Effective Date: April, 16th, 2026
6232 North 7th St., Suite 201, Phoenix, AZ 85014
Phone: (602) 246‑0385
This Notice describes how your health information may be used and disclosed, and how you can access this information. Please read it carefully.
Our Legal Duty
At Central Valley Dentistry, we are required under the Health Insurance Portability and Accountability Act (HIPAA) to protect the privacy of your protected health information (PHI), provide this Notice of our privacy practices, and follow the laws that apply to us. We must also notify you if a breach occurs that compromises your information.
How We May Use and Disclose Your Health Information
- Treatment
We may use or disclose your PHI to provide dental treatment, coordinate care, and consult with other health professionals.
Examples include:
- Diagnosis and treatment planning
- Sending X‑rays or records to specialists
- Consulting with laboratories or other providers
- Payment
We may use or disclose PHI to obtain payment for services, such as:
- Insurance claim submissions
- Benefit verification
- Responding to insurer requests
Your dental plan may require information about your diagnosis or procedures.
- Health Care Operations
We may use PHI for activities that support high‑quality care and efficient office operations. These may include:
- Quality improvement initiatives
- Staff training and credentialing
- Licensing, audits, accreditation, and compliance activities
Other Uses and Disclosures Permitted by Law
Your PHI may be disclosed without written authorization when required or allowed by law, including:
- Public health reporting
- Reporting abuse or neglect
- Health oversight investigations or audits
- Workers’ compensation claims
- Law enforcement requests
- Court orders and administrative proceedings
- Coroner or medical examiner purposes
- Reducing or preventing a serious threat to health or safety
Uses Requiring Your Written Authorization
Your written authorization is required for:
- Marketing communications not related to your care
- The sale of your health information
- Most uses of psychotherapy notes
- Any use of PHI not described in this Notice
You may revoke an authorization at any time in writing.
Your Rights Concerning Your Health Information
- Right to Access
You may request to inspect or obtain copies of your PHI, including electronic copies.
A reasonable fee may apply for printing, copying, or mailing.
- Right to Request Restrictions
You may request restrictions on how we use or disclose your PHI.
We are not required to agree unless you:
- Pay for a service entirely out of pocket, and
- Request that we not submit that information to your dental plan.
- Right to Confidential Communications
You may request that we contact you by:
- A different mailing address
- A specific phone number
- Email (if appropriate)
We will comply with reasonable requests.
- Right to Request an Amendment
If you believe your PHI is inaccurate or incomplete, you may request an amendment.
We may deny the request in certain circumstances, but will notify you in writing.
- Right to an Accounting of Disclosures
You may request a list of certain disclosures made during the past six years, excluding those for treatment, payment, or health care operations.
- Right to a Paper or Digital Copy of This Notice
You may request a copy at any time.
State‑Specific Information: Arizona
Search results did not identify any Phoenix‑specific privacy rules.
Arizona generally follows federal HIPAA regulations, but provides heightened protection for:
- HIV/AIDS‑related information
- Mental health treatment records
- Drug and alcohol treatment records
We require written authorization for these categories except where law mandates disclosure.
Changes to This Notice
We may revise this Notice at any time. Updated versions will be:
- Available in our office
- Provided upon request
Questions or Complaints
If you have concerns about your privacy rights, you may contact:
Central Valley Dentistry
Privacy Officer
6232 North 7th St., Suite 201
Phoenix, AZ 85014
Phone: (602) 246‑0385
You may also file a complaint with the U.S. Department of Health & Human Services.
We will not retaliate against you for filing a complaint.
