TACOMA ENDODONTIC STUDIO

Endodontic Specialists

1550 S Union Ave, Suite 110

Tacoma, WA 98405

Phone: (253) 572-3266

NOTICE OF PRIVACY PRACTICES

Effective Date: April 2026

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

This Notice describes how your medical information may be used and disclosed and how you can access this information.

OUR DUTIES

Tacoma Endodontic Studio is required by law to:

Maintain the privacy and security of your Protected Health Information (PHI)
Provide you with this Notice
Follow the terms currently in effect
Notify you if a breach occurs

HOW WE USE AND DISCLOSE YOUR INFORMATION

Treatment

We use your information to provide endodontic care, including communication with your referring dentist and other healthcare providers.

Payment

We use your information to bill and receive payment from insurance companies and other payers.

Health Care Operations

We use your information for practice operations such as quality improvement, staff training, and administrative functions.

ADDITIONAL PROTECTIONS UNDER WASHINGTON LAW

Washington State law provides additional protections for:

Mental health information
Substance use disorder (SUD) records
HIV/AIDS-related information
Genetic data

When laws differ, we apply the more protective standard.

SUBSTANCE USE DISORDER (SUD) RECORDS

Some of your records may include information related to substance use disorder (SUD).

These records are protected under federal law (42 C.F.R. Part 2) and applicable Washington State law.

HOW WE MAY USE AND DISCLOSE SUD INFORMATION

With your written consent, we may use and disclose SUD records for:

Treatment
Payment
Health care operations

You may sign a single consent form allowing ongoing use for these purposes.

DISCLOSURES WITHOUT YOUR CONSENT

We may disclose SUD records without your consent only in limited situations:

Medical emergencies
Reporting suspected abuse or neglect
Crimes on our premises or against staff
Court orders or as otherwise required by law

IMPORTANT CONFIDENTIALITY PROTECTIONS

SUD records are strictly confidential
Recipients may be prohibited from redisclosing your information
These records generally cannot be used against you in legal proceedings

We will not disclose your SUD information without your written authorization except as permitted by law.

YOUR RIGHTS

You have the right to:

Inspect and obtain a copy of your records
Request corrections
Request confidential communication
Request restrictions on disclosures
Receive an accounting of disclosures
File a complaint

OUR RESPONSIBILITIES

We will:

Protect your information as required by law
Use and disclose only as described
Obtain your written authorization when required

CHANGES TO THIS NOTICE

We reserve the right to change this Notice. Updates will be:

Posted in our office
Posted on our website
Available upon request

CONTACT INFORMATION

Privacy Officer

Tacoma Endodontic Studio