PDG, P.A. (NPI# 1023309549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023309549 |
| Entity Type | Organization |
| Organization Name | PDG, P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
2600 39th Ave Ne 225 Minneapolis MN 55421-4379 |
| Mailing Address |
2200 County Road C W 2210 Roseville MN 55113-2550 |
| Practice Telephone | 7637817475 |
| Practice Fax Number | 7637810828 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. JOHN GULON (PRESIDENT) |
| Authorized Official Telephone | 6516330500 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Park Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1316376668 | Pdg, P.a. | Clinic/Center | 6520 150th St W, Suite 300, Apple Valley, MN 55124-6554 | 2013-11-07 |
| 1639508153 | Pdg, P.a. | Clinic/Center | 501 Cherry Ln, Roberts, WI 54023-9731 | 2013-11-05 |
| 1043649569 | Pdg, P.a. | Clinic/Center | 1003 Pearson Dr, Hudson, WI 54016-8727 | 2013-11-05 |
| 1205265741 | Pdg, P.a. | Clinic/Center | 10150 City Walk Dr, Suite C, Woodbury, MN 55129-9257 | 2013-11-05 |
| 1538598057 | Pdg, P.a. | Clinic/Center | 15015 Cimarron Ave, Rosemount, MN 55068-2771 | 2013-11-05 |
| 1346679859 | Pdg, P.a. | Clinic/Center | 14741 Victor Hugo Blvd N, Hugo, MN 55038-4561 | 2013-11-05 |
| 1285993345 | Pdg, P.a. | Clinic/Center | 3161 Northdale Blvd Nw, Coon Rapids, MN 55433-1825 | 2012-05-10 |
| 1104985456 | Pdg, P.a. | Dentist | 1835 Cty Rd C-west, Suite 220, Roseville, MN 55113-1343 | 2006-12-06 |
| 1487712915 | Pdg, P.a. | Dentist | 9600 Upland Ln N, Suite 200, Maple Grove, MN 55369-4461 | 2006-12-05 |
| Street Address |
2600 39TH AVE NE 225 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55421-4379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407834302 | Fairview Express Care | Clinic/Center | 2600 39th Ave Ne, Ste 220, Minneapolis, MN 55421-4379 | 2006-01-03 |
| 1477820405 | Jennifer Patricia Gray | Physician Assistant | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2011-11-18 |
| 1144559535 | North Memorial Health Care | Clinic/Center | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2009-12-14 |
| 1326376906 | Elizabeth Faith Baker | Physician Assistant | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2009-11-19 |
| 1528212230 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2008-11-07 |
| 1447424692 | Urology Associates, Ltd. | Urology | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2008-04-18 |
| 1972784668 | Calandra D Theisen | Podiatrist | 2600 39th Ave Ne, Suite 250, Minneapolis, MN 55421-4379 | 2007-11-21 |
| 1790868404 | Danny R Dunsworth | Family Medicine | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2006-10-24 |
| 1750461547 | Diana C Liu | Family Medicine | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2006-10-16 |
| 1013097815 | Patrick D Loew | Physician Assistant | 2600 39th Ave Ne, Minneapolis, MN 55421-4379 | 2006-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241782 | Cc Group Home Care Inc | Non-emergency Medical Transport (VAN) | 524 Huset Pkwy Ne, Columbia Heights, MN 55421 | 2019-11-30 |
| 1710455324 | Victoria F Renner | Physical Therapist | 4512, 3700 Foss Rd, Minneapolis, MN 55421 | 2018-11-13 |
| 1245721976 | Complete Care Home Care LLC | Home Health | 4111 Central Ave Ne North Building, Suite 202, Columbia Heights, MN 55421 | 2018-05-29 |
| 1053816389 | Anoka Health Center LLC | Clinic/Center | 4111 Central Ave N.e, Suite 201 North Building, Columbia Heights, MN 55421 | 2018-03-28 |
| 1508381047 | Minnesota Home Health Care LLC | Home Health | 534 Huset Parkway, Columbia Heights, MN 55421 | 2017-08-05 |
| 1720520448 | Tesfa International School | Local Education Agency (LEA) | 1550 40th Avenue Northeast, Columbia Heights, MN 55421 | 2016-11-11 |
| 1487012548 | Icare Transportation | Non-emergency Medical Transport (VAN) | 2816 Silver Ln Ne #305, Saint Anthony, MN 55421 | 2016-02-04 |
| 1194183368 | Warsame Warsame | Non-emergency Medical Transport (VAN) | 1115 45th Ave Ne, Columbia Heights, MN 55421 | 2016-02-03 |
| 1083083398 | Epic Transportation LLC | Clinic/Center | 355 Orendorff Way Ne, Columbia Heights, MN 55421 | 2015-09-16 |
| 1508281023 | Alexandra Marie Hodson | Occupational Therapist | 5155 E. River Rd, Suite #403, Fridley, MN 55421 | 2014-02-20 |
| Find all providers in zip 55421 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528695178 | Nicollet Mall Dental Arts Pllc | Clinic/Center | 825 Nicollet Mall Ste 1737, Minneapolis, MN 55402-2704 | 2020-03-24 |
| 1427572932 | Loop Dental Pllc | Clinic/Center | 207 5th Ave N, Minneapolis, MN 55401-1215 | 2017-07-27 |
| 1780133983 | Cedar Riverside People's Center | Clinic/Center | 3328 Elliot Ave S, Minneapolis, MN 55407-2125 | 2016-09-28 |
| 1528515194 | Regents of The University of Minnesota | Clinic/Center | 814 S 3rd Street, Minneapolis, MN 55415 | 2016-09-01 |
| 1215542618 | Grace A. Warren Dds, Corp | Clinic/Center | 4110 Cedar Ave S, Minneapolis, MN 55407-3433 | 2020-09-11 |
| 1154934891 | Englander Dental Pa | Clinic/Center | 3801 W 50th St, Minneapolis, MN 55410-2047 | 2020-08-24 |
| 1689284481 | Nokomis Family Dental Pa | Clinic/Center | 4948 34th Ave S, Minneapolis, MN 55417-1504 | 2020-08-06 |
| 1881250520 | Lachance Enterprises Pa | Clinic/Center | 2309 Lyndale Ave S, Minneapolis, MN 55405-3661 | 2019-05-17 |
| 1033677208 | Christie Berkseth-rojas LLC | Clinic/Center | 3455 4th Ave S, Minneapolis, MN 55408-4527 | 2019-03-06 |
| 1770095028 | Chicago Lake Family Dental LLC | Clinic/Center | 2900 Chicago Ave, Minneapolis, MN 55407-1322 | 2017-10-26 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55421 |
Please comment or provide details below to improve the information on PDG, P.A..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.