Provider Demographics
NPI:1831102318
Name:SHAO, DAVID S (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:SHAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 POINTS DR NE
Mailing Address - Street 2:
Mailing Address - City:YARROW POINT
Mailing Address - State:WA
Mailing Address - Zip Code:98004-1331
Mailing Address - Country:US
Mailing Address - Phone:425-679-1931
Mailing Address - Fax:
Practice Address - Street 1:15955 NE 85TH ST STE 102
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3550
Practice Address - Country:US
Practice Address - Phone:425-947-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000101511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice