Ty Erickson, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

07867 Issued in IA

Practice address

4855 Mills Civic Pkwy Ste 201
West Des Moines, IA 50265-5268

Phone

(515) 577-4488

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1275669830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PKWY STE 201",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655268",
            "telephone_number": "515-577-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 MILLS CIVIC PKWY STE 201",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655268",
            "telephone_number": "515-577-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "TY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "07867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amerlon L Enriquez, M.D.
• ENT Clinic of Iowa, PC
• Ep True Chiropractic Inc.
• Robin Lynn Epp, M.D., M.P.H.
• Shannon Erickson, RPH
• Thomas A Ericson, M.D.
• Erin Sawhill, LLC
• Zoey Suzanne Erixon, LMSW
• Connie Sue Ertl, D.C.
• Ervin Chiropractic, P.C.

• Endodontics in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Endodontics in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.