Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jac W Pedersen II DDS

Organization Pediatric Dentistry · NPI 1407014541

Jac W Pedersen II DDS is a Pediatric Dentistry in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2008.

Licensed in
CA
In the registry since
2008

Practice location Address checks out

3221 S Higuera St Ste 100
San Luis Obispo, CA 93401-6924
Phone: (805) 544-8111
Fax: (805) 544-6309
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 27472 (CA)

Record details

NPI number1407014541
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jac Pedersen — Owner · (805) 544-8111
NPI enumeratedMay 27, 2008
Last updated in NPPESMay 27, 2008
Mailing address3221 S Higuera St Ste 100, San Luis Obispo, CA 93401-6924

Other providers in San Luis Obispo