Healthcare Provider Details

I. General information

NPI: 1932012630
Provider Name (Legal Business Name): SAM SAUZA DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 YORK AVE S STE 240
EDINA MN
55435-5896
US

IV. Provider business mailing address

7701 YORK AVE S STE 240
EDINA MN
55435-5896
US

V. Phone/Fax

Practice location:
  • Phone: 651-505-5900
  • Fax: 651-505-5901
Mailing address:
  • Phone: 651-505-5900
  • Fax: 651-505-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL SAUZA
Title or Position: OWNER
Credential: DDS
Phone: 619-673-7305