Healthcare Provider Details

I. General information

NPI: 1740115070
Provider Name (Legal Business Name): CALEB HAREB DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 GATEWAY ST STE MT110
SPRINGFIELD OR
97477-7754
US

IV. Provider business mailing address

2912 W CANYON AVE
SAN DIEGO CA
92123-4650
US

V. Phone/Fax

Practice location:
  • Phone: 541-747-9400
  • Fax:
Mailing address:
  • Phone: 858-342-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12353
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: