Individual provider Active NPI

David Scott Tobias, DDS

  • Dentist
  • Lynnwood, WA
National Provider Identifier
1740407105
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010820 Issued in WA
Practice address
19020 33Rd Ave W Ste 380
Lynnwood, WA 98036-4754
Phone
(425) 774-1111
Fax
(425) 775-5624
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D011292 AZ
Dentist 122300000X DE00010820 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W Ste 380
Lynnwood, WA 98036-4754

Mailing address

19020 33Rd Ave W Ste 380
Lynnwood, WA 98036-4754
Phone (425) 774-1111

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D011292AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynnwoodsmiles Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1740407105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 380",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364754",
            "telephone_number": "425-774-1111",
            "fax_number": "425-775-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 380",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364754",
            "telephone_number": "425-774-1111",
            "fax_number": "425-775-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011292",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.