the law requires it.
• Right to confidential communications. You may ask us to contact you in a specific way (for example, only on your mobile phone) or at a different address. We will accommodate reasonable requests.
• Right to a paper copy of this Notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically.
• Right to choose someone to act for you. If you have given someone medical power of attorney or have a legal guardian, that person can exercise your rights.
• Right to be notified of a breach. We will notify you if a breach occurs that may have compromised the privacy or security of your information.

To exercise any of these rights, please submit your request in writing to our Privacy Officer at the address below.

Changes to This Notice

We reserve the right to change this Notice and to make the new Notice apply to all PHI we maintain. The current Notice will be posted in our office and on our website, and a copy is available on request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

Contact Our Privacy Officer

Effective date: September 28, 2026