Effective Date: February 16, 2026
Baltimore Dental, LLC is required by law to maintain the privacy of your Protected Health Information (PHI), provide you with this Notice, and follow the terms currently in effect.
PHI includes information about your past, present, or future physical or mental health condition, treatment, and payment for healthcare services.
Baltimore Dental, LLC
4000 Old Court Road, Suite 302
Baltimore, MD 21208
New Patients: (410) 713-4666
Existing Patients: (410) 764-3363
Email: baltimoredentalllc@gmail.com
Privacy Officer:
Baltimore Dental, LLC
Phone: (410) 713-4666
We may use and disclose your PHI without your written authorization for:
TreatmentTo provide, coordinate, or manage your healthcare.
PaymentTo obtain payment for services provided.
Healthcare OperationsFor quality improvement, staff training, licensing, auditing, compliance, and business management.
Appointment Reminders and Health InformationWe may contact you regarding appointments, treatment options, or other health-related services.
As Required by LawWe may disclose PHI when federal, state, or local law requires it.
Public Health and SafetyFor public health reporting and safety purposes.
Law Enforcement or Legal ProceedingsWhen permitted or required by law, such as in response to a valid court order.
Federal law (42 CFR Part 2) provides additional protections for records relating to substance use disorder diagnosis, treatment, or referral for treatment.
If we create, receive, or maintain SUD treatment records that are subject to Part 2, the following rules apply:
Unlike general HIPAA rules, we generally may not use or disclose Part 2 protected SUD records for treatment, payment, or healthcare operations without your written consent, unless a specific exception under federal law applies.
Your consent must meet specific federal requirements and may be revoked by you in writing at any time, except to the extent we have already acted on it.
Part 2 protected SUD records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless:
• You provide written consent, or
• A court issues a specific order that complies with federal Part 2 regulations.
Federal law prohibits the recipient of Part 2 protected SUD information from redisclosing it without your written consent unless expressly permitted by federal law.
Any disclosure made with your consent must be accompanied by a statement that the information is protected by federal confidentiality rules.
If you believe your Part 2 rights have been violated, you may file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
You may also file a complaint directly with our Privacy Officer. There will be no retaliation for filing a complaint.
You have the following rights under HIPAA, and where applicable, under 42 CFR Part 2:
Right to Inspect and CopyYou may request access to your health information.
Right to AmendYou may request correction of inaccurate or incomplete information.
Right to an Accounting of DisclosuresYou may request a list of certain disclosures of your PHI.
Right to Request RestrictionsYou may request limits on certain uses or disclosures. We are not required to agree to all requests.
Right to Confidential CommunicationsYou may request communication by alternative means or locations.
Right to a Paper Copy of This NoticeYou may request a paper copy at any time.
To exercise any of these rights, contact our Privacy Officer at the number listed above.
We are required by law to:
• Maintain the privacy and security of your PHI
• Provide this Notice
• Follow the terms of this Notice
• Notify you if a breach occurs that may compromise your PHI
We reserve the right to revise this Notice. Any revisions will apply to all PHI we maintain. Updated versions will be available at our office and on our website.
If you believe your privacy rights have been violated, you may file a complaint with:
Baltimore Dental, LLC
Privacy Officer
4000 Old Court Road, Suite 302
Baltimore, MD 21208
Phone: (410) 713-4666
Or with:
U.S. Department of Health and Human Services
Office for Civil Rights
You will not be penalized or retaliated against for filing a complaint.
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