OrganizationActive
Jac W Pedersen II DDS
NPI 1407014541 · Pediatric Dentistry · San Luis Obispo, CA
Jac W Pedersen II DDS is a Pediatric Dentistry organization in San Luis Obispo, CA (NPI 1407014541).
Provider details
- NPI number
- 1407014541
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jac Pedersen, Owner(805) 544-8111
- License
- 27472 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3221 S Higuera St Ste 100
San Luis Obispo, CA 93401-6924
Phone: (805) 544-8111
Fax: (805) 544-6309
Street-level locationGet directions
Mailing address
3221 S Higuera St Ste 100
San Luis Obispo, CA 93401-6924
Registry dates
- Enumerated
- 2008-05-27
- Last updated
- 2008-05-27
Frequently asked questions
- What is Jac W Pedersen II DDS's NPI number?
- Jac W Pedersen II DDS's National Provider Identifier (NPI) is 1407014541, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jac W Pedersen II DDS?
- Jac W Pedersen II DDS is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Jac W Pedersen II DDS located?
- Jac W Pedersen II DDS's practice location on file with NPPES is 3221 S Higuera St Ste 100, San Luis Obispo, CA 93401-6924.
- What is Jac W Pedersen II DDS's phone number?
- The practice phone number listed in the NPPES registry for Jac W Pedersen II DDS is (805) 544-8111.
- Who is the authorized official for Jac W Pedersen II DDS?
- The authorized official listed on Jac W Pedersen II DDS's NPPES record is Jac Pedersen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jac W Pedersen II DDS's NPI active?
- Yes — Jac W Pedersen II DDS's NPI (1407014541) is active in the NPPES registry as of the last update on 2008-05-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.