Notice of Privacy Practice
Effective Date: 19/10/2026
THIS NOTICE DESCRIBES HOW MEDICAL AND DENTAL INFORMATION ABOUT YOU OR YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At Windmill Pediatric Dentistry, protecting the privacy of every child and family we care for is part of how we earn your trust. This HIPAA Privacy Policy, also called our Notice of Privacy Practices, explains how we use and share your child's protected health information (PHI), the choices you have, and the rights you have under the Health Insurance Portability and Accountability Act (HIPAA) and Nevada law. PHI includes any information that identifies your child and relates to their health, dental care, or payment for that care, such as dental records, X rays, treatment notes, and billing details.
Our Commitment to Your Privacy
Windmill Pediatric Dentistry is required by law to:
Keep your child's PHI private and secure
Give you this policy explaining our legal duties and privacy practices
Follow the terms of the notice that is currently in effect
Let you know promptly if a breach occurs that may have compromised the privacy or security of your child's information
We will not use or share your child's information in ways other than those described in this policy unless you tell us we can in writing.
How We Use and Share Your Child's Information
We typically use or share PHI in the following ways, and we do not need your written permission to do so.
For treatment. We use your child's information to provide and coordinate their dental care. For example, Dr. Sisi may share X rays and treatment notes with an orthodontist, oral surgeon, pediatrician, or hospital team involved in your child's care, including care provided under general anesthesia.
For payment. We use and share information to bill and receive payment for the care we provide. For example, we may send details of your child's visit to your dental insurance plan, or use it to manage your account under our membership plan.
For our healthcare operations. We use information to run our practice, improve the quality of care, and train our team. For example, we may review records to evaluate our services, complete audits, or meet licensing requirements.
Appointment reminders and practice communications. We may contact you by phone, text message, email, or mail to remind you of appointments, follow up after treatment, or share information about services that may benefit your child. You can ask us to stop or change how we contact you at any time.
Business associates. Some services are handled for us by outside companies, such as billing, scheduling, IT support, and dental laboratories. These business associates must sign agreements promising to protect your child's information and use it only as we allow.
Other Ways We May Use or Share Information
The law allows or requires us to share information in certain other situations, usually to support public health, safety, or legal duties. We share only what is necessary and only when the conditions set by law are met.
When required by law: to comply with federal, state, or local laws, including when the U.S. Department of Health and Human Services checks that we are following privacy law.
Child safety: to report suspected child abuse or neglect to the appropriate authorities, as Nevada law requires of dental providers.
Public health activities: for example, to prevent or control disease, or to report problems with dental products or medications.
Health oversight: to agencies such as the Nevada State Board of Dental Examiners for audits, inspections, and licensing.
Legal proceedings: in response to a court order, subpoena, or other lawful process.
Law enforcement: for limited purposes, such as responding to a valid legal request.
Serious threats to health or safety: to help prevent or lessen a serious and imminent threat to a person or the public.
Coroners, medical examiners, and funeral directors: when needed for them to carry out their duties.
Organ and tissue donation: to organizations involved in donation and transplants.
Research: when the research has been approved through a privacy review process that protects your information.
Specialized government functions: for military, national security, or other government programs as the law allows.
Workers' compensation: for claims, as permitted by law.
When We Need Your Written Permission
We will ask for your written authorization before we:
Use or share PHI for marketing purposes
Sell PHI
Use or share PHI for any purpose not described in this policy
You may cancel an authorization at any time by writing to us. Canceling stops future uses and disclosures, but it cannot undo information we already shared while your permission was in place.
We do not currently use patient information for fundraising. If that ever changes, you will have the right to opt out of fundraising communications.
If we ever receive records about substance use disorder treatment that are protected under federal law (42 CFR Part 2), we will not use or share them without your specific written consent, except as that law allows.
Your Choices
For some information, you can tell us what you want us to share. If you have a clear preference, let us know and we will follow your instructions where the law allows.
You have both the right and the choice to tell us whether to:
Share information with family members, close friends, or others involved in your child's care or payment for care
Share information in a disaster relief situation
Leave detailed appointment messages on voicemail or by text
If you are not able to tell us your preference, for example in an emergency, we may share information if we believe it is in your child's best interest. We may also share information when needed to lessen a serious and imminent threat to health or safety.
Your Rights
When it comes to your child's health information, you have certain rights. To use any of them, contact our Privacy Officer using the details at the end of this policy.
See or get a copy of dental records. You can ask to see or receive a paper or electronic copy of your child's dental and billing records. We will usually respond within 30 days and may charge a reasonable, cost based fee.
Ask us to correct records. If you believe information in your child's record is wrong or incomplete, you can ask us in writing to correct it. If we say no, we will explain why in writing within 60 days.
Request confidential communications. You can ask us to contact you in a specific way, such as only on your mobile phone, or at a different address. We will agree to all reasonable requests.
Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment, or our operations. We are not required to agree, and we may say no if it would affect your child's care. If you pay for a service in full out of pocket, you can ask us not to share that information with your health plan, and we will agree unless the law requires us to share it.
Get a list of those we have shared information with. You can ask for a list of the times we shared your child's information in the six years before your request, who we shared it with, and why. This list does not include disclosures for treatment, payment, or operations, or those you asked us to make. We provide one list a year free of charge.
Get a copy of this policy. You can ask for a paper copy of this policy at any time, even if you agreed to receive it electronically.
Choose someone to act for you. If you have given someone legal authority to make healthcare decisions, or someone is your legal guardian, that person can exercise these rights for you. We will confirm their authority before we act.
Parents, Guardians, and Minor Patients
Because we care for infants, children, and teens, a parent or legal guardian is generally treated as the child's personal representative and may exercise the rights in this policy on the child's behalf. There are limited exceptions under Nevada and federal law, for example when a minor is legally allowed to consent to their own care, or when we believe sharing information with a parent could put the child at risk. In separated or divorced families, both parents usually keep access to their child's records unless a court order says otherwise. Please give us a copy of any custody order that affects access.
Breach Notification
If a breach occurs that may have compromised the privacy or security of your child's information, we will notify you without unreasonable delay, and no later than 60 days after we discover it.
Questions and Complaints
If you believe your child's privacy rights have been violated, you can file a complaint with us by contacting our Privacy Officer. You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone (toll free): 1-800-368-1019 · TDD: 1-800-537-7697
Online: www.hhs.gov/ocr/complaints
We will never retaliate against you or your child for filing a complaint.
Contact Our Office
Windmill Pediatric Dentistry: 7960 S Rainbow Blvd Ste 8000B, Las Vegas, NV 89139 Phone: (702) 708-1299 Email: wpdlvmarketing@gmail.com
Changes to This Policy
We may change the terms of this policy, and the changes will apply to all information we have about your child. The current policy will always be available in our office, on our website, and on request.