Provider Demographics
NPI:1972172872
Name:BAITINGER, CATHERINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:BAITINGER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14631 WISHING WIND WAY
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6211
Mailing Address - Country:US
Mailing Address - Phone:856-404-7713
Mailing Address - Fax:
Practice Address - Street 1:16850 S US HIGHWAY 441 STE 301
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8657
Practice Address - Country:US
Practice Address - Phone:352-419-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN259591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty