Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1053408302 Deactivated / Inactive NPI Male Practitioner

Dr. William Shaw , DMD

Dentist - General Practice • Portland, OR

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. William Shaw has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 06, 2006
NPI Deactivation Date August 29, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. William Shaw, DMD was a registered Dentist - General Practice practicing in Portland, OR. Throughout an active medical career spanning 16 years, Dr. Shaw provided care at the practice location at 2250 NW FLANDERS ST until profile deactivation on 2022-08-29.

Practice Location & Contact Primary Location

Practice Address

2250 Nw Flanders St
304

Portland, OR 972103443

Telephone 5032233545
Fax 5032233545
Associated Practice Facility / Clinic
🏢 Psychiatric Care Pc Facility NPI 1063468692

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Portland, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
448 Specialists

Practicing in Portland, OR (1994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR 5297

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

32 Associated Practitioners
NPI 1003898669

Doctor of Medicine (M.D.)

Mary Iannuccillo , MSW

Social Worker - Clinical

NPI 1023231982

Master of Social Work

Dr. Sandra Krussel , DO

Psychiatry & Neurology - Psychiatry

NPI 1073794988

Doctor of Osteopathic Medicine (D.O.)

Dr. Barbara Sax , MD

Psychiatry & Neurology - Psychiatry

NPI 1083783682

Doctor of Medicine (M.D.)

Dr. Ann Anthony , MD

Family Medicine

NPI 1104001007

Doctor of Medicine (M.D.)

Jennifer Dimon

Physical Therapist

NPI 1154707917

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated August 29, 2022

Record deactivated on August 29, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2250 NW FLANDERS ST, 304, PORTLAND, OR 972103443 (Tel: 5032233545)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2250 NW FLANDERS ST, 304, PORTLAND, OR 972103443 (Tel: 5032233545)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as WILLIAM SHAW, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #5297 in OR)

🟢
Initial NPI Registration & Enumeration October 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. William Shaw. Be the first to share your experience!

Sign in to leave a review for Dr. William Shaw

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1053408302
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2006
Last Update: July 08, 2007
Deactivation Date: August 29, 2022

Mailing Address

2250 Nw Flanders St, 304

Portland, OR 972103443

Phone: 5032233545

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.