Andrew Pedersen, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS041235 Issued in PA

Practice address

1589 Carlisle Rd
York, PA 17408-4528

Phone

(717) 764-3854

NPI assigned

Oct 4, 2014

Last updated

Feb 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Andrew D. Pedersen, DDS, Ms, PLLC

  dba Dietterick & Pedersen Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • York, PA
  • NPI 1821554221
  NPD

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

{
    "created_epoch": "1412380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1346643350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 CARLISLE RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174084528",
            "telephone_number": "717-764-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 CARLISLE RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174084528",
            "telephone_number": "717-764-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "ANDREW",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-04",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15586",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS041235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sakeena Jamaluddin Payne, M.D.
• PDC Two LLC (Premier Dental of York)
• Steven Pearce, MD
• Joanne E Pears, PA-C
• Michael David Pearson, M.D.
• Pediatric Care of York
• Pediatric Health Associates, PC
• Pediatrix Medical Group of Pennsylvania, P.C.
• Emily Elaine Peffer, BCBA
• Samantha Pelletier, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in York, PA
• Providers in York, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.