Individual provider Active NPI

Maryana Zaverukha, DMD

  • Dentist
  • Orlando, FL
National Provider Identifier
1578356192
Registry record updated May 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN30564 Issued in FL
Practice address
1601 Park Center Dr Ste 1
Orlando, FL 32835-5700
Phone
(407) 982-1912
NPI assigned
May 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN30564 FL Primary

Addresses

Primary practice location

1601 Park Center Dr Ste 1
Orlando, FL 32835-5700

Mailing address

1601 Park Center Dr Ste 1
Orlando, FL 32835-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250917003509 FL Order and Referring Only - DentistPractitioner - Dentist 0143724799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN30564FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Butler Dental Group PA CurrentSince Jun 3, 2025 Accepting new patients

Locations

4014 Winter Garden Vineland Rd
Ste B
Winter Garden, FL 34787
Phone (321) 248-2923

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778976000000",
    "number": "1578356192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PARK CENTER DR STE 1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 PARK CENTER DR STE 1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355700",
            "telephone_number": "407-982-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVERUKHA",
        "first_name": "MARYANA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-05-17",
        "certification_date": "2026-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN30564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.