Active NPI
PDG,P.a.
Doing business as Park Dental
- General Practice Dentistry
- Minnetonka, MN
National Provider Identifier
1730247180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- PDG,P.A.
- Doing business as
- Park Dental
- Practice address
- 13059 Ridgedale Dr
Minnetonka, MN 55305-1807 - Phone
- (952) 545-8603
- NPI assigned
- Dec 5, 2006
- Organization subpart
- Yes
- Parent organization
- PDG, P.A.
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
13059 Ridgedale Dr
Minnetonka, MN 55305-1807
Mailing address
2200 County Road C W
Suite 2210
Roseville, MN 55113-2504
Phone (651) 633-0500
Other names 1
- Park Dental
National Provider Directory
National Provider Directory- Tax ID family
- Pdgpa
- Part of
- Pdgpa
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
13059 Ridgedale Dr
Minnetonka, MN 55305
Phone (952) 545-8603
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Minnetonka, MN
- NPI 1851625099
-
- Dentist
- Minnetonka, MN
- NPI 1235417783
-
- Dentist
- Minnetonka, MN
- NPI 1609494681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1603843200000",
"number": "1730247180",
"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": "13059 RIDGEDALE DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553051807",
"telephone_number": "952-545-8603"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PDG,P.A.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PDG, P.A.",
"enumeration_date": "2006-12-05",
"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 Minnetonka, 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.