Liberty Dental Plan of New York, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

XXXX Issued in NY

Legal business name

LIBERTY DENTAL PLAN OF NEW YORK, INC.

Practice address

1730 Flight Way Ste 125
Tustin, CA 92782-1828

Phone

(888) 703-6999

NPI assigned

Apr 13, 2018

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

Chief Compliance Officer

Phone

(888) 703-6999

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Liberty Dental Plan Corporation

Locations

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1285121400",
    "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": "1730 FLIGHT WAY STE 125",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821828",
            "telephone_number": "888-703-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DENTAL PLAN OF NEW YORK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY DENTAL PLAN CORPORATION",
        "enumeration_date": "2018-04-13",
        "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": "NY",
            "license": "XXXX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XXXX",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Dental Plan Corporation
• Liberty Dental Plan East, LLC
• Liberty Dental Plan New York Ipa, LLC
• Liberty Dental Plan of Missouri, Inc.
• Liberty Dental Plan of New Jersey, Inc.
• Liberty Dental Plan of Oklahoma, Inc.
• Liberty Dental Plan of Texas, Inc.
• Liberty Dental Plan of the Southeast, Inc.
• Liberty Dental Plan Reinsurance Company, LTD.
• Liberty Dental, P.a.

• Health Maintenance Organization in Tustin, CA
• Providers in Tustin, CA by specialty
• Health Maintenance Organization in California

• 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.