Individual provider Active NPI

Daniel Goncharuk, DMD

  • Dentist
  • Cape Coral, FL
National Provider Identifier
1265327282
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN30417 Issued in FL
Practice address
2064 NE Pine Island Rd
Cape Coral, FL 33909-1766
Phone
(239) 420-7594
NPI assigned
Jun 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN30417 FL Primary

Addresses

Primary practice location

2064 NE Pine Island Rd
Cape Coral, FL 33909-1766

Mailing address

16255 Allura Cir Unit 3317
Naples, FL 34110-9325
Phone (646) 468-9413

Other practice location 1

970 Kings Hwy Unit 3
Port Charlotte, FL 33980-4213
Phone (941) 352-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN30417FLMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1265327282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16255 ALLURA CIR UNIT 3317",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341109325",
            "telephone_number": "646-468-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 NE PINE ISLAND RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091766",
            "telephone_number": "239-420-7594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 Kings Hwy Unit 3",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339804213",
            "country_code": "US",
            "telephone_number": "941-352-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONCHARUK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN30417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.