Part of the Maple Shade Dental Group family
Maple Shade Dental of East Peoria
1001 Illini Drive, East Peoria, IL 61611

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
The dental nurse I had was very helpful and so nice!
Chelsea R.
Very nice hygentist.Efficient and friendly.
Laura B.
Had teeth cleaned and am getting ready to get partials. Very satisfied with all involved
Jerry P.
I wrote a previous review about being overcharged for my retainer and not even a day later I received a call saying they read my review and I was […]
Sarah S.
Great service. Always friendly,professional and timely.
Deandrea B.
Very efficient and thorough
Dennis M.
had a filling and it went very smooth…thanks
Janis P.
Love my dental hygienist!!!
Tracy V.
Prompt and on time service in a nice environment.
Jason B.
Such a friendly place! It makes me enjoy going to the dentist!
Samantha L.
My dental hygenist was very attentive to all my needs pertaining to dental health and truly cares that I have healthy teeth, etc.
Joel S.
A++ great staff
Scott S.
Julie and Dr Shanahan were great as usual.
Mary H.
Great place.
Anonymous
I broke a tooth and they got me in within the hour and reconstructed my tooth so I only had to miss a half day of work!!!!!!
Karen C.
They were very straightforward about the state and health of my teeth. They offered me solutions to improve my teeth's health and offered very […]
Latrent B.
I had a great experience, my teeth look and feel great!
Jeremy S.
Erin Shanahan, DMD DID AN AWESOME JOB.
Rachael W.
PROFESSIONAL AND POLITE. PROVIDED ASSISTANCE WITH INSURANCE BALANCE.
Barry G.
Our family has been going to Maple Shade for our dental care for 25 years. That alone represents our confidence in this fine group of dental […]
Steven G.
Always awesome quality care by great people at Maple Shade in East Peoria
Sarah B.
Had a cleaning and found a cavity. Thank goodness it was found before I needed a crown.
Janis P.
Amazing service! Didn't make me feel embarrassed or guilty about any of my dental history.
Kelsey M.
Always have had great experiences with Mapleshade and my family has been going there for the last 20 years!
Riley J.
I have never had a negative experience at maple shade. My dental hygienist, julie has always been friendly and awesome. I know i can count on her to […]
Ronald S.
Always enjoy the friendly people & it didn't hurt.
Michael S.
Friendly staff, good feedback, prompt service.
Michael M.
They are the best, Doctor Duncan and his staff.
Sandra T.
Very personable and friendly. Great with my 6 year old!
Lindsay S.
Yes i would recommend Maple Shade
Bruce W.
Wonderful, as usual!
Christine P.
I have been to Maple Shade on Illini dr three times now. Everyone is so friendly and the Doctors are so nice to. If they can work with my budget, I […]
Sandy O.
I love Maple Shade in East Peoria.Everyone on staff is friendly and caring!
Laura B.
Great friendly staff! Always on time.
Karen P.
Really enjoy going there. Staff is very friendly!
Carrie M.
Had to reschedule my appointment at the last minute. They were able to squeeze me in. Always get great service with a smile!
Emma B.
Julie was amazing! I want her every time I come !!!!!!
Lorie R.
Everything was better than my past experiences!
Gordon K.
As always, my experience was extremely pleasant. The staff is always pleasant and helpful. Thank You!
Christine P.
Excellent and gentle care for my daughter who had a filling done.
Anari H.
They have been my dentist for over 20 years, doesn't matter which staff member you get you always get great service and treated well. I like all of […]
Terri I.
I was pleased with the punctuality. And the staff was professional and thorough.
Alex A.
My appt was excellent as always. My hygenists truly cares for my dental health.
Joel S.
Found everyone VERY Helpful and encourageing......
Ardith K.
I love Maple Shade!Love my dentist and my lovely hygentist!
Laura B.
Great as always. Thanks
Paul(boyd) P.
I like the Maple Shade staff in East Peoria. One of the main reasons I go there is because of Rhonda Trotter.
Kent M.
the results were better than expected
Eyad E.
Nice staff.
Vincent R.
The dentists and hygentists are great at Maple Shade in East Peoria! Our whole family goes there now.The staff is friendly and helpful.Great […]
Jessie B.
Office Hours
Mon. – 8:00 AM - 5:30 PM
Tue. – 8:00 AM - 5:30 PM
Wed. – 8:00 AM - 5:30 PM
Thu. – 8:00 AM - 5:30 PM
Fri. – 8:00 AM - 2:00 PM
Sat. – Closed
Sun. – Closed

1st & 3rd Fridays

Phone: (309) 222-8447
Fax: (309) 698-1205
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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.

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For appointments, call us at: (309) 222-8447 or
Request an Appointment
For appointments, call: (309) 222-8447
Office Hours
  • Monday 8:00 AM - 5:30 PM
  • Tuesday 8:00 AM - 5:30 PM
  • Wednesday 8:00 AM - 5:30 PM
  • Thursday 8:00 AM - 5:30 PM
  • Friday 8:00 AM - 2:00 PM
  • Saturday Closed
  • Sunday Closed
Get in touch:
  • Phone: (309) 222-8447
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