Kelton Ericson DMD MD PLLC
NPI 1790532901ActiveOrganization· Dentist, Oral and Maxillofacial Surgery· Phoenix, AZ
Dentist, Oral and Maxillofacial Surgery in Phoenix, Arizona, registered in NPPES in May 2024. The authorized official on file is Kelton Ericson, DMD MD, Owner/Doctor.
Overview
| NPI | 1790532901 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 4, 2024 |
| Last updated in NPPES | May 13, 2024 |
| Certified by provider | May 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Oral and Maxillofacial Surgery Primary | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dentist, Oral and Maxillofacial Surgery providers in Phoenix
- 1275565871
- 1144002502
- 1144900994
- 1588590194
- 1124392790
- 1588960512
- 1215363320
- 1154596187
- 1861993040
- 1679352009
- 1407986672
- 1710133004
All Dentist, Oral and Maxillofacial Surgery providers in Arizona →