Active NPI
Liberty Dental Plan of Nevada, Inc.
- Health Maintenance Organization
- Las Vegas, NV
National Provider Identifier
1740706985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- Legal business name
- LIBERTY DENTAL PLAN OF NEVADA, INC.
- Practice address
- 6285 S Rainbow Blvd Ste 200
Las Vegas, NV 89118-3289 - Phone
- (888) 703-6999
- NPI assigned
- Aug 18, 2017
- Organization subpart
- Yes
- Parent organization
- LIBERTY DENTAL PLAN CORPORATION
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | Primary |
Addresses
Primary practice location
6285 S Rainbow Blvd Ste 200
Las Vegas, NV 89118-3289
Mailing address
340 Commerce Ste 100
Irvine, CA 92602-1358
Phone (949) 447-3015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| . | Other | . |
National Provider Directory
National Provider Directory- Tax ID family
- Liberty Dental Plan of Nevada Inc
- 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.
-
- Health Maintenance Organization
- Las Vegas, NV
- NPI 1013434810
Locations
6285 S Rainbow Blvd
Ste 200
Las Vegas, NV 89118
Phone (888) 703-6999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1740706985",
"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": "949-447-3015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6285 S RAINBOW BLVD STE 200",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891183289",
"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": "2017-08-18",
"last_updated": "2022-07-21",
"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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": ".",
"identifier": ".",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.