PDG, PA (NPI# 1073904223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073904223 |
| Entity Type | Organization |
| Organization Name | PDG, PA |
| Practice Address |
91 Snelling Ave N Saint Paul MN 55104-6753 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2550 |
| Practice Telephone | 6516463735 |
| Mailing Telephone | 6516330500 |
| Enumeration Date | 2015-02-10 |
| 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 |
| 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 |
91 SNELLING AVE N |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-6753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952388605 | Richard Charles Ehrmanntraut | Dentist | 91 Snelling Ave N, Suite 110, Saint Paul, MN 55104-6753 | 2005-12-23 |
| 1568766244 | Mariken Wogstad-hansen, Phd, LLC | Psychologist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2011-01-10 |
| 1720382062 | Mariken Wogstad-hansen, Phd, LLC | Clinical Nurse Specialist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2010-12-30 |
| 1538496740 | Damaris Teresa Perez Ramirez | Counselor | 91 Snelling Ave N, Saint Paul, MN 55104-6753 | 2009-11-09 |
| 1861658643 | Joan Emily Wernick | Social Worker | 91 Snelling Ave N, Suite 200, Saint Paul, MN 55104-6753 | 2008-07-31 |
| 1619153624 | Delle Jacobs, Limited | Marriage & Family Therapist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2008-01-21 |
| 1932398625 | Leslie Gaidi | Psychologist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2007-10-17 |
| 1548475296 | Laura A. Boe | Psychologist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2007-05-14 |
| 1780700039 | Mariken Ellen Wogstad-hansen | Psychologist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2007-03-21 |
| 1609990084 | Bonnie K Burg | Social Worker | 91 Snelling Ave N, #230, Saint Paul, MN 55104-6753 | 2007-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144860685 | Mn Community Care- Downtown Clinic Dental | Clinic/Center | 424 Dorothy Day Place, Saint Paul, MN 55102-1025 | 2020-01-13 |
| 1184980112 | St. Anthony Park Dental Arts, P.a. | Clinic/Center | 2282 Como Ave, Saint Paul, MN 55108-1722 | 2012-04-04 |
| 1417007436 | West Side Community Health Services, Inc. | Clinic/Center | 478 Robert St S, Saint Paul, MN 55107-2236 | 2007-01-11 |
| 1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
| 1154933661 | Grand Avenue Dental, LLC | Clinic/Center | 960 Grand Ave, Saint Paul, MN 55105-3014 | 2020-08-18 |
| 1043870645 | St Paul Oral Surgery and Dental Implants LLC | Clinic/Center | 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 | 2019-06-17 |
| 1427519529 | Bright Smiles Dental Program | Clinic/Center | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-03-29 |
| 1033675871 | N&m Dds | Clinic/Center | 483 Brimhall St, Saint Paul, MN 55116-1508 | 2019-02-18 |
| 1871064105 | Luna Land Dental, Corp. | Clinic/Center | 1215 Rice St, Saint Paul, MN 55117-4538 | 2018-12-16 |
| 1689181489 | Luna Land Dental, Corp. | Clinic/Center | 555 Wabasha St N Ste 250, Saint Paul, MN 55102-1673 | 2018-01-03 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55104 |
Please comment or provide details below to improve the information on PDG, PA.
| 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.