Jac W Pedersen II DDS
NPI 1407014541ActiveOrganization· Dentist, Pediatric Dentistry· San Luis Obispo, CA
Dentist, Pediatric Dentistry in San Luis Obispo, California, registered in NPPES in May 2008. The authorized official on file is Jac W. Pedersen, Owner.
Overview
| NPI | 1407014541 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2008 |
| Last updated in NPPES | May 27, 2008 |
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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