Doctor profile · Federal record
Dr. Ty Ellsworth, DMD
Dentist · Show Low, AZ
- NPI 1699124123
- 10 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
2650 E Show Low Lake RD Ste 1
Show Low, AZ 859017955
(928) 537-4300
fax (928) 532-6901 - Mailing address
-
Po Box 3630
Flagstaff, AZ 860033630
Credentials & registration
- NPI registered
- June 2016 — 10 yrs on file
- Profile last updated
- June 28, 2021
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Arizona #D009461
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1699124123. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$16
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Solventum Corporation | 1 | $16.13 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
13
Patients
12
Total drug cost
$48
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 13 | 12 | $48 |
Frequently asked questions
What is Dr. Ty Ellsworth's medical specialty?
Dr. Ty Ellsworth practices Dentist in Show Low, AZ.
Where does Dr. Ty Ellsworth practice?
Dr. Ty Ellsworth practices at 2650 E Show Low Lake RD Ste 1, Show Low, AZ 859017955. Office phone: 9285374300.
What is Dr. Ty Ellsworth's NPI?
Dr. Ty Ellsworth's National Provider Identifier (NPI) is 1699124123, issued by NPPES.