Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508493388 Individual Practitioner Female Practitioner

Dr. Tomomi J Ida , DDS

Dentist - Pediatric Dentistry • Everett, WA

Professional Overview & Biography Verified Profile Summary

Dr. Tomomi Ida, DDS is a registered healthcare professional specializing in Dentist - Pediatric Dentistry in Everett, WA. Practice services are available at 111 SE EVERETT MALL WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

111 Se Everett Mall Way

Everett, WA 982083208

Telephone 4253417827
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Pediatric Dentistry in Everett, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
3 Specialists

Practicing in Everett, WA (287 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

CMS Verified: 2026-03-03
Dentist - Pediatric Dentistry Primary Specialty

NUCC Taxonomy Code: 1223P0221X

State License WA DE61165856

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License WA DE61165856

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

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

6 Associated Practitioners
NPI 1306380001

Pharmacist

NPI 1548615776
NPI 1649408964

Doctor of Dental Surgery

NPI 1659669521
NPI 1730466095

Doctor of Pharmacy (Pharm.D.)

NPI 1801216270

Doctor of Dental Medicine, Master of Public Health

Career & Practice History Timeline

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

11 Historical Events
📍
Updated Practice Location March 03, 2026

Registered at 111 SE EVERETT MALL WAY, EVERETT, WA 982083208 (Tel: 4253417827)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2026

Dentist (License #DE61165856 in WA)

📍
Updated Practice Location July 15, 2021

Registered at 4111 194TH ST SW, LYNNWOOD, WA 980364604 (Tel: 4258355200)

📍
Updated Business Mailing Address July 15, 2021

Registered at 4111 194TH ST SW, LYNNWOOD, WA 980364604 (Tel: 4258355200)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2021

Dentist (License #DE61165856 in WA)

NPI Profile Active March 24, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location March 24, 2020

Registered at 6200 13TH AVE S FL 1, SEATTLE, WA 981082706 (Tel: 2064616943)

📍
Updated Business Mailing Address March 24, 2020

Registered at 930 KAHEKA ST APT 401, HONOLULU, HI 968142455

👤
Provider Name / Credentials Updated March 24, 2020

Recorded as TOMOMI IDA, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 24, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508493388
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 24, 2020
Last Update: March 03, 2026
Sole Proprietor: Yes

Mailing Address

4111 194th St Sw

Lynnwood, WA 980364604

Phone: 4258355200

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.