Active NPI
Karl S Shao, DMD
- Dentist
- Portland, OR
National Provider Identifier
1366894453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D10467
- Practice address
- 9370 SW Greenburg Rd Ste 103
Portland, OR 97223-5428 - Phone
- (503) 245-0082
- Fax
- (503) 245-0293
- NPI assigned
- Jul 13, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D10467 | OR | Primary |
Addresses
Primary practice location
9370 SW Greenburg Rd Ste 103
Portland, OR 97223-5428
Mailing address
9370 SW Greenburg Rd Ste 103
Portland, OR 97223-5428
Phone (503) 245-0082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10467 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karl S Shao DMD PC | Current | Accepting new patients | |
| John Bajusack DMD, PC | Current | Accepting new patients | |
| Brookside Dental - Milwaukie, LLC | Past | Accepting new patients | |
| BD-Clackamas, LLC | Past | Accepting new patients |
Locations
511 SW 10th Ave
Ste 704
Portland, OR 97205
Phone (503) 227-2883
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Brookside Dental - Clackamas
- General Practice Dentistry
- Clackamas, OR
- NPI 1649635384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790035200000",
"number": "1366894453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9370 SW GREENBURG RD STE 103",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972235428",
"telephone_number": "503-245-0082",
"fax_number": "503-245-0293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9370 SW GREENBURG RD STE 103",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972235428",
"telephone_number": "503-245-0082",
"fax_number": "503-245-0293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAO",
"first_name": "KARL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-13",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D10467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.