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

Dr. Jack S Broussard Jr., DDS

Individual provider General Practice Dentistry · NPI 1821093832

Dr. Jack S Broussard Jr., DDS is a General Practice Dentistry in Pasadena, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2005
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

301 S Fair Oaks Ave Ste 204
Pasadena, CA 91105-2536
Phone: (626) 796-3161
Fax: (626) 796-6760
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN26040 (CA)

Record details

NPI number1821093832
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 16, 2005
Last updated in NPPESOctober 25, 2007
Mailing address301 S Fair Oaks Ave, Ste 204, Pasadena, CA 91105-2536

Other providers in Pasadena