PDG,P.A. (NPI# 1821164963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821164963 |
| Entity Type | Organization |
| Organization Name | PDG,P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
9145 Springbrook Dr Nw Suite 100 Coon Rapids MN 55433-5885 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2504 |
| Practice Telephone | 7637864632 |
| Practice Fax Number | 7637868673 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2006-11-28 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1689732133 | Pdg,p.a. | Dentist | 4670 Park Nicollet Ave Se, Suite 100, Prior Lake, MN 55372-3908 | 2006-12-05 |
| 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 |
| Street Address |
9145 SPRINGBROOK DR NW SUITE 100 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-5885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750361283 | April B Grudell | Internal Medicine | 9145 Springbrook Dr Nw, Coon Rapids, MN 55433-5885 | 2006-01-19 |
| 1518200286 | Dental Specialists of Minnesota, Pllc | Dentist | 9145 Springbrook Dr Nw, Suite 100, Coon Rapids, MN 55433-5885 | 2013-04-01 |
| 1730365016 | Emily Heitz | Physician Assistant | 9145 Springbrook Dr Nw, Suite 200, Coon Rapids, MN 55433-5885 | 2008-01-16 |
| 1831392554 | Michelle Marie Douvier | Physician Assistant | 9145 Springbrook Dr Nw, Coon Rapids, MN 55433-5885 | 2007-06-08 |
| 1720006422 | Michael Thomas Bader | Internal Medicine | 9145 Springbrook Dr Nw, Suite 200, Coon Rapids, MN 55433-5885 | 2006-07-18 |
| 1275505018 | Neville Basman | Internal Medicine | 9145 Springbrook Dr Nw, Suite 200, Coon Rapids, MN 55433-5885 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1245857655 | Paul Yaeger | Dentist | 3570 River Rapids Dr Nw, Coon Rapids, MN 55448-4100 | 2020-07-01 |
| 1932767688 | Levi Bursch | Dentist | 3570 River Rapids Dr Nw # 110, Coon Rapids, MN 55448-4100 | 2019-05-29 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1316450091 | Tran Dental LLC | Dentist | 3570 River Rapids Dr Nw Ste 110, Coon Rapids, MN 55448-4100 | 2017-11-16 |
| 1003286808 | Modern Dental Professionals, Mn PC | Dentist | 2147 Northdale Blvd Nw, Nwood, Coon Rapids, MN 55433-3006 | 2015-10-06 |
| 1609279140 | Marissa Kaplan | Dentist | 13040 Riverdale Dr Nw Ste 600, Coon Rapids, MN 55448-8419 | 2014-09-29 |
| 1467899708 | Sanket R Nagarkar | Dentist | 3161 Northdale Blvd, Coon Rapids, MN 55433 | 2013-05-28 |
| 1619287562 | Northdale Dentist Pa | Dentist | 2147, Northdale Blvd Nw., Coon Rapids, MN 55433 | 2010-10-13 |
| 1881914182 | Katie Daniels | Dentist | 8960 Springbrook Dr Nw Ste 150, Coon Rapids, MN 55433-5809 | 2010-06-09 |
| 1407085814 | Gina Lorraine Andersland | Dentist | 2519 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-3952 | 2009-07-07 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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.