PDG, PA


Address: 16991 198th Ave Nw, Big Lake, MN 55309
Phone: 7632636350

PDG, PA (NPI# 1629589544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629589544
Entity Type Organization
Organization Name PDG, PA
Other Organization Name PARK DENTAL
Practice Address 16991 198th Ave Nw
Big Lake
MN 55309
Mailing Address 2200 County Road C W Ste 2210
Roseville
MN 55113-2551
Practice Telephone 7632636350
Practice Fax Number 7632630136
Mailing Telephone 6517462815
Mailing Fax Number 6512096312
Enumeration Date 2017-10-18
Last Update Date 2020-10-28
Authorized Official Name SHANNON HESSE (CREDENTIALING SPECIALIST)
Authorized Official Telephone 6517462815
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Park Dental Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1649838343 Pdg, Pa Clinic/Center 7774 Hargis Pkwy Ste 106, Woodbury, MN 55129-2305 2019-05-29
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
1821545930 Pdg, Pa Clinic/Center 4155 Dean Lakes Blvd, Shakopee, MN 55379 2016-09-07

Office Location

Street Address 16991 198TH AVE NW
City BIG LAKE
State MN
Zip Code 55309

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235797820 Neeharika Bhashyam Dentist 16991 198th Ave Nw, Big Lake, MN 55309-4927 2019-05-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356986475 Barbro E Strom Langley Technician 16901 River View Cir, Big Lake, MN 55309 2019-11-13
1669821765 Laura Ann Dill Dentist 290 Eagle Lake Rd N, Big Lake, MN 55309 2016-06-09
1295008068 Cherrywood Advanced Living, LLC Assisted Living Facility 171 Henry Road, Big Lake, MN 55309 2012-02-09
1013280882 Cherrywood Advanced Living, LLC Assisted Living Facility 177 Henry Road, Big Lake, MN 55309 2012-02-09
1760704712 Mary Ellen Venzke Adult Companion 19729 183rd Avenue, Big Lake, MN 55309 2010-02-18
1174700611 Country Services Inc Case Management 641 Park Ave E, Big Lake, MN 55309 2008-01-28
1942481593 Monticello Dental Group Dentist 20460 Co. Rd.11 Nw, Big Lake, MN 55309 2007-11-23
1336367242 Family Prospective Resources, Inc Marriage & Family Therapist 35 Lake St So, Big Lake, MN 55309 2007-04-23
1598983470 Jennifer Ann Lawrence Marriage & Family Therapist 35 Lake Street South #200, Big Lake, MN 55309 2007-04-23
1760548085 Nathan E. Davidson Chiropractor 670 Humboldt Drive, Big Lake, MN 55309 2006-12-29
Find all providers in zip 55309

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740745439 Susan Olson Dmd Inc Clinic/Center 3261 S. Big Lake Rd. Ste D3-d4, Big Lake, AK 99652 2019-02-06
1013328608 Ks Holdings Pa Clinic/Center 751 Rose Dr Nw, Suite 108, Big Lake, MN 55309-8705 2014-05-16
1396971412 Reed D. Dill, D.d.s. P.a. Clinic/Center 171 Lake St N, Big Lake, MN 55309-9254 2009-06-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1033710025 Theresa M. Snell Clinic/Center 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 2020-11-05
1376143248 James M. Williams, D.d.s., P.a. Clinic/Center 620 Union St S, Mora, MN 55051-1818 2020-10-29
1235746058 Asp Dental, PC Clinic/Center 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 2020-09-25
1952918781 Asp Dental, PC Clinic/Center 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 2020-09-25
1518574532 Stillwater Family Dental Clinic/Center 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 2020-09-24
1093321531 Barnett Dental Inc Clinic/Center 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 2020-09-21
1356955868 Todd A Brewer Dds Pllc Clinic/Center 603 Jefferson Ave Sw, Watertown, MN 55388 2020-09-02
1770195158 Mark T. Sherman Dds Pa Clinic/Center 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 2020-08-18
1689286015 Lifelong Dental Care Clinic/Center 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 2020-08-18
1528678497 Custom Smiles Dentistry, Pllc Clinic/Center 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 2020-08-05
Find all providers with the same taxonomy

Competitor

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City BIG LAKE
Zip Code 55309

Improve Information

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Dataset Information

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.

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