Important Information You Need to Know: This notice describes how your dental information may be used and disclosed. Please review it carefully. (Effective Date: October 9, 2025)


When This Notice Applies

This notice summarizes the privacy practices of MAQ SMILE LLC.


Our Obligations

We are committed to protecting the right to privacy of our patients. In this regard and as required by law, we:

  • Obtain your consent to use and disclose records about your health and dental care;
  • Are required to maintain the privacy and security of your protected dental health information;
  • Must abide by the obligations and privacy practices described in this notice and give you a copy of them;
  • Will not use or share your information for any other purpose than those described herein unless you authorize us in writing. Even if you authorize us to share such information, you may change your mind at any time. Inform us if this is the case; and
  • Will notify you promptly if a breach occurs that may compromise the privacy or security of your information.

How We May Use and Disclose Health Information

When you receive services or treatment at MAQ SMILE, you will be asked to sign an acknowledgment of receipt of this notice, which describes how we use and disclose information about you in ways that are permitted by federal law. The following categories describe the ways we may use and disclose health information that identifies you.

With the exception of the purposes described below, we will only use and disclose dental health information with your additional written authorization. If you authorize us to use or disclose dental health information for a purpose not mentioned in this notice, you may revoke that authorization at any time by sending a written request to our email at info@maqsmile.com.

Protected Dental Health Information may also be disclosed to the ADA Department and Human Services for the purpose of investigating or determining compliance with the HIPAA Privacy Rule by the covered entity.


a) For Treatment

We may use your dental health information to provide you with treatment or dental care services. We may disclose your dental health information to doctors, nurses, technicians, or other personnel, including people outside our facility who may be involved in your medical care. For example, to coordinate the continuity of your care, we might exchange medical information with other care providers.


b) For Payment

We may use and disclose dental health information so that we or others may bill or receive payment from you, an insurance company, or a third party for the treatment and services you receive. For example, we may provide your health plan with information about your treatment so they will pay for it.


c) For Dental Healthcare Operations

We may use and disclose health information for healthcare operations and administration. These uses and disclosures are necessary to ensure all our patients receive quality care and for operational and administrative purposes. For example, we may use health information to review the treatment and services we provide, or we might post thank you notes or photos you send us on the Website.


d) Appointment Reminders, Treatment Alternatives, and Health-Related Benefits and Services


We may use and disclose your dental health information to communicate with you and remind you that you have an appointment with us. We may use and disclose your dental health information to inform you about treatment options or alternatives, or about health-related benefits and services that may be of interest to you.


Special Circumstances

a) As Required By Law

We will disclose your dental health information when required by international, federal, state, or local laws.


b) To Prevent a Serious Threat to Health or Safety

We may disclose your dental health information when necessary to prevent or lessen a serious threat to your dental health and safety or to the health and safety of the public or another person.


c) HIV Test Results

If you had an HIV test or gave us the information and did not authorize us to use and disclose the results, we will only do so:

  • (1) To provide you with dental healthcare services, for example, we may inform the doctor and assistant related to the dental procedure.

d) Military and Veterans

If you are a member of the armed forces, we may disclose dental health information as required by military command authorities. We may also disclose information to a foreign military authority, if you are a member of a foreign country's armed forces.


e) Lawsuits and Disputes

If you are involved in a lawsuit or dispute, we may disclose your dental health information in response to a court or administrative order. We may also disclose your dental health information in response to a subpoena, discovery request, or other legal process, but only if efforts have been made to inform you of the request or to obtain an order protecting the information.


f) Law Enforcement

We may disclose health information if a law enforcement official asks us to do so for reasons such as:

  • (1) In response to a court order, subpoena, warrant, summons, or similar process;
  • (2) Limited information to identify or locate a suspect, fugitive, witness, or missing person;
  • (3) Concerning the victim of a crime if we are unable to obtain the person’s agreement;
  • (4) Concerning a death we believe may be the result of criminal conduct;
  • (5) Concerning criminal conduct on our premises; and
  • (6) In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description, or location of the person who committed the crime.

g) Electronic Exchange of Your Dental Health Information

We participate in electronic dental health information exchange systems with other medical providers, health information exchange networks, and health plans. We may share or provide access to your dental medical information with others for purposes of treatment, payment, or healthcare operations. We may also access your health information held by others for the same purposes.


Your Rights

You have the following rights regarding your dental health information that we hold:


a) Right to Inspect and Copy

You have the right to view or receive an electronic or paper copy of your dental medical record and other health information we have about you. We will provide a copy or summary of your dental health information, generally within 30 days of receiving your request. We reserve the right to charge a reasonable, cost-based fee for this.


b) Right to Amend

If you feel that the dental health information we have about you is incorrect or incomplete, you may ask us to amend it. We might deny your request, but we will inform you of the reason in writing within 60 days.


c) Right to Choose a Representative

If you have given someone legal authority to act on your behalf, such as a medical power of attorney or a legal guardian, that person can exercise your rights and make choices about your dental health information.


d) Right to Request Restrictions

You may ask us not to use or share certain dental health information for treatment, payment, or our operations. We are not required to agree to all requests. However, we must agree to a request to restrict disclosure of information to a health plan if:

  • The services were paid for in full "out-of-pocket" by you or on your behalf; and
  • The disclosure is not required by law.


e) Right to Request Confidential Communications

You have the right to ask that we communicate with you about dental medical matters in a certain way or at a certain location (e.g., only by mail or via text). We will accommodate all reasonable requests.


f) Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this notice at any time.


How to Exercise Your Rights

To exercise the rights described in this notice (outside of obtaining a copy of this notice), you must send your request via email to info@maqsmile.com or in writing, to the following address: 5600 Waterford District Dr, Suite #15 Miami FL, 33126.