OrganizationActive
Jon Koeltl DDS, PC
NPI 1447048376 · Dental Clinic/Center · Boise, ID
Jon Koeltl DDS, PC is a Dental Clinic/Center organization in Boise, ID (NPI 1447048376).
Provider details
- NPI number
- 1447048376
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jon Koeltl, Owner/Dentist(208) 322-1112
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12349 W Mcmillan Rd
Boise, ID 83713-5052
Phone: (208) 322-1112
Fax: (208) 322-3928
Street-level locationGet directions
Mailing address
12349 W Mcmillan Rd
Boise, ID 83713-5052
Other names (DBA / former)
- Doing business as
- Centennial Dental
Registry dates
- Enumerated
- 2025-04-29
- Last updated
- 2025-04-29
- Certified
- 2025-04-29
Frequently asked questions
- What is Jon Koeltl DDS, PC's NPI number?
- Jon Koeltl DDS, PC's National Provider Identifier (NPI) is 1447048376, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jon Koeltl DDS, PC?
- Jon Koeltl DDS, PC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Jon Koeltl DDS, PC located?
- Jon Koeltl DDS, PC's practice location on file with NPPES is 12349 W Mcmillan Rd, Boise, ID 83713-5052.
- What is Jon Koeltl DDS, PC's phone number?
- The practice phone number listed in the NPPES registry for Jon Koeltl DDS, PC is (208) 322-1112.
- Who is the authorized official for Jon Koeltl DDS, PC?
- The authorized official listed on Jon Koeltl DDS, PC's NPPES record is Jon Koeltl, Owner/Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jon Koeltl DDS, PC's NPI active?
- Yes — Jon Koeltl DDS, PC's NPI (1447048376) is active in the NPPES registry as of the last update on 2025-04-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.