PDG, P.A. – NPI #1184288979
Clinic/Center

PDG, P.A. is an AHC clinic located in HERMANTOWN, MN. NPPES has assigned the NPI number 1184288979 to PDG, P.A. on April 26, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Oct 28, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PDG, P.A. below.

NPI Profile for
PDG, P.A.

NPI Number
1184288979
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PDG, P.A.
Primary location
4891 MILLER TRUCK HWY.
SUITE 100
HERMANTOWN, MN 55811
Phone: (218) 722-7770 Fax: (218) 740-3234
Mailing address
2200 COUNTY ROAD C W STE 2210
ROSEVILLE, MN 55113-2551
Phone: (651) 746-2815 Fax:
Organization Subpart
No
Authorized Official
SHANNON HESSE
CREDENTIALING SPECIALISTS
Phone: (651) 746-2815
Updated
Certification Date
Oct 28, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.