PDG,P.A. (NPI# 1730247321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730247321 |
| Entity Type | Organization |
| Organization Name | PDG,P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
8559 Edinbrook Pkwy Brooklyn Park MN 55443-3747 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2504 |
| Practice Telephone | 7634253644 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2006-12-05 |
| 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 |
| 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 |
8559 EDINBROOK PKWY |
| City | BROOKLYN PARK |
| State | MN |
| Zip Code | 55443-3747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811923097 | North Memorial Health Care | Clinic/Center | 8559 Edinbrook Pkwy, Suite 100, Brooklyn Park, MN 55443-3728 | 2006-06-23 |
| 1235372731 | Tyler Steven Kettelkamp | Specialist/Technologist | 8559 Edinbrook Pkwy, 104, Brooklyn Park, MN 55443-3747 | 2009-04-14 |
| 1659432664 | Michael Wayne Johnson | Dentist | 8559 Edinbrook Pkwy, Brooklyn Park, MN 55443-3747 | 2006-12-13 |
| 1851450837 | Clarice Ione Hermunslie | Dentist | 8559 Edinbrook Pkwy, Brooklyn Park, MN 55443-3747 | 2006-12-06 |
| 1376602466 | Monica Manoranjin Alley | Dentist | 8559 Edinbrook Pkwy, Brooklyn Park, MN 55443-3747 | 2006-12-06 |
| 1306935309 | Rosalynn Torralba | Family Medicine | 8559 Edinbrook Pkwy, Suite 100, Brooklyn Park, MN 55443-3747 | 2006-10-11 |
| 1750478319 | David E Fuglestad | Family Medicine | 8559 Edinbrook Pkwy, Ste 100, Brooklyn Park, MN 55443-3747 | 2006-10-06 |
| 1972690550 | Joseph J Sicora | Family Medicine | 8559 Edinbrook Pkwy, Ste 100, Brooklyn Park, MN 55443-3747 | 2006-10-06 |
| 1649367210 | Ibrahim A Mujir | Family Medicine | 8559 Edinbrook Pkwy, Ste 100, Brooklyn Park, MN 55443-3747 | 2006-10-06 |
| 1992892541 | April L Fitzloff | Physician Assistant | 8559 Edinbrook Pkwy, Ste 100, Brooklyn Park, MN 55443-3747 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770100521 | El-lyon LLC | Home Health | 5501 88th Crescent North, Brooklyn Park, MN 55443 | 2020-06-28 |
| 1003431628 | Mercy Tasiame Quentin | Home Health | 7310 Unity Lane North, Brooklyn Park, MN 55443 | 2020-06-09 |
| 1386279719 | Andrew Sirlley Dogbe | Nursing Care | 8505 Xerxes Ln N, Brooklyn Park, MN 55443 | 2020-03-05 |
| 1952873630 | Melkezedek Care LLC | Home Health | 8525 N Edinbrook Crossing Suite 204, Brooklyn Park, MN 55443 | 2018-12-19 |
| 1487131330 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 4400 Oak Grove Parkway, Brooklyn Park, MN 55443 | 2018-07-24 |
| 1063901809 | Patient Centered Home Care Services, LLC. | Registered Nurse | 4127 Sunset Ter N, Brooklyn Park, MN 55443 | 2018-05-08 |
| 1093233942 | Ginni Ali | Registered Nurse | 7527 Yates Lane North, Brooklyn Park, MN 55443 | 2017-08-30 |
| 1437676335 | Uplifted Care Services LLC | Case Management | 3301 84th Ave, Brooklyn Park, MN 55443 | 2017-08-23 |
| 1912447780 | Zillah Mulubisha | Nurse Practitioner | Brooklyn Park Clinic, 7650 Zane Ave N, Minneapolis, MN 55443 | 2017-02-27 |
| 1356898985 | Abdul Kabba | Driver | 79oo Lad Parkway, Brooklyn Park, MN 55443 | 2016-09-01 |
| Find all providers in zip 55443 | ||||
| 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 |
|---|---|---|---|---|
| 1558987164 | Joseph Horst | Dentist | 5901 94th Ave N, Brooklyn Park, MN 55443-2388 | 2020-06-19 |
| 1225695174 | Vang Lee | Dentist | 5901 94th Ave N Ste 105, Brooklyn Park, MN 55443-2389 | 2019-05-28 |
| 1194018374 | Bonaventure Chisom Nwokocha | Dentist | 7960 Brooklyn Blvd, Brooklyn Park, MN 55445-2722 | 2011-05-22 |
| 1437223435 | Dean D Heuer | Dentist | 6901 78th Ave N, Brooklyn Park, MN 55445-2720 | 2006-11-20 |
| 1811073992 | Danh Lam | Dentist | 8421 W Broadway Ave, Brooklyn Park, MN 55445-2266 | 2006-10-31 |
| 1205925500 | Zane Dental, LLC | Dentist | 7340 Zane Ave N, Brooklyn Park, MN 55443-3114 | 2006-10-12 |
| 1467420372 | Thomas W Waite Dds Pa | Dentist | 5820 74th Ave N, Brooklyn Park, MN 55443-3140 | 2006-03-08 |
| 1225696925 | Minnesota Dental Professionals, P.C. | Dentist | 5901 94th Ave N Ste 105, Brooklyn Park, MN 55443-2389 | 2019-05-29 |
| 1710358379 | Modern Dental Professionals, Mn PC | Dentist | 7532 Brooklyn Blvd, Brooklyn Park, MN 55443-3101 | 2015-10-08 |
| 1356749659 | Today's Dental | Dentist | 7960 Brooklyn Blvd, Brooklyn Park, MN 55445-2722 | 2014-12-18 |
| Find all providers in BROOKLYN PARK | ||||
| City | BROOKLYN PARK |
| Zip Code | 55443 |
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.