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DR. JACK S BROUSSARD JR. D.D.S.
NPI 1821093832
Dentist - General Practice in Pasadena, CA

Active since June 16, 2005
301 S FAIR OAKS AVE, STE 204, PASADENA, CA 91105(626) 796-3161(626) 796-6760 Get Directions Write a Review

NPPES record last updated: October 25, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack S Broussard Jr. D.d.s. NPPES

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

DR. JACK S BROUSSARD JR. D.D.S. (NPI 1821093832) is an individual general practice provider in Pasadena, California, licensed in California (DN26040) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1821093832
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JACK S BROUSSARD JR.Credential: D.D.S.
Location Address301 S FAIR OAKS AVE, STE 204Pasadena, CA 91105-2536
Mailing Address301 S Fair Oaks Ave, Ste 204Pasadena, CA 91105-2536 · (626) 796-3161 · Fax (626) 796-6760
Phone(626) 796-3161
Fax(626) 796-6760
Sole ProprietorYes
Enumeration DateJune 16, 2005
Last NPPES UpdateOctober 25, 2007
✔ NPI 1821093832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · DN26040
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
301 S FAIR OAKS AVE, Pasadena, CA 91105
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Other Providers at the Same Location NPPES 20

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

KAY ANN DABLER SLP
Speech-Language Pathologist
301 S FAIR OAKS AVE, SUITE 401
PASADENA, CA 91105
Los Angeles County (626) 744-0411
PASADENA FAMILY MEDICINE INC
General Practice
301 S FAIR OAKS AVE, STE #405
PASADENA, CA 91105
Los Angeles County (626) 792-1912
ARROYO SECO MEDICAL GROUP
Internal Medicine
301 S FAIR OAKS AVE, SUITE 300
PASADENA, CA 91105
Los Angeles County (626) 795-7556
AMERICAN MEDICAL EVALUATION CENTERS INC
Internal Medicine
301 S FAIR OAKS AVE, STE 107
PASADENA, CA 91105
Los Angeles County (310) 271-5875
W. FREDERICK STEPHENS,DDS,INC
Dentist (Oral and Maxillofacial Surgery)
301 S FAIR OAKS AVE, SUITE #107
PASADENA, CA 91105
Los Angeles County (626) 440-0099
BERT K. FUNATSU D.D.S.
Dentist (General Practice)
301 S FAIR OAKS AVE, SUITE 205
PASADENA, CA 91105
Los Angeles County (626) 796-8904
MICHAEL E STEUER, MD, PC
Specialist
301 S FAIR OAKS AVE, STE 105
PASADENA, CA 91105
Los Angeles County (626) 229-9425
GIRLFRIENDS MEDICAL GROUP, INC
Obstetrics & Gynecology (Obstetrics)
301 S FAIR OAKS AVE
PASADENA, CA 91105
Los Angeles County (626) 793-5250

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 Jack Broussard's NPI number?

The NPI number for Jack Broussard is 1821093832. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is Jack Broussard located?

Jack Broussard practices at 301 S Fair Oaks Ave Ste 204, Pasadena, CA 91105. The listed phone number is (626) 796-3161.

What is Jack Broussard's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Jack Broussard accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Jack Broussard as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Broussard was last updated on October 25, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.