NPIMap

Organization Active NPI

Liberty Dental Plan of Florida, Inc.

  • Health Maintenance Organization
  • Tampa, FL
National Provider Identifier
1053899526
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
LIBERTY DENTAL PLAN OF FLORIDA, INC.
Practice address
3109 W Dr Martin Luther King Jr Blvd Ste 100
Tampa, FL 33607-6219
Phone
(888) 703-6999
NPI assigned
Aug 6, 2018
Organization subpart
Yes
Parent organization
LIBERTY DENTAL PLAN CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Marzena Fercz
Title
Chief Compliance Officer
Phone
(888) 703-6999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

3109 W Dr Martin Luther King Jr Blvd Ste 100
Tampa, FL 33607-6219

Mailing address

1730 Flight Way Ste 125
Tustin, CA 92782-1828
Phone (888) 703-6999

National Provider Directory

National Provider Directory
Tax ID family
Liberty Dental Plan of Florida Inc11 organizations share this tax ID, including this one
Part of
Liberty Dental Plan Corporation

Other organizations with this tax ID 10

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

Locations

3109 W Dr Martin Luther King Jr Blvd
Ste 100
Tampa, FL 33607
Phone (888) 703-6999

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1053899526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 FLIGHT WAY STE 125",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821828",
            "telephone_number": "888-703-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 W DR MARTIN LUTHER KING JR BLVD STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076219",
            "telephone_number": "888-703-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL PLAN OF FLORIDA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DENTAL PLAN CORPORATION",
        "enumeration_date": "2018-08-06",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "FERCZ",
        "authorized_official_first_name": "MARZENA",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "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": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.