Organization Active NPI

PDG, P.a.

Doing business as Park Dental

  • General Practice Dentistry
  • Apple Valley, MN
National Provider Identifier
1841366093
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PDG, P.A.
Doing business as
Park Dental
Practice address
14990 Glazier Ave
Suite 100
Apple Valley, MN 55124-7818
Phone
(952) 431-5114
NPI assigned
Nov 28, 2006
Last updated
Oct 28, 2020By the provider in NPPES
Organization subpart
No

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.SNPI 1437218088
Title
President
Phone
(952) 949-2536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

14990 Glazier Ave
Suite 100
Apple Valley, MN 55124-7818

Mailing address

3030 Centre Pointe Dr
Suite 100
Roseville, MN 55113-1112
Phone (651) 286-8100

Other names 1

  • Park Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pdgpa65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Locations

14990 Glazier Ave
Ste 100
Apple Valley, MN 55124
Phone (612) 861-9123

3030 Centre Pointe Dr
Ste 100
Saint Paul, MN 55113
Phone (651) 286-8100

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1841366093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 CENTRE POINTE DR",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131112",
            "telephone_number": "651-286-8100",
            "fax_number": "651-633-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14990 GLAZIER AVE",
            "address_2": "SUITE 100",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247818",
            "telephone_number": "952-431-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDG, P.A.",
        "organizational_subpart": "NO",
        "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": "952-949-2536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Apple Valley, 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.