top of page

Notice of Privacy Practices

Effective Date: April 29, 2026


THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
 
1. Our Commitment to Your Privacy

Mohamed Ihsan Kayali, D.D.S, INC. (“we,” “us,” “our”), doing business as:

Covina Periodontics

San Dimas Periodontics

Trojans Periodontics & Dental Implants of Newport Beach

​

Is committed to protecting your protected health information (“PHI”) in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
We are required by law to:

  • Maintain the privacy of your PHI

  • Provide you with this Notice of our legal duties and privacy practices

  • Follow the terms currently in effect

 
2. How We May Use and Disclose Your Information
We may use and disclose your PHI for the following purposes:
Treatment
To provide, coordinate, or manage your dental and periodontal care.
Payment
To bill and collect payment from you, your insurance company, or a third party.
Healthcare Operations
To operate our practice, improve services, conduct quality assessments, and train staff.
 
3. Additional Permitted Uses and Disclosures
We may also use or disclose your PHI:

  • As required by law

  • For public health activities

  • For health oversight activities

  • For judicial or administrative proceedings

  • For law enforcement purposes

  • To avert a serious threat to health or safety

 
4. Uses Requiring Your Authorization
We will obtain your written authorization for:

  • Marketing communications not otherwise permitted

  • Sale of your information

  • Uses not described in this Notice

You may revoke authorization at any time in writing.
 
5. SMS & Electronic Communications
If you opt in to receive text messages or electronic communications:

  • These may include appointment reminders, updates, or limited health information

  • Standard messaging and data rates may apply

  • Text messaging is not always secure, and there is some risk of unauthorized access

By opting in, you acknowledge and accept these risks.
 
6. Your Rights Regarding Your Information
You have the following rights under HIPAA:
Right to Access
You may request copies of your health records.
Right to Amend
You may request corrections to your records if you believe they are incorrect or incomplete.
Right to Request Restrictions
You may request limits on how we use or disclose your information.
Right to Confidential Communications
You may request that we contact you in a specific way (e.g., phone vs. email).
Right to an Accounting of Disclosures
You may request a list of certain disclosures of your PHI.
Right to a Paper Copy
You may request a paper copy of this Notice at any time.
 
7. Our Responsibilities
We are required to:

  • Maintain the privacy and security of your PHI

  • Notify you following a breach of unsecured PHI

  • Abide by the terms of this Notice

 
8. Business Associates
We may share your PHI with third-party service providers (business associates) who perform services on our behalf (e.g., billing, scheduling, messaging platforms).
These parties are required to safeguard your information and comply with HIPAA through formal agreements.
 
9. Breach Notification
In the event of a breach of your unsecured PHI, we will notify you as required by law, including details of the breach and steps you can take to protect yourself.
 
10. Changes to This Notice
We reserve the right to change this Notice at any time. Any updated Notice will be posted on our website and will apply to all information we maintain.
 
11. Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with:
U.S. Department of Health and Human Services
Office for Civil Rights
We will not retaliate against you for filing a complaint.
 
12. Contact Information
If you have questions, requests, or complaints, please contact:

​

Mohamed Ihsan Kayali, D.D.S, INC.

Covina Periodontics
219 E. Badillo St. Covina, CA 91723
(626) 966-9971

covina@perio4life.com

​

Mohamed Ihsan Kayali, D.D.S, INC.

San Dimas Periodontics
1111 W. Covina Blvd. Ste 220. San Dimas, CA 91773

(909) 599-9510
sandimas@perio4life.com

​

Mohamed Ihsan Kayali, D.D.S, INC.

Trojans Periodontics & Dental Implants of Newport Beach

1401 Avocado Ave. Ste 406 Newport Beach CA 92660

(949) 688-6003

newport@perio4life.com​

bottom of page