PDG, P.A. (NPI# 1184782617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184782617 |
| Entity Type | Organization |
| Organization Name | PDG, P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
800 Lasalle Ave Suite 100 Minneapolis MN 55402-2006 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2504 |
| Practice Telephone | 6123384546 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366365 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. JOHN GULON (PRESIDENT) |
| Authorized Official Telephone | 6516330500 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | Y |
| Parent Organization Name | PDG, P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| 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 |
800 LASALLE AVE SUITE 100 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55402-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265514533 | Kurt W. Carlson | Dentist | 800 Lasalle Ave, Minneapolis, MN 55402 | 2006-10-19 |
| 1902951973 | Moss Optical, Inc. | Technician/Technologist | 800 Lasalle Ave, Suite 103, Minneapolis, MN 55402-2006 | 2007-01-23 |
| 1376602896 | Anna Seykora Riester | Dentist | 800 Lasalle Ave, #100, Minneapolis, MN 55402-2006 | 2006-12-08 |
| 1679633010 | Walter F Coombs | Dentist | 800 Lasalle Ave, Suite 100, Minneapolis, MN 55402-2006 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164040457 | Colby Orthodontics LLC | Dentist | 9th St. and Nicollet Ave. Suite 531, Minneapolis, MN 55402 | 2020-07-13 |
| 1124684725 | Eric James Holthaus | Dentist | 825 Nicollet Ave #1025, Minneapolis, MN 55402 | 2019-05-20 |
| 1194216598 | Sean Templeman | Optometrist | 825 Nicollet Mall Fl 20, Minneapolis, MN 55402 | 2018-05-22 |
| 1124529417 | Danielle Marie Kasprzak | Social Worker | 825 Nicollet Mall Ste 1005, Minneapolis, MN 55402 | 2018-02-22 |
| 1275073181 | Yellow Coriander, Psc | Nurse Practitioner | 60 South 6th Street, Suite 2800, Minneapolis, MN 55402 | 2017-02-27 |
| 1780039263 | Ursula Mcguckin | Dentist | 825 Nicollet Avenue #1025, Minneapolis, MN 55402 | 2016-05-03 |
| 1265891600 | Carl Mothes | Counselor | 825 Nicollet Mall Ste 556, Minneapolis, MN 55402 | 2016-02-13 |
| 1295084309 | Cardiology Prevention, LLC | Clinic/Center | 730 Second Ave South, Suite 295, Baker Center, Minneapolis, MN 55402 | 2012-09-05 |
| 1629389341 | Michael Stephen Bevan | Podiatrist | 825 Nicollet Mall Ste 517, Minneapolis, MN 55402 | 2010-06-28 |
| 1235368226 | Anna Dickens | Nurse Practitioner | 902 2nd Ave S, Ste 400, Minneapolis, MN 55402 | 2009-07-10 |
| Find all providers in zip 55402 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1124684725 | Eric James Holthaus | Dentist | 825 Nicollet Ave #1025, Minneapolis, MN 55402 | 2019-05-20 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1154828283 | Ari Michael Lederman | Dentist | 825 Nicollet Mall Ste 425, Minneapolis, MN 55402-2608 | 2018-04-05 |
| 1730604877 | Daryl Grigsby Jr. | Dentist | 515 Delaware St Se # 8-166, Minneapolis, MN 55455-0357 | 2017-08-10 |
| 1033630371 | Margaret Elizabeth Craven | Dentist | 250 2nd Ave S Ste 250, Minneapolis, MN 55401-2173 | 2017-06-27 |
| 1013330661 | Helen Oboro-onuora | Dentist | 606 24th Ave S Suite 200, Umphysicians Dental Clinic, Minneapolis, MN 55454 | 2014-01-31 |
| 1548690001 | Patrick J. Foy Dds,pa | Dentist | 606 24th Ave S Ste 806, Minneapolis, MN 55454-1438 | 2013-11-20 |
| 1659719078 | Deanna Miller | Dentist | 3428 20th Ave S, Minneapolis, MN 55407-2408 | 2013-06-07 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55402 |
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.