Individual provider Active NPI

Tyler Ross Ehrick, D.M.D.

  • General Practice Dentistry
  • Peoria, AZ
National Provider Identifier
1972953511
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009500 Issued in AZ
Practice address
8253 W Thunderbird Rd
Ste 101
Peoria, AZ 85381-4616
Phone
(623) 412-2439
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D009500 AZ Primary

Addresses

Primary practice location

8253 W Thunderbird Rd
Ste 101
Peoria, AZ 85381-4616

Mailing address

3807 W Phelps Rd
Phoenix, AZ 85053-2858
Phone (602) 697-2812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D009500AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
C and E Dental Professionals General Practice Current Accepting new patients
C and E Dental Professionals PLLC General Practice Current Accepting new patients

Locations

8253 W Thunderbird Rd
Ste 101
Peoria, AZ 85381
Phone (623) 412-2439

13821 N 35th Dr
Ste 2
Phoenix, AZ 85053
Phone (602) 547-9007

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1972953511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 W PHELPS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532858",
            "telephone_number": "602-697-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8253 W THUNDERBIRD RD",
            "address_2": "STE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814616",
            "telephone_number": "623-412-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRICK",
        "first_name": "TYLER",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.