Jasen Pedersen, DPM

NPI 1114182326 · on the registry since 2008 · sole proprietor

Practice

Address: 6400 Westwind Way
Suite B
Crestwood, KY 40014
Phone: (502) 276-9999
Fax: (502) 276-9999
Organisation at this address: Elm Pediatric Dentistry, Pllc
Kentucky Tongue-Tie Center Llc
Oldham County Foot & Ankle Pllc
Distler, Huntington & Blair Psc
Distler, Huntington & Blair, Psc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 213ES0103X
213ES0103X
Also registered as: 213E00000X
Licence states on file: KY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2020-04-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky