PDG,P.A. (NPI# 1306912480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306912480 |
| Entity Type | Organization |
| Organization Name | PDG,P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
4200 W Old Shakopee Rd Suite 100 Bloomington MN 55437-2976 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2504 |
| Practice Telephone | 9528316126 |
| 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 |
4200 W OLD SHAKOPEE RD SUITE 100 |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55437-2976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093747354 | Kris J Kalenda | Dentist | 4200 W Old Shakopee Rd, Suite 221, Bloomington, MN 55437 | 2006-07-07 |
| 1558433748 | Dana John Isaacson | Dentist | 4200 W Old Shakopee Rd, Suite 223, Bloomington, MN 55437-2976 | 2006-11-14 |
| 1396817482 | Timothy John Isaacson | Dentist | 4200 W Old Shakopee Rd, Suite 223, Bloomington, MN 55437-2976 | 2006-11-14 |
| 1447322532 | Edmund Theis | Dentist | 4200 W Old Shakopee Rd, Suite 223, Bloomington, MN 55437-2976 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710344494 | Bloomington Smiles Dentistry, PC | Dentist | 10700 France Avenue, Suite 102, Bloomington, MN 55437 | 2016-01-26 |
| 1851788988 | Rachael Anne Wilson | Dentist | 4200 West Old Shakopee Rd, Suite 100, Bloomington, MN 55437 | 2015-04-15 |
| 1518166891 | Ronald Lawrence Shapiro | Internal Medicine | 5270 W 84th St, #500, Minneapolis, MN 55437 | 2007-07-16 |
| 1275742900 | Riverview Spine, P.a. | Chiropractor | 5402 W. Old Shakopee Road, Bloomington, MN 55437 | 2007-05-21 |
| 1184846149 | Michael Robert Wiles | Chiropractor | 5017 West 106th Street, Bloomington, MN 55437 | 2007-05-02 |
| 1821181421 | Tms Treatment Center Inc | Community Based Residential Treatment Facility, Mental Illness | 5414 West Old Shakopee Circle, Bloomington, MN 55437 | 2006-10-02 |
| 1952493736 | The James Inc | Home Health | 4533 Normandale Highlands Drive, Bloomington, MN 55437 | 2006-09-29 |
| 1871560078 | Gregory Borg Hanson | Dentist | 5270 W 84 St, Bloomington, MN 55437 | 2006-03-07 |
| 1770076184 | Cal Leonard Johnson | Physical Therapist | 5001 American Blvd W Ste 945, Bloomington, MN 55437 | 2018-06-11 |
| 1427438092 | Lucy Neitzel | Family Medicine | 5320 Hyland Greens Dr, Bloomington, MN 55437 | 2015-06-09 |
| Find all providers in zip 55437 | ||||
| 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 |
|---|---|---|---|---|
| 1972162527 | Pournawattie Andrea Chandradatt | Dentist | 7936 Portland Ave S, Bloomington, MN 55420-1315 | 2019-06-07 |
| 1336601756 | Neha Shah | Dentist | 17644 Valley Blvd Ste 1, Bloomington, CA 92316-3908 | 2019-04-03 |
| 1033689054 | Erick Esmenjaud D.d.s. Inc | Dentist | 18793 Valley Blvd Ste A-b, Bloomington, CA 92316-2253 | 2018-12-03 |
| 1336620160 | Mohamed Owais Sultan | Dentist | 857 S Auto Mall Rd Ste 4, Bloomington, IN 47401-5488 | 2018-08-29 |
| 1285184259 | Children's Center for Dentistry | Dentist | 2111 E Oakland Ave Ste C, Bloomington, IL 61701-5783 | 2016-10-13 |
| 1255783320 | Fatima Quadri | Dentist | 401 N Veterans Pkwy, Unit D, Bloomington, IL 61704-3550 | 2016-07-12 |
| 1528419686 | Brandt Allen Finney | Dentist | 2909 E Buick Cadillac Blvd, Bloomington, IN 47401-5443 | 2016-06-29 |
| 1942668702 | Point Family Dentistry | Dentist | 10611 France Ave S Ste 201, Bloomington, MN 55431-3554 | 2016-02-08 |
| 1710344494 | Bloomington Smiles Dentistry, PC | Dentist | 10700 France Avenue, Suite 102, Bloomington, MN 55437 | 2016-01-26 |
| 1497160204 | Jp Dental - Bloomington, LLC | Dentist | 409 S Dunn St, Bloomington, IN 47401-4822 | 2014-07-01 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55437 |
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.