JEROME WAYNE PEDERSEN DDS
NPI 1225126063
Dentist in Hibbing, MN

Q: What is Jerome Pedersen's NPI number?

The NPI number for Jerome Pedersen is 1225126063. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Q: What is Jerome Pedersen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Jerome Pedersen was last updated on August 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 10, 2006PECOS Enrolled

1515 E 25TH ST, C-153 HIBBING COMMUNITY COLLEGE, HIBBING, MN 55746(218) 263-2918 Get Directions Write a Review

NPPES record last updated: August 20, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Jerome Wayne Pedersen Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEROME WAYNE PEDERSEN DDS (NPI 1225126063) is an individual dentist in Hibbing, Minnesota, licensed in Minnesota (D8426) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225126063

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameJEROME WAYNE PEDERSENCredential: DDS

Location Address1515 E 25TH ST, C-153 HIBBING COMMUNITY COLLEGEHibbing, MN 55746-3354

Mailing Address1515 E 25th St, Room C-153Hibbing, MN 55746-3354

Phone(218) 263-2918

Sole ProprietorNo

Enumeration DateOctober 10, 2006

Last NPPES UpdateAugust 20, 2007

✔ NPI 1225126063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · D8426

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1515 E 25TH ST, Hibbing, MN 55746

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerome Wayne Pedersen Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55746 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGENTS OF THE UNIVERSITY OF MINNESOTA

Clinic/Center (Dental)

1515 E 25TH ST, ROOM C-153
HIBBING, MN 55746

St. Louis County (218) 263-2917

DR. JOHN THOMAS ZUPANCIC DDS

Dentist (General Practice)

1515 E 25TH ST, C-153
HIBBING, MN 55746

St. Louis County (218) 263-2916

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerome Pedersen's NPI number?

The NPI number for Jerome Pedersen is 1225126063. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Jerome Pedersen located?

Jerome Pedersen practices at 1515 E 25th St C-153 Hibbing Community College, Hibbing, MN 55746. The listed phone number is (218) 263-2918.

What is Jerome Pedersen's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jerome Pedersen enrolled in Medicare?

Yes. Jerome Pedersen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jerome Pedersen was last updated on August 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.