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.
Effective Date: 02/16/2026 | Publication Date: 02/16/2026
Judith Monterrey DDS LLC d/b/a Creative Toothwork
Protected health information (PHI) about you is maintained as a written and/or electronic record of your contacts or visits for healthcare services with our practice. Specifically, PHI is information about you, including demographic information (i.e., name, address, phone, etc.), that may identify you and relates to your past, present or future physical or mental health condition and related healthcare services.
Our practice is required to follow specific rules on maintaining the confidentiality of your PHI, using your information, and disclosing or sharing this information with other healthcare professionals involved in your care and treatment. This notice describes your rights to access and control your PHI. It also describes how we follow applicable rules and use and disclose your PHI to provide your treatment, obtain payment for services you receive, manage our healthcare operations, and for other purposes that are permitted or required by law.
Your Rights Under the Privacy Rule
The following is a statement of your rights, under the Privacy Rule, in reference to your PHI. Please feel free to discuss any questions with our staff.
You have the right to receive, and we are required to provide you with, a copy of this Notice of Privacy Practices. We are required to follow the terms of this notice. We reserve the right to change the terms of our notice, at any time. Upon request, we will provide you with a revised Notice of Privacy Practices.
You have the right to authorize other use and disclosure. This means you have the right to authorize any use or disclosure of PHI that is not specified within this notice. For example, we would need your written authorization to use or disclose your PHI for marketing purposes, for most uses or disclosures of psychotherapy notes, or if we intended to sell your PHI.
You have the right to request alternative means of confidential communication. This means you have the right to ask us to contact you about medical matters using an alternative method (i.e., email, telephone), and to a destination (i.e., cell phone number, alternative address, etc.) designated by you. You must inform us in writing, using a form provided by our practice, how you wish to be contacted if other than the address/phone number that we have on file.
You have the right to inspect and copy your PHI. This means you may inspect and obtain a copy of your complete health record. If your health record is maintained electronically, you will also have the right to request a copy in electronic format. We have the right to charge a reasonable fee for paper or electronic copies as established by professional, state, or federal guidelines.
You have the right to request a restriction of your PHI. This means you may ask us, in writing, not to use or disclose any part of your PHI. We are not required to agree to a requested restriction, but if we do agree, we are bound by our agreement except when otherwise required by law, in emergency circumstances, or when the information is necessary to treat you.
You may have the right to request an amendment to your protected health information. This means you may request an amendment of your PHI as long as we maintain this information. In certain cases, we may deny your request.
You have the right to request a disclosure accountability. This means that you may request a listing of disclosures that we have made, of your PHI, to entities or persons outside of our office.
You have the right to receive a privacy breach notice. You have the right to receive written notification if the practice discovers a breach of your unsecured PHI, and determines, through a risk assessment, that notification is required.
You have additional rights under federal law. Under the HITECH Act, you have the right to request a restriction on disclosures of your PHI to your health plan for purposes of carrying out payment or healthcare operations if you have paid for the service or item out of pocket in full. You also have the right to request and receive an electronic copy of your records if they are maintained electronically.
If you have questions regarding your privacy rights, please feel free to contact our Privacy Officer using the contact information provided at the end of this notice.
How We May Use or Disclose Protected Health Information
The following are examples of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but to describe possible types of uses and disclosures.
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your healthcare and any related services. This includes the coordination or management of your healthcare with a third party that is involved in your care and treatment. For example, we would disclose your PHI, as necessary, to a pharmacy that would fill your prescriptions. We will also disclose PHI to other Healthcare Providers who may be involved in your care and treatment.
Special Notices. We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment. We may contact you by phone or other means to provide results from exams or tests and to provide information that describes or recommends treatment alternatives regarding your care. Also, we may contact you to provide information about health-related benefits and services offered by our office, for fund-raising activities, or with respect to a group health plan, to disclose information to the health plan sponsor.
Payment. Your PHI will be used, as needed, to obtain payment for your healthcare services. This may include certain activities that your health insurance plan may undertake before it approves or pays for the healthcare services we recommend for you such as making a determination of eligibility or coverage for insurance benefits.
Healthcare Operations. We may use or disclose, as needed, your PHI in order to support the business activities of our practice. This includes, but is not limited to business planning and development, quality assessment and improvement, medical review, legal services, auditing functions and patient safety activities.
Health Information Organization. The practice may elect to use a health information organization, or other such organization to facilitate the electronic exchange of information for the purposes of treatment, payment, or healthcare operations.
To Others Involved in Your Healthcare. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your healthcare. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
Other Permitted and Required Uses and Disclosures
We are also permitted to use or disclose your PHI without your written authorization for the following purposes, as required by law: for public health activities; health oversight activities; in cases of abuse or neglect; to comply with Food and Drug Administration requirements; research purposes; legal proceedings; law enforcement purposes; coroners, funeral directors, organ donation; criminal activity; military activity; national security; worker’s compensation; when an inmate in a correctional facility; and if requested by the Department of Health and Human Services in order to investigate our compliance with the requirements of the Privacy Rule.
Substance Use Disorder Records (42 CFR Part 2). Records relating to substance use disorder treatment are protected under federal law (42 CFR Part 2). These records may not be used or disclosed without your specific written consent except as expressly permitted by law. Such records cannot be used in civil, criminal, administrative, or legislative proceedings without a written court order.
Our Legal Duties
We are required by law to maintain the privacy and security of your protected health information. We are required to abide by the terms of this Notice of Privacy Practices currently in effect, and to notify you in the event of a breach of your unsecured PHI. We reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that we maintain. If we make a material change to this notice, we will post the revised notice in our office, make it available upon request, and post the current version on our website with its effective date.
Your Right to a Paper Copy
You have the right to obtain a paper copy of this notice upon request, even if you have agreed to receive it electronically. You may request a paper copy at any time by contacting our office.
Privacy Complaints
You have the right to complain to us, or directly to the Secretary of the U.S. Department of Health and Human Services, if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer using the contact information below.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.
Contact Information
Privacy Officer: Dr. Judith Monterrey
Judith Monterrey DDS LLC d/b/a Creative Toothwork
9000 SW 137th Ave, Suite 205, Miami, Florida 33186
Phone: (305) 784-0033
Email: creativetoothwork@gmail.com
