Anne Pedersen, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS102117 Issued in CA

Practice address

1414 S Miller St Ste 8
Santa Maria, CA 93454-6961

Phone

(805) 345-3702

NPI assigned

Jul 1, 2014

Last updated

Dec 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17363/brand/1/csg/1/fhir/r4

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.

• A. Pedersen Dental Corporation

  • Pediatric Dentistry
  • San Luis Obispo, CA
  • NPI 1043173628
  NPD Authorized official
• A. Pedersen Dental Corporation

  • Pediatric Dentistry
  • San Luis Obispo, CA
  • NPI 1255294211
  NPD Authorized official
• Anne Pedersen DDS Inc

  dba Mariposa Pediatric Dentistry

  • Pediatric Dentistry
  • Santa Maria, CA
  • NPI 1750971719
  NPD Authorized official
• Community Health Centers of the Central Coast

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1891925905
  NPD (past)

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639180800000",
    "number": "1386059103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 S MILLER ST STE J",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546915",
            "telephone_number": "805-922-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 S MILLER ST STE 8",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546961",
            "telephone_number": "805-345-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS102117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Bartley Paulson, RN, APN
• Lynda Loie Paxton
• Maria Angeles Paz Camacho, MFT
• Paz FCC
• Justine Paz
• Mary Jo Pedersen, LMFT
• Pediatric Inpatient Specialists PC
• Pediatric Medical Group of Santa Maria Inc
• Edgar Pedraza
• Peds Care LLC (Melinda Belgrave MD inc)

• Pediatric Dentistry in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.