Wayne N Pedersen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

031510 Issued in CA

Practice address

1010 Nut Tree Rd
Suite 280
Vacaville, CA 95687-4172

Phone

(707) 447-1010

Fax

(707) 447-7040

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

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

• North Valley Dental

  • Dentist
  • Vacaville, CA
  • NPI 1730631086
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700983780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 NUT TREE RD",
            "address_2": "SUITE 280",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874172",
            "telephone_number": "707-447-1010",
            "fax_number": "707-447-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NUT TREE RD",
            "address_2": "SUITE 280",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874172",
            "telephone_number": "707-447-1010",
            "fax_number": "707-447-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "WAYNE",
        "middle_name": "N",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "031510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George G. Paz, MD
• Ruth Anne Peace, D.P.M.
• Betsy A Peacock, CRNA
• Peak Potential ABA LLC
• Dena Colleen Pearson, LVN
• Cynthia M. Peffers, BC-HIS
• Casey Mae Pelletier, PA-C
• Anahy Pena Lemus, BEHAVIOR THERAPIST
• Gisselle Pena Maldonado
• Jaime Alicia Pena

• General Practice Dentistry in Vacaville, CA
• Providers in Vacaville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.