Provider Demographics
NPI:1285853457
Name:ARLINE G. MACARAEG, D.M.D., INC.
Entity Type:Organization
Organization Name:ARLINE G. MACARAEG, D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MACARAEG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-258-9943
Mailing Address - Street 1:125 N JACKSON AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1903
Mailing Address - Country:US
Mailing Address - Phone:408-258-9943
Mailing Address - Fax:
Practice Address - Street 1:125 N JACKSON AVENUE
Practice Address - Street 2:SUITE 207
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1903
Practice Address - Country:US
Practice Address - Phone:408-258-9943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty