Organization Active NPI

Liberty Dental Plan Corporation

  • Health Maintenance Organization
  • Tustin, CA
National Provider Identifier
1740747492
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
LIBERTY DENTAL PLAN CORPORATION
Practice address
1730 Flight Way Ste 125
Tustin, CA 92782-1828
Phone
(888) 703-6999
NPI assigned
Feb 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 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
(917) 922-2313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

1730 Flight Way Ste 125
Tustin, CA 92782-1828

Mailing address

1730 Flight Way Ste 125
Tustin, CA 92782-1828

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1740747492",
    "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"
        },
        {
            "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 CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "FERCZ",
        "authorized_official_first_name": "MARZENA",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "917-922-2313"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.