Dental One Associates of Kennesaw
2616 George Busbee Parkway NW, Kennesaw, GA 30144

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
Our Dentist was very personable, engaging and open to answer our questions; even the children. So, thank you. You are of exceptional service and […]
Sidnei O.
Efficient, competent, friendly, helpful. We go for the quality of care provided by Dr. C. Smith and Hygenist, Laura T. but the entire experience is […]
Anonymous
Dr Smith was very helpful explaining solutions for my dental problems.
Nancy W.
Everyone in the office is kind, and seems to know what they are doing.
Gayla G.
Had a great experience with Dr. Smith and his staff.
Jose R.
A+++ courteous, professional and caring!
Anonymous
Great!!! Mouth feels great after having temp crowns put in! Well informed what they where doing. Dr. Smith and his assistant where wonderful!
Michael Y.
I was very pleased with the adodonist Jeannette Jimenez I didn't have any pain during or after the root canal procedure.
Rodney U.
I have been extremely satisfied with the services I've received with this office in the last two months. thank you to everyone that's been there in […]
Tracy W.
Good experience. Great customer service.
Vicki B.
I want to commend Dr. Jimenez and Alana for going above and be on to take care of my dental needs before going on my vacation to New York yesterday.
Larry A.
Very friendly, on-time and profient service. Couldn't ask for much more. Great job Dental One!
John K.
Really nice and friendly. Best dentist I've ever been to.
Jessica H.
I really like the new Dental Hygienist. Well she's new to me since I haven't been in a while. I felt like she was very thorough unlike some of the […]
Patrice B.
I had a great time at my appointment. Always make me feel comfortable.
Jamie J.
I had a dental emergency and the dentist I normally go to would not fit me in last minute. I called Dental One and they were able to get me in and […]
Anonymous
Dr. Smith and Stacy are attuned to the patient , efficient and personable.
Marie H.
Very friendly staff. Everyone was very nice including the dentist.
Lusila L.
The personnel are always friendly and helpful, the location is central and easy.
Marie H.
Love Dr Smith and staff. I experienced no pain and would never consider using another dentist other than Dr. Smith. If he were to ever leave Dental […]
Lisa H.
Excellent service and staff.
Mary A.
I must honestly say that I was considering changing dental offices due to a prior experience with a former staff member. However, after my visit […]
Letisha M.
The staff was amazing, very friendly. Dr. Smith and his assistant Stacey were great. I know I made the right decision to make Dental One my place to […]
Brenda T.
Mary at front desk is very polite and cheerful. Dr smith and assistants were very informative on my consult and then my procedure was great. I felt […]
Donna Y.
The people are great and knowledgeable. I just wish the work can a little more affordable.
Terrance A.
BEST DENTIST AND STAFF I HAVE EVER HAD.
Jessica C.
I am an long-time patient of Dr. Smith. It broke my heart when he left Coast Dental and I am so very happy to have located him. As usual I received […]
Nancy D.
Very professional and kind.
Mary A.
I have high anxiety regarding dental care. Dr. Smith and Tech Daniel did a tremendous job of taking the time to explain my procedure and make sure I […]
Anonymous
The staff at Kennesaw Dental One was excellent. They really know what they're doing.
Don M.
Excellent work. I fully expected a lot of pain. but 26 hours after all the work by Dr Smith and his aid (sorry about the memory loss) I do not have […]
John J.
Great Staff and explained everything in a non confusing way.
Joseph H.
The facility is clean, people are friendly.
Carlton J.
Have a couple of more procedures to go, but so far, my dental work has gone as planned and the work (including an extraction) has been painless.
Anonymous
No waiting, excellent service, friendly staff
Sue W.
Prompt professional and courteous service
Richard P.
First time I had two tempory crowns put in at same time. DR Smith was very proffresional along with his staff. Made me feel very much at ease. Thanks […]
Warren S.
Everyone was very pleasant and my procedure was handled quick and efficient.
Fredrick P.
Laura Jean Tirico is the best dental hygienist around. I highly recommend her. She has been cleaning my teeth for years and I'm always completely […]
Bruce E.
Wonderful staff! Very pleasant appointment.
Alaric(aj) J.
I would highly recommend Dental one Kennesaw to anyone in need of a dentist. Dr. Craig Smith and his staff do a great job and make what I dread […]
Robert B.
My visit was wonderful, dentistry has become so innovative.
Kyesha S.
Very friendly staff. Very professional. The last couple of visits to my previous dentist had felt like dealing with high pressure sales force. The […]
Keith G.
Excellent patient care from front office all the way to the dentist.
Warren S.
The staff is very friendly and thorough when providing a service.
Dora H.
Dental One Kennesaw currently has a great team: Dr. Craig Smith, expert hygienist LauraJean Forbes, gifted dental assistants Stacy and Daniel. I was […]
Anonymous
The health of my teeth is much better now that I am having regular check ups. I now have a bridge and cavities have been filled. I feel more […]
Richard W.
Very friendly & courteous front office staff. Making appts is easy. The dental assistant was very knowledgeable as was the dentist Dr. Smith. I am […]
Patricia W.
Very clean facility and cheerful people. A good experience.
Diane T.
Best service and staff in Georgia!
David C.
Office Hours
Mon. – 8:00 AM - 5:00 PM
Tue. – 8:00 AM - 5:00 PM
Wed. – 8:00 AM - 5:00 PM
Thu. – 8:00 AM - 5:00 PM
Fri. – 8:00 AM - 1:00 PM
Sat. – Closed
Sun. – Closed
Phone: (404) 381-1480
Fax: (770) 428-0288
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.

No Insurance? No Worries! See our discounts and offers here

For appointments, call us at: (404) 381-1480 or
Request an Appointment
For appointments, call: (404) 381-1480
Office Hours
  • Monday 8:00 AM - 5:00 PM
  • Tuesday 8:00 AM - 5:00 PM
  • Wednesday 8:00 AM - 5:00 PM
  • Thursday 8:00 AM - 5:00 PM
  • Friday 8:00 AM - 1:00 PM
  • Saturday Closed
  • Sunday Closed
Get in touch:
  • Phone: (404) 381-1480
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