Glenda Eidenshink, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039719 Issued in PA

Practice address

853 2ND Street Pike Ste B104
Richboro, PA 18954-1083

Phone

(215) 322-7800

NPI assigned

Oct 18, 2013

Last updated

Apr 9, 2015By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1003244542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 2ND STREET PIKE STE B104",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541083",
            "telephone_number": "215-322-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 2ND STREET PIKE STE B104",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541083",
            "telephone_number": "215-322-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDENSHINK",
        "first_name": "GLENDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Dubas
• Izabella Dyakovetsky, M.D.
• Yevgeniy Dyakovetsky
• Rosanne Lee Edenhart-Pepe, PH.D.
• Matthew Edwards, DPT
• Elizabeth Soucar, PH.D., LLC
• Barbara M Ennis
• Eternity Home Care Inc
• Eye Associates of Richboro PC
• Alan J Finzimer

• General Practice Dentistry in Richboro, PA
• Providers in Richboro, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.