OrganizationActive
Boulos Dental Care, P.C.
NPI 1023308392 · Exclusive Provider Organization · Shoreview, MN
Provider details
- NPI number
- 1023308392
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Samy Boulos, Dentist (DDS)(952) 465-7210
- License
- 12329 (MN)
Specialties & taxonomies
Managed Care Organizations
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
470 Highway 96 W
Suite 200
Shoreview, MN 55126-1996
Phone: (952) 465-7210
Street-level locationGet directions
Mailing address
110 Carlson Pkwy
Minnetonka, MN 55305-5334
Registry dates
- Enumerated
- 2011-04-07
- Last updated
- 2011-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.