PDG, PA (NPI# 1548687296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548687296 |
| Entity Type | Organization |
| Organization Name | PDG, PA |
| Other Organization Name | PARK DENTAL |
| Practice Address |
15535 34th Ave N Suite 250 Plymouth MN 55447-1481 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2550 |
| Practice Telephone | 7632333310 |
| Practice Fax Number | 7632333312 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. JOHN GULON (PRESIDENT) |
| Authorized Official Telephone | 6516330500 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1144780420 | Pdg, Pa | Clinic/Center | 906 Woodland Ave, Duluth, MN 55812-1113 | 2019-03-22 |
| 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 |
| Street Address |
15535 34TH AVE N SUITE 250 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55447-1481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194763003 | Madeline Hallie Gartner | Surgery | 15535 34th Ave N, Plymouth, MN 55447-1481 | 2006-06-03 |
| 1518274398 | Aisha B. Chaudhry | Family Medicine | 15535 34th Ave N, Plymouth, MN 55447-1585 | 2010-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916165 | Benjamin Thomas Garbow | Nurse Anesthetist, Certified Registered | 14700 28th Avenue North, Plymouth, MN 55447 | 2020-09-14 |
| 1588146914 | Alicia Mae Donahue | Social Worker | 15805 26th Ave N Unit D, Plymouth, MN 55447 | 2018-09-01 |
| 1497262224 | Rajo Care Home Inc | Assisted Living Facility | 14015 Rockford Rd, Plymouth, MN 55447 | 2018-01-02 |
| 1790145647 | Mary Kathleen Salveson | Occupational Therapist | Therapy Junction 14130 23rd Ave N, Plymouth, MN 55447 | 2016-03-03 |
| 1477954253 | Very Best PCa Services | Home Health | 14300 34th Ave N, #111, Plymouth, MN 55447 | 2014-09-11 |
| 1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
| 1336480946 | Arthur Andrew Hoffman | Chiropractor | 16815 22nd Ave North, Plymouth, MN 55447 | 2013-03-06 |
| 1598001067 | North Memorial Health Care | Clinic/Center | 15535 34th Avenue N., Plymouth, MN 55447 | 2013-01-02 |
| 1396097069 | Kristin Lynn Spencer | Nurse Practitioner | 3007 Harbor Lane North, Park Nicollet Clinic Plymouth - Family Medicine, Plymouth, MN 55447 | 2012-10-05 |
| 1689930554 | Linda Gail Olson | General Practice | 17935 24th Ave N, Minneapolis, MN 55447 | 2012-04-05 |
| Find all providers in zip 55447 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1326670886 | Plymouth Ardent | Clinic/Center | 40400 Ann Arbor Rd E Ste 103, Plymouth, MI 48170-4590 | 2020-02-12 |
| 1427695063 | Beacon Dental Health PC | Clinic/Center | 1 Scobee Cir # 2a, Plymouth, MA 02360-4887 | 2019-12-03 |
| 1952965949 | Minnesota Sleep and Wellness LLC | Clinic/Center | 15600 36th Ave N Ste 270a, Plymouth, MN 55446-3369 | 2019-04-25 |
| 1134611122 | Chad W. Barber, Dds, PC | Clinic/Center | 9331 N Lilley Rd, Plymouth, MI 48170-4609 | 2018-06-05 |
| 1194215616 | Four Seasons Dental Pa | Clinic/Center | 4205 Lancaster Ln N Ste 101, Plymouth, MN 55441-1702 | 2018-05-10 |
| 1396258752 | Advanced Dental Care Clinic Sc | Clinic/Center | 62 S Pleasant View Road, Plymouth, WI 53073 | 2017-11-08 |
| 1053834481 | Mondale Dental | Clinic/Center | 10600 Old County Road 15 Ste 120, Plymouth, MN 55441-6205 | 2017-07-18 |
| 1902060213 | Thomas F. Rogers, D.d.s., P.C. | Clinic/Center | 141 Court St, Plymouth, MA 02360-3807 | 2008-07-16 |
| 1093939712 | Frank Gatyas,d.d.s.,s.c. | Clinic/Center | 623 E Mill St, Plymouth, WI 53073-1944 | 2007-04-12 |
| Find all providers in PLYMOUTH | ||||
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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.