NPI age
1 years
Enumerated 2025-04-29
● Active Type 2 · Organization
Jon Koeltl Dds, Pc
Jon Koeltl Dds, Pc is 1 of 202 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Koeltl
Owner/dentist
Last NPPES update
2025-04-29
Source: monthly bulk 2026-05
How this organization compares
Across 202 active clinic/center providers in Idaho.
NPI age
1 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2025 → 2026
2025-04Enumerated in NPPES
2025
2026
Where they practice
Primary practice location
12349 W McMillan Rd
Boise, ID 837135052
Mailing address
12349 W McMillan Rd
Boise, ID 837135052
Authorized official
Jon Michael Koeltl, DDS
Owner/dentist
📞 2083221112
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Jon Koeltl, D.D.S. Dentist NPI 1477672533
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Centennial Dental
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.