Dental Cleaning For The Best Patients!

Meet Dr. Patrick & His Staff

Dr. Donald R. Patrick graduated from the University of NC at Chapel Hill. Dr. Patrick moved to Greenville and has been serving Greenville and its surrounding areas since 1964. Dr. Patrick along with his professionally trained, courteous, and friendly staff will treat you with the most personal and professional care you deserve.

Dr. Donald Patrick is a member of the American Dental Association, North Carolina Dental Society, the Academy of General Dentistry, and other professional organizations.

We gladly welcome new patients! We accept most dental insurances. Come visit us today. We are conveniently located at 3740 South Evans Street Suite C, where there is ample parking available. Dr. Patrick and his staff look forward to serving you and your family for a lifetime of healthy teeth and gums.

Office location: 3740 South Evans, Suite C

      Our Comfortable Waiting Room  

We Offer:

• General Dentistry

We are an affordable dentist who performs routine preventative maintenance on teeth and gums such as routine dental cleaning, fillings, x-rays and check-ups.

• Extractions

Tooth extraction is the removal of a tooth from its socket in the bone.

• Teeth Whitening

Brightening technique performed by applying certain medicaments. Can be done at home or in office. Not a permanent treatment, it lasts for six to twelve months and is easily maintained or retreated.

• Crowns

A covering placed on a tooth to replace missing structure and reinforce or strengthen it. Commonly made from metal with porcelain baked to the outside. Crowns are used for broken or cracked teeth or over teeth where a previous filling encompasses more than one-half of the tooth. Crowns usually require two appointments for preparation and placement.

• Bridges

Replacing a missing tooth by placing at least two crowns on adjacent teeth and suspending a false tooth in between. This restoration is cemented to your teeth and is not removable.

• Tooth-colored Fillings

Tooth-colored fillings are a safer and more attractive alternative to older silver amalgam fillings. By precisely matching tooth-colored composite fillings with the natural color of your teeth, a skilled cosmetic dentist is able to provide you with white fillings that are virtually invisible. The removal of amalgam fillings can provide patients with white fillings that provide a more pleasing, silver-free smile.

• Full/Partial Dentures

A removable appliance that replaces missing teeth in either the upper or lower jaw.

• Cosmetic Dentistry

Methods used to enhance the smile including bleaching, porcelain veneers and porcelain crowns.

• Gum Treatments

Periodontal procedures including reshaping of gum contours or removal of excess gum tissue for health or esthetic purposes.

One of our Exam Rooms

HIPAA & Your Privacy Rights

HIPAA & Your Privacy Rights
We strongly believe in doing everything we possibly can to safeguard the privacy and security of your health information and records.

As a result, we have made some changes in our office management procedures to make sure we follow the Health Information Portability and Accountability Act (HIPAA). Passed into law in 1996, HIPAA sets federal standards for the privacy and security of patient information for all healthcare providers, plans, insurance companies and anyone they do business with.

HIPAA gives you additional rights regarding control and use of your health information, meaning you have more access and control than ever. Please take a few minutes to review these new rights. We're happy to answer any questions you may have.

Control over Your Health Information

All healthcare providers (and health plans) are now required to give you a written explanation of how they use and disclose your personal health information before they can treat you. This way, you can decide if a provider is doing everything they should to protect your privacy before you choose them as your caregiver.

We must, by law, post a Notice of Privacy Practices, which outlines how we secure the privacy of patient information, in a place where you can easily see it.

We must get your signature for non-routine uses and disclosures of your information. A non-routine use is any situation not directly related to treatment, payment or operations. For example, if your child is going to summer camp and the camp needs a medical history, you will be asked to authorize us to release it before we can send the information. You have the right to say no, and you don't have to tell anyone why.

Authorizations of non-routine information are one-time-only, case by case, for the use defined by you.

Access to Your Health Information

You can get copies of your medical records simply by asking for them. Healthcare providers are required to get you a copy of your records within 60 days of your request. There may be a cost for this service.

Providers also must give you a history of non-routine disclosures if you ask for it. All you need to do is ask for the record and it is provided to you - no justification is needed.

You can also amend your medical records. You cannot change the existing record, buy you can add notes or comment on any procedures, treatments, payment or operations.

The provider then has the right to respond to your amendment. This way, you can be sure your records reflect your side of the story about treatment and payment issues. 

Donald R. Patrick, DDS

3740 S. Evans Street

Suite C

Greenville, NC 27834

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.

If you have any questions about this Notice please contact Jane 

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operation and for other purposes that are permitted or required by law.  It also describes your rights to access and control your protected health information.  “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. 

We are required to abide by the terms of this Notice of Privacy Practices.  We may change the terms of our notice, at any time.  The new notice will be effective for all protected health information that we maintain at that time.  Upon your request, we will provide you with any revised Notice of Privacy Practices by [accessing our web site (Insert Physician Practice website address)], calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment. 

1. Uses and Disclosures of Protected Health Information

Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you.  Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of the physician’s practice. 

Following are examples of the types of uses and disclosures of your protected health care information that the physician’s office is permitted to make.  These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office. 

Treatment: We will use and disclose your protected health information to provide, coordinate or manage your health care and any related services.  This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your protected health information.  For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you.  We will also disclose protected health information to other physicians who may be treating you when we have the necessary permission from you to disclose your protected health information.  For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. 

In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician. 

Payment: Your protected health information will be used, as needed, to obtain payment for your health care services.  This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as; making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, an and undertaking utilization review activities.  For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission. 

Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of your physician’s practice.  These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities. 

For example, we may disclose your protected health information to medical school students that see patients at our office.  In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician.  We may also call you by name in the waiting room when your physician is ready to see you.  We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment and, if you are unavailable, we may leave the information with another member of your household or on your voice mail. 

We will share your protected health information with third party “business associates” that perform various activities (e.g., billing, transcription services) for the practice.  Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information. 

We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.  We may also use and disclose your protected health information for other marketing activities.  For example, your name and address may be used to send you a newsletter about our practice and the services we offer.  We may also send you information about products or services that we believe may be beneficial to you.  You may contact our Privacy Contact to request that these materials not be sent to you. 

We may use or disclose your demographic information and the dates that you received treatment from your physician, as necessary, in order to contact you for fundraising activities supported by our office.  If you do not want to receive these materials, please contact our Privacy Contact and request that these fundraising materials not be sent to you. 

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition. 

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections.  Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws. 

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect.  In addition, we may disclose your protected health information if we believe that you have been victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information.  In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws. 

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required. 

Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), in certain conditions in response to a subpoena, discovery request or other lawful process. 

Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes.  These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information request for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicions that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on the Practice’s premises) and it is likely that a crime has occurred. 

Coroners, Funeral Directors, and Organ Donation:  We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law.  We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties.  We may disclose such information in reasonable anticipation of death.  Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes. 

Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information. 

Uses and Disclosures or Protected Health Information Based upon Your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below.  You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action reliance on the use or disclosure indicated in the authorization. 

Other Permitted and Required Uses and Disclosures That May Be Made With Your Authorization or Opportunity to Object

We may use and disclose your protected health information in the following instances.  You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information.  If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest.  In this case, only the protected health information that is relevant to your health care will be disclosed. 

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 indentify, your protected health information that directly relates to that person’s involvement in your health care.  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 interested based on our professional judgment.  We may use or disclose health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death.  Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care. 

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object

We may use or disclose your protected health information in the following situations without your authorization.  These situations include: 

Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law.  The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.  You will be notified, as required by law, of any such uses or disclosures. 

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information.  The disclosure will be made for the purpose of controlling disease, injury or disability.  We may also disclosure your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority. 

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.  We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual. 

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services.  We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized. 

Workers’ Compensation: Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs. 

Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.

Required Uses and Disclosures: Under the laws, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq. 

2.      Your Rights

Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights. 

You have the right to inspect and copy your protected health information.  This means you may inspect and obtain a copy of protected health information about you that is contained in a designated record set for as long as we maintain the protected health information.  A “designated record set” contains medical and billing records and any other records that your physician and the practices uses for making decisions about you.

Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative  action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.  Depending on the circumstances, a decision to deny access may be reviewable.  In some circumstances, you may have a right to have this decision reviewed.  Please contact our Privacy Contact if you have questions about access to your medical record. 

You have the right to request a restriction of your protected health information.  This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family member or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices.  Your request must state the specific restriction requested and to whole you want the restriction to apply. 

Your physician is not required to agree to a restriction that you may request.  If physician believes it is in your best interest to permit use and disclosure of your protected health information will not be restricted.  If your physician does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment.  With this in mind, please discuss any restriction you wish to request with your physician.  You may request a restriction by [describe how patient may obtain a restriction.] 

You have the right to request to receive confidential communications from us by alternative means or at an alternative location.  We will accommodate reasonable requests.  We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.  We will not request an explanation from you as to the basis for the request.  Please make this request in writing to our Privacy Contact. 

You may have the right to have your physician amend your protected health information.  This means you may request an amendment of protected health information about you in a designated record set for as long as we maintain this information.  In certain cases, we may deny your request for an amendment.  If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.  Please contact our Privacy Contact to determine if you have questions about amending your medical record. 

You have the right to receive an accounting of certain disclosures we have made, if any , of your protected health information.  This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices.  It excludes disclosures we may have made to you, to family members or friends involved in your care, as a result of an authorization signed by you or for notification purposes.  You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003.  You may request them for the previous six years or a shorter timeframe.  The right to receive this information is subject to certain exceptions, restrictions and limitations. 

You have the right to obtain a paper copy of this notice from this, upon request, even if you have agreed to accept this notice electronically. 

3.      Complaints

You may complain to us or to the Secretary 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 contact of your complaint.  We will not retaliate against you for filing a compliant. 

You may contact our Privacy Contact, Jane, at (252)493-4926 for further information about the complaint process. 

This notice was published and becomes effective on [complete with a date which should be no later than April 14, 2003.]

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