Individual provider · Type 1 NPI

Ty Ellsworth, DMD

Dentist · Show Low, AZ

NPI number 1699124123 Active

Practice location

2650 E Show Low Lake Rd Ste 1
Show Low, AZ 85901-7955

Call (928) 537-4300 Map

Fax (928) 532-6901

Mailing address

PO Box 1231
Tucson, AZ 85702-1231

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	D009461 (AZ)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

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About NPI 1699124123

Ty Ellsworth, DMD's National Provider Identifier is 1699124123, issued on Jun 6, 2016. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Show Low, AZ. The record was last updated on Apr 21, 2026.