Dr Katerina Goncharova DDS PLC

Primary specialty

DentistTaxonomy code 122300000X

License

D5808 Issued in AZ

Legal business name

DR KATERINA GONCHAROVA DDS PLC

Practice address

2853 S Sossaman Rd
A110
Mesa, AZ 85212

Phone

(480) 986-5860

Fax

(480) 986-5870

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ekaterina N Goncharova, DDS

Title

Dentist Owner

Phone

(480) 986-5860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1972560571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 S SOSSAMAN RD",
            "address_2": "A110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85212",
            "telephone_number": "480-986-5860",
            "fax_number": "480-986-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 S SOSSAMAN RD",
            "address_2": "A110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85212",
            "telephone_number": "480-986-5860",
            "fax_number": "480-986-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KATERINA GONCHAROVA DDS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "GONCHAROVA",
        "authorized_official_first_name": "EKATERINA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "480-986-5860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D5808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.