Individual provider Active NPI

Jennifer Arce Cacho

  • General Practice Dentistry
  • Chula Vista, CA
National Provider Identifier
1104555291
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108174 Issued in CA
Practice address
520 Broadway Ste 1
Chula Vista, CA 91910-5376
Phone
(619) 202-4751
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019033696 IL
General Practice Dentistry 1223G0001X 108174 CA Primary

Addresses

Primary practice location

520 Broadway Ste 1
Chula Vista, CA 91910-5376

Mailing address

830 Regulo PL Apt 2016
Chula Vista, CA 91910-7722
Phone (619) 354-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
108174CAMDGeneral Practice Dentistry
019033696ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Cacho DMD Inc Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1104555291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 REGULO PL APT 2016",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107722",
            "telephone_number": "619-354-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BROADWAY STE 1",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105376",
            "telephone_number": "619-202-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACHO",
        "first_name": "JENNIFER",
        "middle_name": "ARCE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033696",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.