Effective date: September 20, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice describes the privacy practices of Park Center Family Dentistry (“PCFD,” “we,” “our,” or “the practice”). “You” and “your” means our patient. It applies to all of the protected health information we create or receive about you, including records we received from the practice previously operated at this location.
This Notice has one effective date and no prior revisions. It replaces any notice you may have received from a prior owner of this practice.
I. Our Privacy Official and How to Contact Us
If you have questions about this Notice, want to exercise any of the rights described below, or wish to file a complaint, contact:
Thailong Tran, DDS, Privacy Official
Park Center Family Dentistry
14207 Park Center Drive, Suite 105
Laurel, MD 20707
Phone: (301) 776-9686
Email: smile@parkcenterfamilydentistry.com
II. Our Legal Duties
We understand that information about your health and your dental care is personal, and we are committed to protecting it. Protected Health Information (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or dental health, your care, or payment for that care.
Federal and state law require us to:
- Keep your protected health information private;
- Give you this Notice describing our legal duties and privacy practices regarding your information;
- Follow the terms of the Notice currently in effect;
- Notify you if a breach occurs that compromises the privacy or security of your information; and
- Obtain your written authorization before using or disclosing your information for any purpose not described in this Notice.
Where Maryland law or another federal law gives your information greater protection than HIPAA does, we will follow the more protective law.
III. How We Use and Disclose Your Health Information
The examples below describe the ways we typically use and share your information. They are examples, not a complete list.
A. Everyday uses
Treatment. We use your information to provide your dental care — examining and cleaning your teeth, diagnosing conditions, planning and performing procedures. We may share it with dental specialists, your physician, an anesthesia provider, a dental laboratory, or others involved in your care.
Payment. We use and share your information to bill and collect payment for your care, including submitting claims to your dental or medical plan, verifying benefits, and obtaining prior authorization.
Health Care Operations. We use your information to run the practice — reviewing the quality of our treatment, training staff and students, evaluating clinical performance, conducting billing and compliance audits, obtaining legal and accounting services, and business planning. If the practice is ever sold or transferred, your records may transfer with it.
Appointment Reminders and Recall. We may contact you about appointments, recall visits, and treatment you have not yet scheduled, by postcard, letter, phone, voicemail, text message, or email. Tell us if you want us to use a particular method or avoid one.
Treatment Alternatives and Related Services. We may tell you about treatment options, alternatives, or health-related products and services that may benefit you.
Family and Friends. We may share information relevant to your care with a family member, friend, or other person you involve in your care or in paying for it — including discussing your treatment in their presence — unless you object. Tell any member of our team if you would like to limit this; you do not need to put it in writing.
Business Associates. We use outside vendors for services such as practice management software, IT support, billing, and document storage. These vendors are our “business associates,” and each is required by written contract to protect your information and use it only as our contract permits.
B. Other uses permitted or required by law
We may use or disclose your information without your authorization in these situations:
Required by law. When federal, state, or local law requires it — including disclosures to the U.S. Department of Health and Human Services to investigate a complaint or review our HIPAA compliance.
Public health. To prevent or control disease, report births or deaths, report suspected child abuse or neglect, report adverse reactions to medications or products, or notify someone who may have been exposed to a communicable disease.
Abuse, neglect, or domestic violence. To the appropriate government authority when we believe a patient is a victim, as Maryland law requires or permits.
Health oversight. To agencies conducting audits, investigations, licensure actions, and inspections — including the Maryland State Board of Dental Examiners.
Legal proceedings. In response to a court or administrative order, or to a subpoena or discovery request where the requesting party has made the efforts HIPAA requires to notify you or to obtain a protective order.
Law enforcement. For limited law enforcement purposes permitted by 45 CFR 164.512(f), such as responding to a court order or, in narrow circumstances and limited to specific identifying details, a request to identify or locate a suspect, fugitive, material witness, or missing person.
Coroners, medical examiners, and funeral directors. To allow them to carry out their duties, including dental identification of a deceased person.
Organ and tissue donation. To organ procurement organizations.
Serious threat to health or safety. When necessary to prevent or lessen a serious and imminent threat to you or to someone else.
Specialized government functions. For military and veterans’ activities, national security, protective services, and correctional institutions.
Workers’ compensation. To comply with workers’ compensation laws and similar programs.
IV. Uses That Require Your Written Authorization
The following always require your written authorization:
Marketing. Most uses and disclosures of your information for marketing purposes.
Sale of information. Any disclosure that constitutes a sale of your protected health information.
Psychotherapy notes. Most uses and disclosures of psychotherapy notes, in the unlikely event we ever hold any.
Any other use or disclosure not described in this Notice will be made only with your written authorization. You may revoke an authorization at any time, in writing, except to the extent we have already acted in reliance on it.
V. Your Rights
You have the following rights regarding the health information we maintain about you. Except where noted, submit requests in writing to our Privacy Official.
Right to inspect and get a copy. You may inspect and get a copy of your dental records and billing records. We will respond within 30 days. If you want an electronic copy and we maintain the record electronically, we will provide it in the form you request if we can readily produce it, or in another electronic form we agree on. You may also direct us to send an electronic copy to a person or entity you name. We may charge a reasonable, cost-based fee limited to copying labor, supplies, and postage, subject to the limits of Maryland Health-General §4-304. We may deny your request in limited circumstances; if we do, we will tell you in writing and, where the law provides for it, you may have the denial reviewed by a licensed health care professional we designate who was not involved in the original decision. You will not be charged for that review.
Right to request an amendment. If you believe information in your record is incorrect or incomplete, you may ask us to amend it. We may deny the request in certain circumstances; if we do, we will explain why in writing, and you may submit a written statement of disagreement that we will include with your record.
Right to request restrictions. You may ask us to limit how we use or disclose your information for treatment, payment, or health care operations, or to a family member or friend. We are generally not required to agree, with one exception: if you pay for a service in full out of pocket and ask us not to submit the claim to your health plan, we must honor that request.
Right to confidential communications. You may ask us to contact you at a specific phone number or address, or by a specific method. We will accommodate reasonable requests and will not ask you to explain why.
Right to an accounting of disclosures. You may request a list of certain disclosures we made in the six years before your request. The list excludes disclosures for treatment, payment, and health care operations, disclosures you authorized, and several other categories. The first list in any 12-month period is free; we may charge a reasonable cost-based fee for additional requests within that period and will tell you the cost in advance so you can withdraw or modify the request.
Right to a paper copy of this Notice. You may have a paper copy at any time, even if you agreed to receive it electronically. Just ask any member of our team — no written request needed.
Right to notice of a breach. We will notify you if a breach compromises the privacy or security of your unsecured health information. We will notify you without unreasonable delay and no later than 60 days after we discover the breach, and the notice will describe what happened, the information involved, steps you can take to protect yourself, what we are doing in response, and how to contact us.
Right to choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise these rights on your behalf. We will verify their authority before acting.
VI. Changes to This Notice
We may change this Notice at any time, and the changes will apply to information we already have about you as well as information we create or receive afterward. The current Notice will always be posted in our office and on our website, and will show its effective date. You may request a paper copy of the current Notice at any time.
VII. How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Official at the address on the first page of this Notice.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Washington, DC 20201, by calling 1-877-696-6775, or through the complaint portal at hhs.gov/ocr/privacy/hipaa/complaints.