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JAC W PEDERSEN II DDS
NPI 1407014541
Dentist - Pediatric Dentistry in San Luis Obispo, CA

Active since May 27, 2008
3221 S HIGUERA ST STE 100, SAN LUIS OBISPO, CA 93401(805) 544-8111(805) 544-6309 Get Directions Write a Review

NPPES record last updated: May 27, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jac W Pedersen Ii Dds NPPES

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

JAC W PEDERSEN II DDS (NPI 1407014541) is a healthcare organization registered as a pediatric dentistry in San Luis Obispo, California and active in the NPI registry since May 2008. The organization lists Jac W Pedersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1407014541
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameJAC W PEDERSEN II DDS
Location Address3221 S HIGUERA ST STE 100San Luis Obispo, CA 93401-6924
Mailing Address3221 S Higuera St Ste 100San Luis Obispo, CA 93401-6924
Phone(805) 544-8111
Fax(805) 544-6309
Organization SubpartNo
Authorized OfficialJac W PedersenOwner · (805) 544-8111
Enumeration DateMay 27, 2008
✔ NPI 1407014541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in CA · 27472
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

3221 S HIGUERA ST STE 100, San Luis Obispo, CA 93401
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Jac W Pedersen II Dds's NPI number?

The NPI number for Jac W Pedersen II Dds is 1407014541. It was assigned to this organization in the NPPES registry on May 27, 2008.

Where is Jac W Pedersen II Dds located?

Jac W Pedersen II Dds is located at 3221 S Higuera St Ste 100, San Luis Obispo, CA 93401. The listed phone number is (805) 544-8111.

What is Jac W Pedersen II Dds's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Jac W Pedersen II Dds was last updated on May 27, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.