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KOENTJORO & LE DENTISTRY PLC
NPI 1104494830
Dentist - General Practice in Council Bluffs, IA

Active since June 17, 2021
3617 DENMARK DR STE 100, COUNCIL BLUFFS, IA 51501(712) 326-3205 Get Directions Write a Review

NPPES record last updated: June 24, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 24, 2021, Jun 17, 2021 (2 updates tracked since 2021).

About Koentjoro & Le Dentistry Plc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOENTJORO & LE DENTISTRY PLC (NPI 1104494830) is a healthcare organization registered as a general practice in Council Bluffs, Iowa and active in the NPI registry since June 2021. The organization lists Aldo Koentjoro, Owner, as its authorized official.

NPPES Registry Identity

NPI1104494830
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKOENTJORO & LE DENTISTRY PLC
Location Address3617 DENMARK DR STE 100Council Bluffs, IA 51501-7756
Mailing AddressPo Box 3189Syracuse, NY 13220-3189
Phone(712) 326-3205
Organization SubpartNo
Authorized OfficialAldo KoentjoroOwner · (712) 326-3205
Enumeration DateJune 17, 2021
Last NPPES UpdateJune 24, 20212 updates tracked since enumeration
NPPES CertifiedJune 24, 2021
✔ NPI 1104494830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3617 DENMARK DR STE 100, Council Bluffs, IA 51501
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TANNER JAMES TEMPLIN DDS
Dentist (General Practice)
3617 DENMARK DR STE 100
COUNCIL BLUFFS, IA 51501
Pottawattamie County (712) 326-3205
MUSKAAN TANEJA
Dentist
3617 DENMARK DR STE 100
COUNCIL BLUFFS, IA 51501
Pottawattamie County (712) 326-3205

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koentjoro & Le Dentistry Plc's NPI number?

The NPI number for Koentjoro & Le Dentistry Plc is 1104494830. It was assigned to this organization in the NPPES registry on June 17, 2021.

Where is Koentjoro & Le Dentistry Plc located?

Koentjoro & Le Dentistry Plc is located at 3617 Denmark Dr Ste 100, Council Bluffs, IA 51501. The listed phone number is (712) 326-3205.

What is Koentjoro & Le Dentistry Plc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Koentjoro & Le Dentistry Plc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan list Koentjoro & Le Dentistry Plc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Koentjoro & Le Dentistry Plc was last updated on June 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.