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Jac W. Pedersen II, D.D.S., Inc

Pediatric Dentistry in San Luis Obispo, CA · enumerated 2006 · authorized official Jac Pedersen, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1194803049

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Registry record

Entity type Organization (Type 2)
Legal business name Jac W. Pedersen II, D.D.S., Inc
Practice address 620 California Blvd Ste H, San Luis Obispo, CA, 93401
Phone (805) 544-8111
Fax (805) 544-6309
Enumeration date Nov 1, 2006
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

1223P0221X Pediatric Dentistry Dental Providers · License 27472 (CA) Primary

Authorized official

Name Jac Pedersen
Title Owner
Phone (805) 544-8111

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Jac W. Pedersen II, D.D.S., Inc?
Jac W. Pedersen II, D.D.S., Inc is registered in NPPES as a Pediatric Dentistry (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.