NPIMap

Organization Active NPI

PDG,P.a.

  • Dental Clinic/Center
  • Edina, MN
National Provider Identifier
1083762041
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PDG,P.A.
Practice address
6545 France Ave S
Suite 366
Edina, MN 55435
Phone
(952) 926-3858
NPI assigned
Jan 8, 2007
Organization subpart
Yes
Parent organization
PDG, P.AAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Gulon, D.D.S.
Title
President
Phone
(651) 633-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

6545 France Ave S
Suite 366
Edina, MN 55435

Mailing address

2200 County Road C W
Suite 2210
Roseville, MN 55113-2550
Phone (651) 633-0500

Other names 1

  • Facial Pain Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Casey Luke Newton65 organizations share this tax ID, including this one
Part of
Casey Luke Newton

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1083762041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W",
            "address_2": "SUITE 2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132550",
            "telephone_number": "651-633-0500",
            "fax_number": "651-636-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "address_2": "SUITE 366",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-926-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDG,P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PDG, P.A",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "GULON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-633-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Facial Pain Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Facial Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.