Tomomi J. Ida, DDS

Pediatric Dentistry · Everett, WA

Individual Active NPI

NPI number 1508493388

Practice location

111 SE Everett Mall Way
Everett, WA 98208-3208
Phone
(425) 341-7827

Open in Google Maps

NPI record

NPI
1508493388
Entity type
Individual (Type 1)
Enumeration date
March 24, 2020
Last updated
March 3, 2026
Certified
March 3, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatric Dentistry Primary 1223P0221X DE61165856 WA
Dentist 122300000X DE61165856 WA
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

4111 194TH St SW
Lynnwood, WA 98036-4604
Phone
(425) 835-5200

About Dr. Ida

Tomomi J. Ida, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 111 SE Everett Mall Way, Everett, WA 98208-3208. The NPI number 1508493388 was assigned on March 24, 2020 and the record was last updated on March 3, 2026.

Dr. Ida lists 2 licenses in the registry: #DE61165856 (WA) for Pediatric Dentistry; #DE61165856 (WA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tomomi J. Ida, DDS?

The NPI number is 1508493388.

What is the phone number of Dr. Ida?

The phone number listed for the practice location is (425) 341-7827.

Where is Dr. Ida located?

111 SE Everett Mall Way, Everett, WA 98208-3208.

What is the taxonomy code for Dr. Ida?

The primary taxonomy code is 1223P0221X – Pediatric Dentistry; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

Other Pediatric Dentistry providers in Everett

All Pediatric Dentistry providers in Everett, WA →