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

Ty Ellsworth, DMD

Individual provider Dentist · NPI 1699124123

Ty Ellsworth, DMD is a Dentist in Show Low, Arizona. Licensed in Arizona. Registered with an NPI since 2016.

Licensed in
AZ
In the registry since
2016
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

2650 E Show Low Lake Rd Ste 1
Show Low, AZ 85901-7955
Phone: (928) 537-4300
Fax: (928) 532-6901
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D009461 (AZ)

Record details

NPI number1699124123
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 6, 2016
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026
Mailing addressPo Box 1231, Tucson, AZ 85702-1231

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