Gary T. Pederson
Gary T. Pederson is a healthcare organization registered as Oral and Maxillofacial Surgery (Dentist) in Salem, OR, holding Type 2 (organization) NPI 1154517415 since 2007. The authorized official on file is Gary Pederson, Oral Surgeon.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1154517415 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Gary T. Pederson |
| Practice address | 1565 LIBERTY ST SE, Salem, OR, 97302 |
| Phone | 5035810223 |
| Fax | 5035816794 |
| Enumeration date | 2007-09-20 |
| Last updated in NPPES | 2007-09-20 |
Authorized official
| Name | Gary Pederson |
|---|---|
| Title | Oral Surgeon |
| Phone | 5035810223 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | Primary | D4658 | OR |
Copy-ready billing details
Provider: Gary T. Pederson NPI: 1154517415 Taxonomy: 1223S0112X (Oral and Maxillofacial Surgery (Dentist)) Address: 1565 LIBERTY ST SE, Salem, OR, 97302
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1447258223 | Gary Pederson | Individual | Oral and Maxillofacial Surgery (Dentist) | Salem, OR |
| 1356320576 | David Swiderski | Individual | Oral & Maxillofacial Surgery (D.M.D.) | Salem, OR |
| 1386901734 | Mid-Valley Oral, Maxillofacial & Implant Surgery | Organization | Oral and Maxillofacial Surgery Clinic/Center | Salem, OR |
Verify this record
Cross-check NPI 1154517415 against the authoritative CMS record: view Gary T. Pederson on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Gary T. Pederson?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-09-20.