Provider Demographics
NPI:1730603481
Name:CABRERA ARELLANO, JORGE RAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:JORGE RAUL
Middle Name:
Last Name:CABRERA ARELLANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44806 SHALE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:323-408-9709
Mailing Address - Fax:
Practice Address - Street 1:361 RAILROAD CANYON ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532
Practice Address - Country:US
Practice Address - Phone:951-471-1400
Practice Address - Fax:951-471-1411
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2024-05-13
Deactivation Date:2024-04-24
Deactivation Code:
Reactivation Date:2024-05-10
Provider Licenses
StateLicense IDTaxonomies
CA101767122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist