NPIMap

Organization Active NPI

PDG, PA

  • Dental Clinic/Center
  • Owatonna, MN
National Provider Identifier
1861931545
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, PA
Practice address
605 Hillcrest Ave Ste 210
Owatonna, MN 55060-3680
Phone
(507) 451-5844
Fax
(507) 451-0756
NPI assigned
Feb 15, 2017
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
John Gulon
Title
Prsident
Phone
(651) 633-0500

Specialties & licenses 1

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

Addresses

Primary practice location

605 Hillcrest Ave Ste 210
Owatonna, MN 55060-3680

Mailing address

2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815

National Provider Directory

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

Organizations with this tax ID in the same state 18

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

View all 18

Locations

605 Hillcrest Ave
Ste 210
Owatonna, MN 55060
Phone (507) 451-5844

Practitioners & affiliated clinicians

Practitioners 4

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": "1487116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1861931545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W STE 2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132551",
            "telephone_number": "651-746-2815",
            "fax_number": "651-209-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 HILLCREST AVE STE 210",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603680",
            "telephone_number": "507-451-5844",
            "fax_number": "507-451-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDG, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-15",
        "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": "PRSIDENT",
        "authorized_official_telephone_number": "651-633-0500"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, 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.