PDG, P.A. (NPI# 1932275971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932275971 |
| Entity Type | Organization |
| Organization Name | PDG, P.A. |
| Other Organization Name | PARK DENTAL |
| Practice Address |
1895 Plaza Dr Suite 130 Eagan MN 55122-4600 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2504 |
| Practice Telephone | 6514542700 |
| Practice Fax Number | 6514541469 |
| 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 |
| 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 |
|---|---|---|---|---|
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1316376668 | Pdg, P.a. | Clinic/Center | 6520 150th St W, Suite 300, Apple Valley, MN 55124-6554 | 2013-11-07 |
| 1639508153 | Pdg, P.a. | Clinic/Center | 501 Cherry Ln, Roberts, WI 54023-9731 | 2013-11-05 |
| 1043649569 | Pdg, P.a. | Clinic/Center | 1003 Pearson Dr, Hudson, WI 54016-8727 | 2013-11-05 |
| 1205265741 | Pdg, P.a. | Clinic/Center | 10150 City Walk Dr, Suite C, Woodbury, MN 55129-9257 | 2013-11-05 |
| 1538598057 | Pdg, P.a. | Clinic/Center | 15015 Cimarron Ave, Rosemount, MN 55068-2771 | 2013-11-05 |
| 1346679859 | Pdg, P.a. | Clinic/Center | 14741 Victor Hugo Blvd N, Hugo, MN 55038-4561 | 2013-11-05 |
| 1285993345 | Pdg, P.a. | Clinic/Center | 3161 Northdale Blvd Nw, Coon Rapids, MN 55433-1825 | 2012-05-10 |
| 1104985456 | Pdg, P.a. | Dentist | 1835 Cty Rd C-west, Suite 220, Roseville, MN 55113-1343 | 2006-12-06 |
| 1487712915 | Pdg, P.a. | Dentist | 9600 Upland Ln N, Suite 200, Maple Grove, MN 55369-4461 | 2006-12-05 |
| Street Address |
1895 PLAZA DR SUITE 130 |
| City | EAGAN |
| State | MN |
| Zip Code | 55122-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699106773 | Life Wellness Center-eagan, Pa | Chiropractor | 1895 Plaza Dr, Suite 200, Eagan, MN 55122-4600 | 2013-11-27 |
| 1194042135 | Emergent Health Chiropractic Wellness, Inc | Chiropractor | 1895 Plaza Dr, Suite 200, Eagan, MN 55122-4600 | 2010-04-30 |
| 1740438076 | Dental Specialists of Minnesota, Pllc | Dentist | 1895 Plaza Dr, Suite 130, Eagan, MN 55122-4600 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651753 | Alvaro Jesus Jimenez Aguilar | Registered Nurse | 1764 Silver Bell Rd, Eagan, MN 55122 | 2019-01-02 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1831541168 | Mackenzie Lea Kerber | Counselor | 3410 Federal Dr Suite 101, Eagan, MN 55122 | 2016-07-11 |
| 1285010074 | Eagan Pointe Senior Living | Assisted Living Facility | 4232 Black Hawk Road, Eagan, MN 55122 | 2015-08-04 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
| 1528451028 | Judi Ross Holistic Therapy, LLC | Marriage & Family Therapist | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2015-03-09 |
| 1447649637 | Leah Ruth Streitman | Physician Assistant | 3460 Washington Dr Ste 200, Eagan, MN 55122 | 2015-01-12 |
| 1518362193 | Cedar Valley Center for Child & Family Therapy | Preferred Provider Organization | 3460 Washington Dr., Suite 110, Eagan, MN 55122 | 2014-10-25 |
| 1316351703 | Wecare Dental of Eagan P.c | Clinic/Center | 1625 Lena Court Suite 100, Eagan, MN 55122 | 2014-06-13 |
| Find all providers in zip 55122 | ||||
| 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 |
|---|---|---|---|---|
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1730734708 | Ideal Dental Pllc | Dentist | 2130 Cliff Rd Ste 107, Eagan, MN 55122-2486 | 2019-08-07 |
| 1760972749 | Nicholas Theodore Schulte | Dentist | 1960 Cliff Lake Rd Ste 127, Eagan, MN 55122-2439 | 2018-05-15 |
| 1710357520 | Modern Dental Professionals, Mn PC | Dentist | 1625 Lena Ct, Suite 100, Eagan, MN 55122-2959 | 2015-10-06 |
| 1184093551 | Eagan Smiles Dentistry, PC | Dentist | 3405 Promenade Ave, Suite 300, Eagan, MN 55123-4404 | 2015-09-16 |
| 1225265309 | Molly Anne Henry | Dentist | 1965 Cliff Lake Rd, Suite #102, Eagan, MN 55122-2590 | 2009-06-16 |
| 1144353780 | Eagan Family Dentistry | Dentist | 4178 Knob Dr Ste C, Eagan, MN 55122-1875 | 2007-03-13 |
| 1871632026 | Karrie Marie Glasgow | Dentist | 1260 Yankee Doodle Rd, Suite 102, Eagan, MN 55121-2201 | 2007-02-05 |
| 1528127917 | Mark Joseph Skala | Dentist | 1905 Plaza Dr, Eagan, MN 55122-2883 | 2006-12-08 |
| 1841368545 | Dr Gerald W Rauchwarter Dds LLC | Dentist | 1960 Cliff Lake Road, #127, Eagan, MN 55122 | 2006-12-01 |
| Find all providers in EAGAN | ||||
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| 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.