Effective Date:
18th January 2026
Protected Health Information (PHI)
THIS NOTICE DESCRIBES HOW DENTAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Shan Dental (“Practice,” “we,” “us,” “our”) is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable Texas Health and Safety Code chapter 181. Section 181.001 et seq. to maintain the privacy of protected health information (PHI) and to provide patients with this Notice of our legal duties and privacy practices.
● Treatment: We may use or disclose your dental health information to provide, coordinate, or manage your dental treatment and related services, including consultations with specialists such as oral surgeons, orthodontists, periodontists, and endodontists.
● Payment: We may use and disclose dental health information to obtain payment for dental services provided, including billing activities, claims management, and collection activities.
● Healthcare Operations: We may use and disclose dental health information for healthcare operations, including quality assessments, staff credentialing, training, and regulatory compliance.
● Required by Law: We may use or disclose your dental health information when required to do so by federal, state, or local law, including under the Texas Medical Privacy Act and the Texas Occupations Code—Chapter 258 (regulation of dental records).
You have the following rights regarding your dental health information:
● Right to Inspect and Copy: You have the right to inspect and copy your dental health information
● Right to Request Amendments: You may request amendments to your dental health information
● Right to Request Restrictions: You may request restrictions on uses and disclosures of your information
● Right to Request Alternative Communications: You may request confidential communications
● Right to an Accounting: You may request an accounting of disclosures of your dental health information
If you believe your privacy rights have been violated, you may file a complaint with the Practice or with the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint.
Contact:
Privacy Officer
Shan Dental
