PDG,P.A. (NPI# 1689732133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689732133 |
| Entity Type | Organization |
| Organization Name | PDG,P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
4670 Park Nicollet Ave Se Suite 100 Prior Lake MN 55372-3908 |
| Mailing Address |
3030 Centre Pointe Dr Suite 100 Roseville MN 55113-1112 |
| Practice Telephone | 9524477606 |
| Mailing Telephone | 6512868100 |
| Mailing Fax Number | 6516336811 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. JOHN GULON (PRESIDENT) |
| Authorized Official Telephone | 9529492536 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| 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 |
|---|---|---|---|---|
| 1932256344 | Pdg,p.a. | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113 | 2007-01-05 |
| 1417015009 | Pdg,p.a. | Dentist | 917 Grand Ave, Saint Paul, MN 55105-3043 | 2006-12-05 |
| 1730247180 | Pdg,p.a. | Dentist | 13059 Ridgedale Dr, Minnetonka, MN 55305-1807 | 2006-12-05 |
| 1518033695 | Pdg,p.a. | Dentist | 6437 Brooklyn Blvd, Brooklyn Center, MN 55429-2174 | 2006-11-28 |
| 1215003371 | Pdg,p.a. | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-11-28 |
| 1083762041 | Pdg,p.a. | Clinic/Center | 6545 France Ave S, Suite 366, Edina, MN 55435 | 2007-01-08 |
| 1083772669 | Pdg,p.a. | Dentist | 6545 France Ave S, Suite 390, Edina, MN 55435-2131 | 2006-12-05 |
| 1730247321 | Pdg,p.a. | Dentist | 8559 Edinbrook Pkwy, Brooklyn Park, MN 55443-3747 | 2006-12-05 |
| 1184782542 | Pdg,p.a. | Dentist | 40 W Nicollet Blvd, Burnsville, MN 55337-4524 | 2006-12-05 |
| 1306912480 | Pdg,p.a. | Dentist | 4200 W Old Shakopee Rd, Suite 100, Bloomington, MN 55437-2976 | 2006-11-28 |
| Street Address |
4670 PARK NICOLLET AVE SE SUITE 100 |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740265396 | Matthew T Kremer | Internal Medicine | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-3908 | 2005-12-07 |
| 1316432974 | Brianna Marie Seawell | Physical Therapist | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2018-06-26 |
| 1811323512 | Andrea J Berger | Physical Therapist | 4670 Park Nicollet Ave Se, Rehabilitation Services, Prior Lake, MN 55372-4119 | 2013-09-25 |
| 1598049603 | Nicholas John Schneider | Physical Therapist | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2011-10-07 |
| 1093032484 | Nicole Lynn Ulrich | Family Medicine | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2010-04-26 |
| 1699009506 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2009-09-24 |
| 1881841021 | Northland Dental Partners Pllc | Dentist | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2008-08-19 |
| 1558520361 | Samuel Asante-buabeng | Family Medicine | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-4119 | 2008-06-06 |
| 1497879951 | Orthodontic Care Group | Dentist | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-3908 | 2007-03-19 |
| 1558460113 | Kristen Dee Lindstrom | Physical Therapist | 4670 Park Nicollet Ave Se, Prior Lake, MN 55372-3908 | 2006-09-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1508806530 | Kelly Brooks | Nurse Anesthetist, Certified Registered | 3564 Willow Beach St Sw, Prior Lake, MN 55372 | 2006-06-07 |
| Find all providers in zip 55372 | ||||
| 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 |
|---|---|---|---|---|
| 1225285208 | Dr. Howard E. Olson Pa | Dentist | 15870 Franklin Trl Se, Prior Lake, MN 55372-2092 | 2008-08-21 |
| 1871716688 | Chad Olson | Dentist | 15870 Franklin Trl Se Ste 200, Prior Lake, MN 55372-2021 | 2007-04-10 |
| 1356426332 | David A Linde | Dentist | 14464 Shady Beach Trl Ne, Prior Lake, MN 55372-1350 | 2006-10-26 |
| 1518056704 | Shrirang Mahajan | Dentist | 14070 Commerce Ave Ne Ste 100, Prior Lake, MN 55372-1424 | 2006-10-12 |
| 1508823139 | Charles Walter Puffer | Dentist | 14120 Commerce Ave Ne, Suite 300, Prior Lake, MN 55372-1500 | 2006-04-27 |
| 1134119266 | Ronald Marvin Bliss | Dentist | 4792 Dakota St Se, Prior Lake, MN 55372-1883 | 2005-10-28 |
| 1720076169 | Michael C. Babcock | Dentist | 16670 Franklin Trl Se, Prior Lake, MN 55372-2924 | 2005-10-10 |
| 1548264898 | Karl M. Haemig | Dentist | 2330 Sioux Trl Nw, Prior Lake, MN 55372-9077 | 2005-06-01 |
| 1811489909 | Blake Belland | Dentist | 4667 Dakota St Se, Prior Lake, MN 55372-1714 | 2018-06-04 |
| 1790014777 | Olson Dental LLC | Dentist | 15870 Franklin Trl Se, Suite 200, Prior Lake, MN 55372-2092 | 2009-12-21 |
| Find all providers in PRIOR LAKE | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
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.