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PARK DENTAL
NPI 1215003371
Dentist - General Practice in Blaine, MN

Active since November 28, 2006
12904 CENTRAL AVE NE, BLAINE, MN 55434(763) 755-1330 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Park Dental NPPES

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

PARK DENTAL (NPI 1215003371) is a healthcare organization registered as a general practice in Blaine, Minnesota and active in the NPI registry since November 2006. The organization lists John Gulon, President, as its authorized official.

NPPES Registry Identity

NPI1215003371
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePDG,P.A.
Location Address12904 CENTRAL AVE NEBlaine, MN 55434-4147
Mailing Address2200 County Road C W, Suite 2210Roseville, MN 55113-2504 · (651) 633-0500 · Fax (651) 636-6350
Phone(763) 755-1330
Organization SubpartYesParent: Pdg, P.a.
Authorized OfficialJohn GulonPresident · (651) 633-0500
Enumeration DateNovember 28, 2006
Last NPPES UpdateOctober 28, 2020
NPPES CertifiedOctober 28, 2020
✔ NPI 1215003371 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.
12904 CENTRAL AVE NE, Blaine, MN 55434
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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

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEFFREY MARK RUHLMANN
Dentist (General Practice)
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 755-1330
DR. ANISSA JANE KOZLOWSKI DDS
Dentist (General Practice)
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 755-1330
DR. THIEN QUANG PHAM D.D.S.
Dentist
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (651) 621-4515
JACOB DANIEL MEYER
Dentist
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 755-1330
DR. ROBB DAVID KOZLOWSKI DDS
Dentist (General Practice)
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 755-1330
JOSE ALEJANDRO GIGATO GONZALEZ DDS
Dentist (General Practice)
12904 CENTRAL AVE NE
MINNEAPOLIS, MN 55434
Anoka County (763) 755-1330
DR. SHAWN MCCARTHY D.D.S., M.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 201-6960
DR. PETER JON THOMPSON DDS
Dentist (General Practice)
12904 CENTRAL AVE NE
BLAINE, MN 55434
Anoka County (763) 755-1330

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 1215003371. It was assigned to this organization in the NPPES registry on November 28, 2006. The provider is doing business as Park Dental.

Where is Pdg,p.A. located?

Pdg,p.A. is located at 12904 Central Ave NE, Blaine, MN 55434. The listed phone number is (763) 755-1330.

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.