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GARY THEODORE PEDERSON D.D.S.
NPI 1447258223
Dentist - Oral and Maxillofacial Surgery in Salem, OR

Active since July 14, 2005
1565 LIBERTY ST SE, SALEM, OR 97302(503) 581-0223(503) 581-6794 Get Directions Write a Review

NPPES record last updated: July 17, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gary Theodore Pederson D.d.s. NPPES

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

GARY THEODORE PEDERSON D.D.S. (NPI 1447258223) is an individual oral and maxillofacial surgery provider in Salem, Oregon, licensed in Oregon (D4658) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1447258223
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameGARY THEODORE PEDERSONCredential: D.D.S.
Location Address1565 LIBERTY ST SESalem, OR 97302-4345
Mailing Address1565 Liberty St SeSalem, OR 97302-4345 · (503) 581-0223 · Fax (503) 581-6794
Phone(503) 581-0223
Fax(503) 581-6794
Sole ProprietorYes
Enumeration DateJuly 14, 2005
Last NPPES UpdateJuly 17, 2007
✔ NPI 1447258223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in OR · D4658
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1565 LIBERTY ST SE, Salem, OR 97302
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Other Providers at the Same Location NPPES 3

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

GARY T. PEDERSON
Dentist (Oral and Maxillofacial Surgery)
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223
DAVID C SWIDERSKI DDS, MD
Oral & Maxillofacial Surgery
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223
MID-VALLEY ORAL, MAXILLOFACIAL & IMPLANT SURGERY
Clinic/Center (Oral and Maxillofacial Surgery)
1565 LIBERTY ST SE
SALEM, OR 97302
Marion County (503) 581-0223

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 Gary Pederson's NPI number?

The NPI number for Gary Pederson is 1447258223. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Gary Pederson located?

Gary Pederson practices at 1565 Liberty St SE, Salem, OR 97302. The listed phone number is (503) 581-0223.

What is Gary Pederson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Gary Pederson was last updated on July 17, 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.