Individual provider Active NPI

Chao Shen, DMD

  • Endodontics
  • Vancouver, WA
National Provider Identifier
1558610584
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE60308272 Issued in WA
Practice address
601 SE 117TH Ave Ste 110
Vancouver, WA 98683-5297
Phone
(360) 334-4400
NPI assigned
Sep 6, 2012
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60308272 WA
Dentist 122300000X D10723 OR
Endodontics 1223E0200X D10723 OR
Endodontics 1223E0200X DE60308272 WA Primary

Addresses

Primary practice location

601 SE 117TH Ave Ste 110
Vancouver, WA 98683-5297

Mailing address

601 SE 117TH Ave Ste 110
Vancouver, WA 98683-5297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801002979 WA Order and Referring Only - DentistPractitioner - Dentist 9739697616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60308272WAMDDentist
D10723ORMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Chao Shen DMD PLLC Endodontics CurrentSince Jul 3, 2022 Accepting new patients
Vancouver Endodontic Specialists PC Inc. Endodontics PastSince Jul 3, 2022 Accepting new patients

Locations

601 SE 117th Ave
Ste 110
Vancouver, WA 98683
Phone (360) 334-4400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1558610584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-334-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "CHAO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60308272",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10723",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D10723",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60308272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.