- Working Hours: Mon - Fri: 9 AM - 6 PM, sat - Sun: 9 AM - 3 pM
Effective Date: 8/27/2026
AVANTI DENTAL GROUP, INC.
YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
This Notice of Privacy Practices describes how medical and dental information about you may be used and disclosed and how you can obtain access to this information.
Please review this notice carefully.
Avanti Dental Group, Inc. (“Avanti Dental Group,” “we,” “us,” or “our”) is committed to protecting the privacy of your protected health information (“PHI”) and complying with applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
This Notice applies to protected health information created, received, maintained, or transmitted by Avanti Dental Group in connection with your dental care.
You have the following rights regarding your protected health information:
You have the right to inspect and obtain a copy of your protected health information that may be used to make decisions about your dental care.
You may request your records in paper or electronic form, where available.
We may charge a reasonable, cost-based fee as permitted by applicable law.
If you believe information in your medical or dental records is incorrect or incomplete, you may request that we amend the information.
Your request must be made in writing and explain why you believe the information should be amended.
We may deny your request in certain circumstances permitted by law. If we deny your request, we will provide you with a written explanation.
You have the right to request that we communicate with you about your health information in a specific manner or at a specific location.
For example, you may request that we contact you at a particular telephone number or send correspondence to a different address.
We will consider all reasonable requests and will not require you to explain the reason for your request.
You may ask us to limit how we use or disclose your health information for treatment, payment, or healthcare operations.
We are not required to agree to every restriction request.
However, if you pay for a healthcare service or item completely out-of-pocket and request that we not disclose information about that service or item to your health plan for payment or healthcare operations, we will generally agree to the restriction unless disclosure is required by law.
You have the right to request a list of certain disclosures of your protected health information made by us during the six years prior to the date of your request.
The accounting does not include certain disclosures, such as disclosures made for treatment, payment, healthcare operations, disclosures you authorized, and other disclosures excluded by law.
You have the right to receive a paper copy of this Notice of Privacy Practices at any time.
You may also obtain an electronic copy by visiting our website or requesting one from our office.
If you have legally authorized someone to act on your behalf, that person may exercise certain rights and make decisions regarding your protected health information.
We will verify the authority of the person before allowing access to your information.
If you believe your privacy rights have been violated, you may file a complaint with Avanti Dental Group or with the U.S. Department of Health and Human Services Office for Civil Rights.
You will not be retaliated against for filing a complaint.
We may use or disclose your health information to provide, coordinate, or manage your dental care.
For example, we may share relevant information with another healthcare professional involved in your treatment.
We may use or disclose your health information to obtain payment for dental services we provide to you.
This may include communicating with your dental or health insurance plan regarding eligibility, coverage, claims, or payment.
We may use or disclose your health information for healthcare operations.
Healthcare operations may include activities such as quality assessment, staff training, compliance activities, auditing, business planning, and improving the quality of our services.
We may use your contact information to contact you regarding appointments, appointment reminders, scheduling, or other information related to your dental care.
We may contact you about treatment alternatives or other health-related services or products that may be of interest to you.
We may disclose relevant health information to a family member, close friend, or another person you identify as being involved in your care or payment for your care, when permitted by law.
We may also disclose information when necessary to notify or assist someone involved in your care, subject to applicable legal requirements.
We may use or disclose your protected health information when required to do so by federal, state, or local law.
We may disclose health information for certain public health activities permitted or required by law, including activities related to preventing or controlling disease, injury, or disability.
We may disclose health information to appropriate authorities when we reasonably believe that an individual may be a victim of abuse, neglect, or domestic violence, when permitted or required by law.
We may disclose health information to government agencies authorized to conduct audits, investigations, inspections, licensing activities, or other oversight activities.
We may disclose protected health information in response to a court or administrative order, subpoena, discovery request, or other lawful process when permitted by applicable law.
We may disclose certain health information to law enforcement officials when permitted or required by law.
We may use or disclose health information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, consistent with applicable law.
We may disclose health information as authorized or required by laws relating to workers’ compensation and similar programs.
Other uses and disclosures of your protected health information not described in this Notice will generally require your written authorization.
If you provide us with written authorization, you may revoke that authorization in writing at any time, except to the extent that we have already relied on the authorization.
We will use information for purposes consistent with the reason it was provided and as otherwise permitted or required by applicable law.
Certain uses and disclosures of protected health information require your written authorization.
Except where otherwise permitted by law, we will obtain your authorization before:
You may revoke an authorization in writing at any time, subject to actions already taken in reliance on that authorization.
Avanti Dental Group is required by law to:
We reserve the right to change our privacy practices and this Notice.
If we make a material change to our privacy practices, we will update this Notice and make the revised Notice available upon request and on our website.
Avanti Dental Group, Inc.
5415 Camden Ave C
San Jose, CA 95124
Phone: (408) 266-4100
Email: dds@avantidentalgroup.com
U.S. Department of Health and Human Services
Office for Civil Rights
You may submit a complaint through the HHS Office for Civil Rights website or by contacting the Office for Civil Rights directly.
Avanti Dental Group will not retaliate against you for filing a complaint
Effective Date: 8/27/2026
We may change the terms of this Notice at any time.
Any revised Notice will apply to all protected health information that we maintain.
The most current version of this Notice will be available at our office and on our website.
You may request a paper copy of the current Notice at any time.
I acknowledge that I have received or been provided access to Avanti Dental Group’s Notice of Privacy Practices.
My signature acknowledges receipt of the Notice only. It does not constitute authorization for any use or disclosure of my protected health information beyond those uses and disclosures permitted by law.
