Individual provider · Type 1 NPI

Mina Samy Boulos, DDS

General Practice Dentistry · Shoreview, MN

NPI number 1912837774 Active

Practice location

470 Highway 96 W Ste 200
Shoreview, MN 55126-3214

Call (651) 366-6880 Map

Fax (651) 366-6880

Mailing address

7702 Narcissus Ln N
Maple Grove, MN 55311-1849

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XD15431 (MN)

General Practice Dentistry: 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.

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About NPI 1912837774

Mina Samy Boulos, DDS's National Provider Identifier is 1912837774, issued on May 21, 2026. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Shoreview, MN. The record was last updated on May 21, 2026.