Dental Associates of Northern Virginia in Burke
6035 Burke Centre Pkwy, Suite #200, Burke, VA 22015

Privacy Policy

NOTICE OF PRIVACY PRACTICES

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.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires all health care records and other individually identifiable health information (protected health information) used or disclosed to us in any form, whether electronically, on paper, or orally, be kept confidential. This federal law gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

Without specific written authorization, we are permitted to use and disclose your health care records for the purposes of treatment, payment and health care operations.

  • Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. Examples of treatment would include crowns, fillings, teeth cleaning services, etc.
  • Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be billing your dental plan for your dental services.
  • Health Care Operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would include a periodic assessment of our documentation protocols, etc.

In addition, your confidential information may be used to remind you of an appointment (by phone or mail) or provide you with information about treatment options or other health-related services including release of information to friends and family members that are directly involved in your care or who assist in taking care of you. We will use and disclose your protected when we are required to do so by federal, state or local law. We may disclose your PROTECTED HEALTH INFORMATION to public health authorities that are authorized by law to collect information, to a health oversight agency for activities authorized by law included but not limited to: response to a court or administrative order, if you are involved in a lawsuit or similar proceeding, response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested. We will release your PROTECTED HEALTH INFORMATION if requested by a law enforcement official for any circumstance required by law. We may release your PROTECTED HEALTH INFORMATION to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information in order for funeral directors to perform their jobs. We may release PROTECTED HEALTH INFORMATION to organizations that handle organ, eye or tissue procurement or transplantation, including organ donation banks, as necessary to facilitate organ or tissue donation and transplantation if you are an organ donor. We may use and disclose your PROTECTED HEALTH INFORMATION when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat. We may disclose your PROTECTED HEALTH INFORMATION if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities. We may disclose your PROTECTED HEALTH INFORMATION to federal officials for intelligence and national security activities authorized by law. We may disclose PROTECTED HEALTH INFORMATION to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations. We may disclose your PROTECTED HEALTH INFORMATION to correctional institutions or law enforcement HIPAA/@Notice of Privacy Practices.doc officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals or the public. We may release your PROTECTED HEALTH INFORMATION for workers’ compensation and similar programs.

Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have certain rights in regards to your PROTECTED HEALTH INFORMATION, which you can exercise by presenting a written request to our Privacy Officer at the practice address listed below:

  • The right to request restrictions on certain uses and disclosures of PROTECTED HEALTH INFORMATION, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
  • The right to request to receive confidential communications of PROTECTED HEALTH INFORMATION from us by alternative means or at alternative locations.
  • The right to access, inspect and copy your PROTECTED HEALTH INFORMATION.
  • The right to request an amendment to your PROTECTED HEALTH INFORMATION.
  • The right to receive an accounting of disclosures of PROTECTED HEALTH INFORMATION outside of treatment, payment and health care operations.
  • The right to obtain a paper copy of this notice from us upon request.

We are required by law to maintain the privacy of your PROTECTED HEALTH INFORMATION and to provide you with notice of our legal duties and privacy practices with respect to PROTECTED HEALTH INFORMATION.

We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all PROTECTED HEALTH INFORMATION that we maintain. Revisions to our Notice of Privacy Practices will be posted on the effective date and you may request a written copy of the Revised Notice from this office.

You have the right to file a formal, written complaint with us at the address below, or with the Department of Health & Human Services, Office of Civil Rights, in the event you feel your privacy rights have been violated. We will not retaliate against you for filing a complaint.

For more information about our Privacy Practices, please contact:
Dental Care Alliance
6240 Lake Osprey Dr.
Sarasota, FL 34240
Ph #: 941-955-3150

For more information about HIPAA or to file a complaint:
The U.S. Department of Health & Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
877-696-6775 (toll-free)

Read What Our Patients Say
Patient Reviews
I love Dr. Price. I definitely have a phobia with dental work and I have never felt so comfortable having major issues taken care of. Dr. Price takes the time needed and truly cares. I also love the […]
Mary D.
Warm friendly and courtesy staff. The attention provided was unlike any doctors visit let alone any visit to a dentist. More medical professionals should model this practice. Excellent experience
Richard M.
Those at the front desk are very friendly, and the overall staff are competent and knowledgeable.
Charlotte C.
Warm and friendly staff. On my second visit and the front desk already know me by face. Julie Chan is very wonderful. She made me at ease on my first visit and it has been like that ever since. I […]
King D.
Easy appointments and kindness of Dr. Price.
Nancy L.
From the front staff Holly, Mary, Karen, Katie, And my dental hygienist Madeeha- it always feels like I’m coming to my family home and not a dental office. Great customer care & concer!
Sumaira T.
Friendly staff, great location
Emilie S.
Love the office. It’s bright and inviting. And the staff is very welcoming. It’s a good community.
Debra T.
Clear and detailed doctors. Thorough and efficient hygienists. Incredibly friendly and attentive office staff. Enough said.
Jesse C.
Kind, Gentle and very skilled practice. Wouldn’t go anywhere else.
Gina G.
Crown
Ronald H.
Wonderful work cleaning and inspecting my teet. Also the office personal are very nice and super ! helpful scheduling my appointments, and my ordering antibiotics. More than ” highly satisfied […]
Yavuz D.
Super clean, bright and sunny, excellent advice and care. Dr. Allgeyer takes the time to explain the necessary details and provide options and clear expectations. The staff are warm and friendly. […]
Jason J.
The timely and friendly manner used to schedule me in to see the dentist quickly. The positive way I was treated by the dentist and the staff.
Jan A.
I never got the message that my bite plate was ready to pick up and I had to call the office to find out that it had been delivered a while ago and I was not informed.
Jo-ann M.
I like the warm, sterile environment and the professionalism of the staff and medical doctors.
Gwendolyn R.
I’m very happy with this dentist office, they are very professional and do a great job.
Marina A.
Very friendly staff
Yumi T.
I’ve always been scared to go to the dentist but when I went this time Cecilia made me feel comfortable with her angel touch hands
Jose R.
Excellent care, outstanding professionals, beautiful office in a convenient location!
Michelle B.
Office Hours
Mon. – 7:00 AM - 5:00 PM
Tue. – 7:00 AM - 5:00 PM
Wed. – 7:00 AM - 5:00 PM
Thu. – 7:00 AM - 5:00 PM
Fri. – 7:00 AM - 1:00 PM
Phone: (703) 935-2879
Fax: (703) 239-1679
Healthcare Financing with
CareCredit
We Accept Most Insurance Plans!
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We accept most insurance plans and will be happy to help you understand the coverage that you have. We will do our best to see that you receive your maximum insurance benefits for all covered services.

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For appointments, call us at: (703) 935-2879 or
Book Appointment
For appointments, call: (703) 935-2879
Office Hours
  • Monday 7:00 AM - 5:00 PM
  • Tuesday 7:00 AM - 5:00 PM
  • Wednesday 7:00 AM - 5:00 PM
  • Thursday 7:00 AM - 5:00 PM
  • Friday 7:00 AM - 1:00 PM
Get in touch:
  • Phone: (703) 935-2879
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