LAKESIDE ENDODONTICS – Endodontics, NPI 1104056910

LAKESIDE ENDODONTICS is a healthcare provider. based in Everett, Washington. specializing in Endodontics. The NPI Number for LAKESIDE ENDODONTICS is 1104056910

Main info

Organization
Name
LAKESIDE ENDODONTICS
NPI
1104056910
Phone
(425) 357-8747
Address
10025 19TH AVE SE STE 202
Authorized Official
DR. SHAHIN ETEMADI PRESIDENT D.D.S., M.S.D.
Enumeration Date
15 July 2009
Last Update Date
14 April 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:16State licenses:0Digital endpointsOther names

Provider Addresses for LAKESIDE ENDODONTICS

  • 10025 19TH AVE SE STE 202

    EVERETT, WA 982084275

    Phone: (425) 357-8747

    Fax: (425) 337-6190

    Type: Mailing

  • 19th Avenue Southeast, Everett, Snohomish County, Washington, 98208, United States

    SUITE 202

    EVERETT, WA 982084275

    Phone: (425) 357-8747

    Fax: (425) 337-6190

    Type: Mailing

  • 9505 19TH AVE SE STE 115

    EVERETT, WA 982083843

    Phone: (425) 357-8747

    Fax: (425) 337-6190

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98208)

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Reviews

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Frequently asked questions

How do payers reference LAKESIDE ENDODONTICS?
For LAKESIDE ENDODONTICS, use NPI 1104056910 as the unique 10-digit identifier.
Is LAKESIDE ENDODONTICS shown as active in public data?
Registry records indicate LAKESIDE ENDODONTICS maintains an active NPI.
What expertise is attributed to LAKESIDE ENDODONTICS?
LAKESIDE ENDODONTICS's specialty line reads Endodontics. Clinical services aligned with this taxonomy classification.
What locale is associated with LAKESIDE ENDODONTICS?
Directory geography for LAKESIDE ENDODONTICS centers on Everett, Washington.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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