Provider Demographics
NPI:1760113997
Name:KING, CATHERINE JENNINGS (DMD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JENNINGS
Last Name:KING
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 1:781 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5854
Mailing Address - Country:US
Mailing Address - Phone:321-230-4706
Mailing Address - Fax:
Practice Address - Street 1:2531 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4432
Practice Address - Country:US
Practice Address - Phone:407-425-0087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN269121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics