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 provides 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