Jac W. Pedersen II, D.D.S., Inc
NPI 1194803049ActiveOrganization· Dentist, Pediatric Dentistry· San Luis Obispo, CA
Dentist, Pediatric Dentistry in San Luis Obispo, California, registered in NPPES in November 2006. The authorized official on file is Jac W. Pedersen, Owner.
Overview
| NPI | 1194803049 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 1, 2006 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Pediatric Dentistry Primary | 1223P0221X | 27472 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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