Healthcare Provider Details

I. General information

NPI: 1801182191
Provider Name (Legal Business Name): DR. CATHERINE A MULDOON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2648 NW FEDERAL HWY
STUART FL
34994-9318
US

IV. Provider business mailing address

2648 NW FEDERAL HWY
STUART FL
34994-9318
US

V. Phone/Fax

Practice location:
  • Phone: 772-232-7201
  • Fax:
Mailing address:
  • Phone: 772-232-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN28691
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13053
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number110008
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401413175
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number060357
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: