Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GLEN ALLEN EISENHUTH, DDS
ActiveDR. GLEN ALLEN EISENHUTH, DDS is a Endodontics healthcare provider located in FORT DEFIANCE, Arizona. NPI 1962580472 is currently active in the NPPES registry. Verify at CMS.
Endodontics · FORT DEFIANCE, AZ
Registration Details
- NPI Number
- 1962580472
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 1, 2006 (19.7775716466 yrs)
- Last Updated
- Dec 19, 2025
- Licenses
-
D10716 (MN)DD2828 (NM)D008343 (AZ)
Practice Information
- Address
-
CORNER OF ROUTE N12 AND N7FORT DEFIANCE, AZ, 86504Browse AZ providers · Browse ZIP 86504
- Phone
- 9287298885
- Primary Specialty
-
Endodontics
1223E0200X
- Additional Specialty
- Endodontics
- Additional Specialty
- Endodontics
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.