Healthcare Provider Details

I. General information

NPI: 1508714098
Provider Name (Legal Business Name): JACLYN G PAK DDS MS DENTAL SLEEP MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 SUNSET BLVD STE X
ROCKLIN CA
95677-3090
US

IV. Provider business mailing address

3111 SUNSET BLVD STE X
ROCKLIN CA
95677-3090
US

V. Phone/Fax

Practice location:
  • Phone: 916-678-8904
  • Fax: 916-624-0635
Mailing address:
  • Phone: 916-678-8904
  • Fax: 916-624-0635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JACLYN G PAK
Title or Position: DENTIST/OWNER
Credential: DDS, MS
Phone: 916-624-0635