Liberty Dental Plan of Nevada, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

LIBERTY DENTAL PLAN OF NEVADA, INC.

Practice address

6385 S Rainbow Blvd Ste 200
Las Vegas, NV 89118-3208

Phone

(888) 703-6999

NPI assigned

Aug 23, 2017

Organization subpart

Yes

Parent organization

LIBERTY DENTAL PLAN CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marzena Fercz

Title

Director, Compliance

Phone

(888) 703-6999

Specialties & licenses 1

Addresses

Tax ID family

Liberty Dental Plan of Nevada Inc2 organizations share this tax ID, including this one

Part of

Liberty Dental Plan Corporation

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Liberty Dental Plan of Nevada, Inc.

  • Health Maintenance Organization
  • Las Vegas, NV
  • NPI 1740706985
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503446400000",
    "number": "1013434810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 COMMERCE STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021358",
            "telephone_number": "888-703-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 S RAINBOW BLVD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183208",
            "telephone_number": "888-703-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL PLAN OF NEVADA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DENTAL PLAN CORPORATION",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A",
        "authorized_official_last_name": "FERCZ",
        "authorized_official_first_name": "MARZENA",
        "authorized_official_title_or_position": "DIRECTOR, COMPLIANCE",
        "authorized_official_telephone_number": "888-703-6999"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberations LLC
• Liberations LLC
• Liberty Behavioral Consultants
• Liberty Behavioral Consultants
• Liberty Creek Hospice, LLC
• Liberty Dental Plan of Nevada, Inc.
• Liberty Healthcare Pharmacy of Nevada LLC
• Liberty Wellness Outpatient Counseling
• Diana Badeo Libiran
• William Adam Libling, DO, MS

• Health Maintenance Organization in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Health Maintenance Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.