JON KOELTL DDS, PC
NPI 1447048376
Clinic/Center - Dental in Boise, ID

Q: What is Jon Koeltl Dds, PC's NPI number?

The NPI number for Jon Koeltl Dds, PC is 1447048376. It was assigned to this organization in the NPPES registry on April 29, 2025. The provider is doing business as Centennial Dental.

Q: What is Jon Koeltl Dds, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since April 29, 2025

12349 W MCMILLAN RD, BOISE, ID 83713(208) 322-1112(208) 322-3928 Get Directions Write a Review

NPPES record last updated: April 29, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Jon Koeltl Dds, Pc NPPES

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

JON KOELTL DDS, PC (NPI 1447048376), doing business as Centennial Dental, is a healthcare organization registered as a dental in Boise, Idaho and active in the NPI registry since April 2025. The organization lists Jon Michael Koeltl, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1447048376

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameJON KOELTL DDS, PC

Location Address12349 W MCMILLAN RDBoise, ID 83713-5052

Mailing Address12349 W Mcmillan RdBoise, ID 83713-5052 · (208) 322-1112 · Fax (208) 322-3928

Phone(208) 322-1112

Fax(208) 322-3928

Organization SubpartNo

Authorized OfficialJon Michael KoeltlOwner/dentist · (208) 322-1112

Enumeration DateApril 29, 2025

NPPES CertifiedApril 29, 2025

✔ NPI 1447048376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

12349 W MCMILLAN RD, Boise, ID 83713

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Other Names 1

Doing Business AsCentennial Dental

Other Providers at the Same Location NPPES

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

DR. JON MICHAEL KOELTL D.D.S.

Dentist (General Practice)

12349 W MCMILLAN RD
BOISE, ID 83713

Ada County (208) 322-1112

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 Jon Koeltl Dds, PC's NPI number?

The NPI number for Jon Koeltl Dds, PC is 1447048376. It was assigned to this organization in the NPPES registry on April 29, 2025. The provider is doing business as Centennial Dental.

Where is Jon Koeltl Dds, PC located?

Jon Koeltl Dds, PC is located at 12349 W Mcmillan Rd, Boise, ID 83713. The listed phone number is (208) 322-1112.

What is Jon Koeltl Dds, PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Jon Koeltl Dds, PC was last updated on April 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.