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PARK DENTAL
NPI 1487712915
Dentist - General Practice in Maple Grove, MN

Active since December 05, 2006
9600 UPLAND LN N, SUITE 200, MAPLE GROVE, MN 55369(763) 416-0037(763) 420-5428 Get Directions Write a Review

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

About Park Dental NPPES

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

PARK DENTAL (NPI 1487712915) is a healthcare organization registered as a general practice in Maple Grove, Minnesota and active in the NPI registry since December 2006. The organization lists John Gulon, President, as its authorized official.

NPPES Registry Identity

NPI1487712915
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePDG, P.A.
Location Address9600 UPLAND LN N, SUITE 200Maple Grove, MN 55369-4461
Mailing Address2200 County Road C W, Suite 2210Roseville, MN 55113-2504 · (651) 633-0500 · Fax (651) 636-6350
Phone(763) 416-0037
Fax(763) 420-5428
Organization SubpartYes
Authorized OfficialJohn GulonPresident · (651) 633-0500
Enumeration DateDecember 5, 2006
Last NPPES UpdateOctober 28, 2020
NPPES CertifiedOctober 28, 2020
✔ NPI 1487712915 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.
9600 UPLAND LN N, Maple Grove, MN 55369
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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 3

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

MRS. RACHEL MAE CLARK MS, CGC
Genetic Counselor, MS
9600 UPLAND LN N, STE 180
MAPLE GROVE, MN 55369
Hennepin County (763) 236-0753
SARA ELIZABETH JOHNSON MSW, LICSW
Social Worker (Clinical)
9600 UPLAND LN N
MAPLE GROVE, MN 55369
Hennepin County (952) 993-6200
DR. JEFFREY ALLEN PUMPER D.D.S.
Dentist (General Practice)
9600 UPLAND LN N, SUITE 200
MAPLE GROVE, MN 55369
Hennepin County (763) 416-0037

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 1487712915. It was assigned to this organization in the NPPES registry on December 5, 2006. The provider is doing business as Park Dental.

Where is Pdg, P.A. located?

Pdg, P.A. is located at 9600 Upland Ln N Suite 200, Maple Grove, MN 55369. The listed phone number is (763) 416-0037.

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.