PARK DENTAL
NPI 1104985456
Dentist - General Practice in Roseville, MN

Q: What is Pdg, P.A.'s NPI number?

The NPI number for Pdg, P.A. is 1104985456. It was assigned to this organization in the NPPES registry on December 6, 2006. The provider is doing business as Park Dental.

Q: What is Pdg, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Pdg, P.A. was last updated on October 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 06, 2006

1835 CTY RD C-WEST, SUITE 220, ROSEVILLE, MN 55113(651) 636-2123 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Park Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK DENTAL (NPI 1104985456) is a healthcare organization registered as a general practice in Roseville, Minnesota and active in the NPI registry since December 2006. The organization lists John Gulon, President, as its authorized official.

NPPES Registry Identity

NPI1104985456

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NamePDG, P.A.

Location Address1835 CTY RD C-WEST, SUITE 220Roseville, MN 55113-1343

Mailing Address2200 County Road C W, Suite 2210Roseville, MN 55113-2504 · (651) 746-2804 · Fax (651) 636-6350

Phone(651) 636-2123

Organization SubpartYes

Authorized OfficialJohn GulonPresident · (651) 633-0500

Enumeration DateDecember 6, 2006

Last NPPES UpdateOctober 28, 2020

NPPES CertifiedOctober 28, 2020

✔ NPI 1104985456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1835 CTY RD C-WEST, Roseville, MN 55113

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Other Names 1

Doing Business AsPark Dental

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pdg, P.A.'s NPI number?

The NPI number for Pdg, P.A. is 1104985456. It was assigned to this organization in the NPPES registry on December 6, 2006. The provider is doing business as Park Dental.

Where is Pdg, P.A. located?

Pdg, P.A. is located at 1835 Cty Rd C-West Suite 220, Roseville, MN 55113. The listed phone number is (651) 636-2123.

What is Pdg, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Pdg, P.A. was last updated on October 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.