0001567619-20-002251.txt : 20200206 0001567619-20-002251.hdr.sgml : 20200206 20200205182312 ACCESSION NUMBER: 0001567619-20-002251 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200206 DATE AS OF CHANGE: 20200205 EFFECTIVENESS DATE: 20200206 FILER: COMPANY DATA: COMPANY CONFORMED NAME: LIBERTY DENTAL PLAN Corp CENTRAL INDEX KEY: 0001431351 IRS NUMBER: 264074848 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-359890 FILM NUMBER: 20580213 BUSINESS ADDRESS: STREET 1: 340 COMMERCE STREET STREET 2: SUITE 100 CITY: IRVINE STATE: CA ZIP: 92602 BUSINESS PHONE: 8882732997 MAIL ADDRESS: STREET 1: 340 COMMERCE STREET STREET 2: SUITE 100 CITY: IRVINE STATE: CA ZIP: 92602 FORMER COMPANY: FORMER CONFORMED NAME: LIBERTY DENTAL PLAN CORP DATE OF NAME CHANGE: 20080402 D 1 primary_doc.xml X0708 D LIVE 0001431351 LIBERTY DENTAL PLAN Corp 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 8882732997 DELAWARE None LIBERTY DENTAL PLAN CORP Corporation true Amir Neshat 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 Executive Officer Director Ernest Burnett 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 Director John Carvelli 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 Executive Officer Director Randy Brecher 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 Director Maja Kapic 340 Commerce Street Suite 100 Irvine CA CALIFORNIA 92602 Executive Officer Other Health Care Decline to Disclose 06b false 2019-12-31 false true true true true In the merger, surviving corporation became a wholly owned subsidiary of Issuer and stockholders of target received .2250 shares of Issuer's stock for each share of target's stock. Issuer assumed outstanding options of target. 0 11797903 11797903 0 true 21 27 0 0 0 false LIBERTY DENTAL PLAN Corp /s/ Maja Kapic Maja Kapic CFO 2020-02-05