Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES MD Periodontics 9735 Wilshire Blvd, Suite 419, Beverly Hills, CA 90212 Effective Date: February 1, 2026 | Last Revised: March 2026 (per ADA January 2026 update)

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.

Our Commitment to Your Privacy

MD Periodontics is committed to protecting the privacy of your health information. We are required by federal law, the Health Insurance Portability and Accountability Act (HIPAA), to maintain the privacy of your Protected Health Information (PHI) and to provide you with this Notice of our legal duties and privacy practices. We are required to follow the terms of this Notice while it is in effect. We reserve the right to change our privacy practices and the terms of this Notice at any time, provided that the changes are permitted by applicable law. When we make a material change to our privacy practices, we will update this Notice and make the new version available upon request.

How We May Use and Disclose Your Health Information

The following describes the ways we may use and disclose your health information. Not every possible use or disclosure is listed, but all the ways we are permitted to use and disclose information fall within one of the following categories:

Treatment We may use and disclose your health information to provide, coordinate, or manage your periodontal and dental implant care and related services. For example, we may share your information with other healthcare providers involved in your care, such as specialists, oral surgeons, or laboratories.

Payment We may use and disclose your health information to obtain payment for services we provide to you. For example, we may contact your dental insurance company to verify coverage or to submit a claim for reimbursement of services rendered.

Healthcare Operations We may use and disclose your health information for our internal operations, including quality assurance activities, staff training, accreditation reviews, and business planning. For example, we may review treatment records to evaluate the quality of care provided.

Appointment Reminders We may use and disclose your health information to contact you as a reminder that you have a scheduled appointment.

Treatment Alternatives and Health-Related Benefits We may use and disclose your health information to tell you about possible treatment options, alternatives, or health-related benefits and services that may be of interest to you.

Business Associates We may share your health information with our business associates, companies that perform services on our behalf, such as billing services, IT support, and appointment scheduling. Our business associates are required by contract to protect the privacy of your health information.

Required by Law We will disclose your health information when required to do so by federal, state, or local law.

Public Health Activities We may disclose your health information for public health activities, such as reporting communicable diseases to public health authorities or reporting adverse reactions to medications.

Health Oversight Activities We may disclose your health information to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.

Law Enforcement We may disclose your health information to a law enforcement official as required by law or in response to a valid court order, warrant, or subpoena.

Serious Threats to Health or Safety We may use and disclose your health information to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Substance Use Disorder Records If you have received substance use disorder treatment services, federal law (42 CFR Part 2) provides additional protections for that information. We will not disclose records of substance use disorder treatment without your written consent, except as permitted or required by law.

Other Uses and Disclosures Any other uses or disclosures of your health information not described above will only be made with your written authorization. You may revoke that authorization at any time by notifying us in writing, except to the extent that we have already taken action in reliance on your authorization.

Your Rights Regarding Your Health Information

You have the following rights with respect to your health information held by MD Periodontics:

Right to Inspect and Copy You have the right to inspect and obtain a copy of your health information that we maintain in a designated record set, such as your periodontal records and billing records. We may charge a reasonable fee for copies. To request access, please contact us in writing using the contact information below.

Right to Amend If you believe that health information we have about you is incorrect or incomplete, you have the right to request that we amend it. We may deny your request under certain circumstances. To request an amendment, please contact us in writing.

Right to an Accounting of Disclosures You have the right to request an accounting of certain disclosures of your health information that we have made in the past six years, other than disclosures for treatment, payment, or healthcare operations, and certain other exceptions. To request an accounting, please contact us in writing.

Right to Request Restrictions You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do agree, we will comply with your request except in emergency situations. To request a restriction, please contact us in writing.

Right to Request Confidential Communications You have the right to request that we communicate with you about your health information in a certain way or at a certain location. For example, you may ask that we contact you only by mail or at a specific phone number. We will accommodate all reasonable requests. To make this request, please contact us in writing.

Right to a Paper Copy of This Notice You have the right to a paper copy of this Notice at any time. To obtain a paper copy, contact us using the information below or download and print this page directly from mdperio.com.

Right to Notification of a Breach If your unsecured protected health information is breached, we will notify you as required by law.

How to File a Complaint

If you believe your privacy rights have been violated, you have the right to file a complaint with MD Periodontics or with the U.S. Department of Health and Human Services Office for Civil Rights. To file a complaint with our practice, contact our Privacy Officer using the information below. We will not retaliate against you for filing a complaint.

To file a complaint with the U.S. Department of Health and Human Services: Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Toll-Free: 1-877-696-6775 Website: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

Contact Our Privacy Officer

If you have questions about this Notice or wish to exercise any of your rights described above, please contact:

Privacy Officer MD Periodontics 9735 Wilshire Blvd, Suite 419 Beverly Hills, CA 90212 Phone: (310) 859-9449 Email: MDperioStaff@gmail.com Hours: Monday through Friday, 9:00 AM to 5:00 PM

This Notice of Privacy Practices is provided in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations, including the HIPAA Omnibus Rule (2013) and subsequent amendments. It reflects the ADA’s revised Notice of Privacy Practices template updated January 2026. This Notice is effective as of February 1, 2026. MD Periodontics reserves the right to revise this Notice at any time. The current version will always be available at mdperio.com and at the front desk of our Beverly Hills office.