Individual provider Active NPI

Kateryna Zhukova

  • General Practice Dentistry
  • Ponte Vedra, FL
National Provider Identifier
1295534758
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN31103 Issued in FL
Practice address
238 Solana Rd
Ponte Vedra, FL 32082-2297
Phone
(904) 575-3932
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN31103 FL Primary

Addresses

Primary practice location

238 Solana Rd
Ponte Vedra, FL 32082-2297

Mailing address

11727 Abess Blvd Apt 1315
Jacksonville, FL 32225-6054
Phone (469) 422-9068

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
DN31103FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1295534758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11727 ABESS BLVD APT 1315",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256054",
            "telephone_number": "469-422-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SOLANA RD",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320822297",
            "telephone_number": "904-575-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHUKOVA",
        "first_name": "KATERYNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN31103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.