Provider Demographics
NPI:1104555291
Name:CACHO, JENNIFER ARCE
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ARCE
Last Name:CACHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 REGULO PL APT 2016
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7722
Mailing Address - Country:US
Mailing Address - Phone:619-354-0898
Mailing Address - Fax:
Practice Address - Street 1:520 BROADWAY STE 1
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5376
Practice Address - Country:US
Practice Address - Phone:619-202-4751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190336961223G0001X
CA1081741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice