PARK DENTAL
NPI 1629589544
Clinic/Center - Dental in Big Lake, MN

Active since October 18, 2017
16991 198TH AVE NW, BIG LAKE, MN 55309(763) 263-6350(763) 263-0136 Get Directions Write a Review

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

Record update history: Oct 28, 2020, Oct 24, 2017, Oct 18, 2017 (3 updates tracked since 2017).

About Park Dental NPPES

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

PARK DENTAL (NPI 1629589544) is a healthcare organization registered as a dental in Big Lake, Minnesota and active in the NPI registry since October 2017. The organization lists Shannon Hesse, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1629589544
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NamePDG, PA
Location Address16991 198TH AVE NWBig Lake, MN 55309
Mailing Address2200 County Road C W Ste 2210Roseville, MN 55113-2551 · (651) 746-2815 · Fax (651) 209-6312
Fax(763) 263-0136
Organization SubpartNo
Authorized OfficialShannon HesseCredentialing Specialist · (651) 746-2815
Enumeration DateOctober 18, 2017
Last NPPES UpdateOctober 28, 20203 updates tracked since enumeration
NPPES CertifiedOctober 28, 2020
NPI 1629589544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
16991 198TH AVE NW, Big Lake, MN 55309

Other Names 1

Doing Business AsPark Dental

Other Providers at the Same Location NPPES 2

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

Dentist
16991 198TH AVE NW
BIG LAKE, MN 55309
Dentist (General Practice)
16991 198TH AVE NW
BIG LAKE, MN 55309

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, PA's NPI number?

The NPI number for Pdg, PA is 1629589544. It was assigned to this organization in the NPPES registry on October 18, 2017. The provider is doing business as Park Dental.

Where is Pdg, PA located?

Pdg, PA is located at 16991 198th Ave NW, Big Lake, MN 55309. The listed phone number is (763) 263-6350.

What is Pdg, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Pdg, PA 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.