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

Jac W. Pedersen II, DDS, Inc

Organization Pediatric Dentistry · NPI 1194803049

Jac W. Pedersen II, DDS, Inc is a Pediatric Dentistry in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

620 California Blvd Ste H
San Luis Obispo, CA 93401-2500
Phone: (805) 544-8111
Fax: (805) 544-6309
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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 number1194803049
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jac Pedersen — Owner · (805) 544-8111
NPI enumeratedNovember 1, 2006
Last updated in NPPESAugust 22, 2020
Mailing address620 California Blvd Ste H, San Luis Obispo, CA 93401-2500

Other providers in San Luis Obispo