Union Dental Center
Notice of Privacy Practices
Effective Date: 01/01/2026

1. OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
We understand that your health information is personal. We are committed to protecting it. This notice applies to all records of your care generated by [Name of Dental Practice].

2. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use and share your health information for the following purposes:

• Treatment: To provide, coordinate, or manage your dental care (e.g., sharing X-rays with a specialist).
• Payment: To bill and receive payment for services from you, your insurance, or a third party (e.g., submitting claims to insurance).
• Healthcare Operations: To run our practice, improve care, and train staff (e.g., quality assurance audits).
• Appointment Reminders: To contact you via email, text, or phone about upcoming appointments.
• Required by Law: As required by federal, state, or local law, including public health activities, law enforcement, or workers’ compensation.

3. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

• Right to Inspect and Copy: You have the right to inspect and copy your dental records.
• Right to Amend: You may request that we amend records you believe are incorrect.
• Right to an Accounting of Disclosures: You can request a list of certain disclosures we have made.
• Right to Request Restrictions: You may ask us to restrict how we use your information.
• Right to Confidential Communications: You can request to be contacted at a specific location or via a specific method.
• Right to a Paper Copy: You have the right to a paper copy of this notice.

4. OUR DUTIES
We are required by law to maintain the privacy of your health information, provide you with this notice, and comply with its terms.

5. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services.
 
Telephone: 213-483-0772
Address: 1517 W. 6th St, Los Angeles, CA 90017