Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelton Ericson DMD MD PLLC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1790532901

Kelton Ericson DMD MD PLLC is an Oral and Maxillofacial Surgery (Dentist) in Phoenix, Arizona. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8043 N 10th St
Phoenix, AZ 85020-3770
Phone: (602) 758-9009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1790532901
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelton Ericson — Owner/Doctor · (602) 758-9009
NPI enumeratedMay 4, 2024
Last updated in NPPESMay 13, 2024
Certification dateMay 13, 2024
Mailing address8043 N 10th St, Phoenix, AZ 85020-3770

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