OrganizationActive
Pdg, P.A.
NPI 1639509334 · Dental Clinic/Center · Lake Elmo, MN
Pdg, P.A. is a Dental Clinic/Center organization in Lake Elmo, MN (NPI 1639509334).
Provider details
- NPI number
- 1639509334
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Gulon, President(651) 633-0500
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11240 Stillwater Blvd N
Lake Elmo, MN 55042-9321
Phone: (651) 777-0210
Fax: (651) 777-0320
Street-level locationGet directions
Mailing address
2200 County Road C W
Roseville, MN 55113-2550
Other names (DBA / former)
- Doing business as
- Park Dental
Registry dates
- Enumerated
- 2013-11-15
- Last updated
- 2020-10-28
- Certified
- 2020-10-28
Frequently asked questions
- What is Pdg, P.A.'s NPI number?
- Pdg, P.A.'s National Provider Identifier (NPI) is 1639509334, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pdg, P.A.?
- Pdg, P.A. is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pdg, P.A. located?
- Pdg, P.A.'s practice location on file with NPPES is 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321.
- What is Pdg, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Pdg, P.A. is (651) 777-0210.
- Who is the authorized official for Pdg, P.A.?
- The authorized official listed on Pdg, P.A.'s NPPES record is John Gulon, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pdg, P.A.'s NPI active?
- Yes — Pdg, P.A.'s NPI (1639509334) is active in the NPPES registry as of the last update on 2020-10-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.