What is Jack Broussard's NPI number?

Jack Broussard's National Provider Identifier (NPI) is 1821093832, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Jack Broussard's specialty?

Jack Broussard is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).

Where is Jack Broussard located?

Jack Broussard's practice location on file with NPPES is 301 S Fair Oaks Ave, Pasadena, CA 91105-2536.

What is Jack Broussard's phone number?

The practice phone number listed in the NPPES registry for Jack Broussard is (626) 796-3161.

Is Jack Broussard's NPI active?

Yes — Jack Broussard's NPI (1821093832) is active in the NPPES registry as of the last update on 2007-10-25.

IndividualActive

Jack Broussard, D.D.S.

NPI 1821093832 · General Practice Dentistry · Pasadena, CA

Jack Broussard, D.D.S. is a General Practice Dentistry provider in Pasadena, CA (NPI 1821093832).

Provider details

NPI number: 1821093832
Entity type: Individual
Primary specialty: General Practice DentistryDental Providers
Credential: D.D.S.
Sex: Male
Sole proprietor: Yes
License: DN26040 (CA)

Specialties & taxonomies

General Practice DentistryPrimary1223G0001XLicense DN26040 (CA)
Dental Providers

Profile Score

Detailed profile(91/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
21 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

301 S Fair Oaks Ave

Ste 204

Pasadena, CA 91105-2536

Phone: (626) 796-3161

Fax: (626) 796-6760

Street-level locationGet directions

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Mailing address