NPIMap

PDG, P.a.

Organization Active NPI General Practice Dentistry · Chaska, MN

NPI 1437225554 · NPPES record last updated Oct 28, 2020

Key facts

NPI
1437225554
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
PDG, P.A.
Practice address
1150 Hazeltine Blvd
Chaska, MN 55318-3054
Phone
(952) 361-0777
Fax
(952) 361-6729
NPI assigned
Nov 28, 2006
Organization subpart
Yes
Parent organization (as reported)
PDG, P.A.

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Casey Luke Newton (65 organizations share this tax ID)
Part of
Casey Luke Newton

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP		 1223G0001X Yes

Addresses

Primary practice location

1150 Hazeltine Blvd
Chaska, MN 55318-3054

Mailing address

2200 County Road C W
Suite 2210
Roseville, MN 55113-2504
Phone (651) 633-0500

Other names

  • Park Dental Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 28, 2020.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1437225554",
    "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": "551132504",
            "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": "1150 HAZELTINE BLVD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553183054",
            "telephone_number": "952-361-0777",
            "fax_number": "952-361-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDG, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PDG, P.A.",
        "enumeration_date": "2006-11-28",
        "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": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chaska, MN

All providers in Chaska, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.