NPI 1619631413 · live from the CMS NPI Registry
Melvin David Pederson, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in Aurora, CO. National Provider Identifier 1619631413, active.
NPI record
| NPI | 1619631413 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 15121 E Mississippi Ave, Aurora, CO 80012 |
| Practice phone | 303-802-1022 |
| Mailing address | 400 E Main St Ste 190, Hillsboro, OR 97123 |
| Enumerated | October 27, 2021 |
| Last updated | August 29, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DEN.00204856 (CO) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | D11868 (OR) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | DEN.00204856 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.