PDG, PA (NPI# 1144780420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144780420 |
Entity Type | Organization |
Organization Name | PDG, PA |
Practice Address |
906 Woodland Ave Duluth MN 55812-1113 |
Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
Practice Telephone | 2186061040 |
Practice Fax Number | 2186061060 |
Mailing Telephone | 6517462815 |
Enumeration Date | 2019-03-22 |
Last Update Date | 2020-10-28 |
Authorized Official Name | SHANNON HESSE (CREDENTIALING SPECIALISTS) |
Authorized Official Telephone | 6517462815 |
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 BlueStone | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649838343 | Pdg, Pa | Clinic/Center | 7774 Hargis Pkwy Ste 106, Woodbury, MN 55129-2305 | 2019-05-29 |
1629589544 | Pdg, Pa | Clinic/Center | 16991 198th Ave Nw, Big Lake, MN 55309 | 2017-10-18 |
1861931545 | Pdg, Pa | Clinic/Center | 605 Hillcrest Ave Ste 210, Owatonna, MN 55060-3680 | 2017-02-15 |
1285170464 | Pdg, Pa | Clinic/Center | 18230 Zane St Nw, Elk River, MN 55330-4501 | 2017-01-12 |
1518403831 | Pdg, Pa | Clinic/Center | 324 W Superior St Ste 1130, Duluth, MN 55802-1714 | 2017-01-10 |
1396199832 | Pdg, Pa | Clinic/Center | 3780 Marketplace Dr Nw Ste 112, Rochester, MN 55901-3225 | 2016-04-21 |
1598128647 | Pdg, Pa | Clinic/Center | 14170 Highway 13 S, Savage, MN 55378-2587 | 2016-04-05 |
1689122442 | Pdg, Pa | Clinic/Center | 7501 80th St S, #214, Cottage Grove, MN 55016-3020 | 2016-09-21 |
1346798600 | Pdg, Pa | Clinic/Center | 901 Marquette Ave Ste 230, Minneapolis, MN 55402-3260 | 2016-09-15 |
1821545930 | Pdg, Pa | Clinic/Center | 4155 Dean Lakes Blvd, Shakopee, MN 55379 | 2016-09-07 |
Street Address |
906 WOODLAND AVE |
City | DULUTH |
State | MN |
Zip Code | 55812-1113 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720165905 | Whitney Christine Hustad Davidson | Dentist | 906 Woodland Ave, Duluth, MN 55812-1113 | 2006-11-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942743950 | Thomas Anthony Olson | Specialist/Technologist | 1049 Ordean Court, 170 Sports & Health Center, Duluth, MN 55812 | 2016-11-22 |
1922457183 | Zen Eye Care Pllc | Optometrist | 2106 London Road, Duluth, MN 55812 | 2016-06-08 |
1295134088 | Charla Buxbaum | Specialist/Technologist | 1216 Ordean Ct. Sphc 170, University of Minnesota Duluth, Duluth, MN 55812 | 2014-08-18 |
1346473998 | Patricia A Trachte | Nurse Practitioner | 107 Ksc, Umd Quick Care, Duluth, MN 55812 | 2009-08-31 |
1003088543 | Arrowhead House Inc | Community Based Residential Treatment Facility, Mental Illness | 16 South 18th Avenue East, Duluth, MN 55812 | 2008-03-25 |
1073689295 | Nicolle Marie Nicklas | Nurse Anesthetist, Certified Registered | 219 Garden St., Duluth, MN 55812 | 2006-11-28 |
1346328762 | Timothy Patrick Stratton | Pharmacist | 386a Kirby Plaza, 1208 Kirby Drive, Duluth, MN 55812 | 2006-11-02 |
1316960701 | Questar Duluth, Inc | Specialist | 1527 London Road, Duluth, MN 55812 | 2006-07-26 |
1063401297 | Clinton T Moen | Specialist | 2711 E 5th St, Duluth, MN 55812 | 2005-10-20 |
1124016563 | Christine Aas-larson | Nurse Practitioner | 1502 London Road, Suite 102, Duluth, MN 55812 | 2005-10-10 |
Find all providers in zip 55812 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518403831 | Pdg, Pa | Clinic/Center | 324 W Superior St Ste 1130, Duluth, MN 55802-1714 | 2017-01-10 |
1417210576 | Gregory H. Kaake, D.d.s. P.a. | Clinic/Center | 1832 Maple Grove Rd, Duluth, MN 55811-1811 | 2012-06-22 |
1780839803 | Mark L Shefrin Dmd PC | Clinic/Center | 3540 Duluth Park Ln Ste 270, 270, Duluth, GA 30096-8511 | 2008-11-18 |
1437320512 | Natalie Peterson Dds Family Dentistry LLC | Clinic/Center | 110 W 10th St, Duluth, MN 55806-2536 | 2008-03-17 |
1831387661 | Crawford Orthodontic Care | Clinic/Center | 3950 Pleasant Hill Rd, Suite 6, Duluth, GA 30096 | 2007-10-05 |
1740400985 | Lake Superior College Dental Clinic | Clinic/Center | 2101 Trinity Road, Duluth, MN 55811-3349 | 2007-04-30 |
1609425032 | M Dental Pllc | Clinic/Center | 4707 E Superior St, Duluth, MN 55804-2339 | 2019-09-09 |
1285110379 | Matthew D Jugovich Dds Pa | Clinic/Center | 5651 Miller Trunk Hwy, Duluth, MN 55811-1229 | 2018-07-12 |
1619424827 | Duluth Dental and Dentures LLC | Clinic/Center | 1625 Pleasant Hill Rd, Suite #140, Duluth, GA 30096-2326 | 2016-09-06 |
1972952265 | Kyle Hammer Dds Pllc | Clinic/Center | 1432 London Rd, Duluth, MN 55805-2425 | 2016-06-07 |
Find all providers in DULUTH |
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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.