DR. LEONARD AARON KOLTUN D.D.S.
NPI 1619969276
Dentist - Periodontics in Mesa, AZ

Q: What is Leonard Koltun's NPI number?

The NPI number for Leonard Koltun is 1619969276. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Q: What is Leonard Koltun's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Leonard Koltun was last updated on July 6, 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.

Active since August 19, 2005PECOS Enrolled

1425 S GREENFIELD RD STE 110, MESA, AZ 85206(480) 854-3434 Get Directions Write a Review

NPPES record last updated: July 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Leonard Aaron Koltun D.d.s. NPPES

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

DR. LEONARD AARON KOLTUN D.D.S. (NPI 1619969276) is an individual periodontics provider in Mesa, Arizona, licensed in Arizona (D010172) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619969276

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. LEONARD AARON KOLTUNCredential: D.D.S.

Location Address1425 S GREENFIELD RD STE 110Mesa, AZ 85206-5505

Mailing Address761 E Snowy Farm DrQueen Creek, AZ 85140-7211 · (760) 613-7991

Phone(480) 854-3434

Sole ProprietorNo

Enumeration DateAugust 19, 2005

Last NPPES UpdateJuly 6, 2021

NPPES CertifiedJuly 6, 2021

✔ NPI 1619969276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Licenses✔ Licensed in AZ · D010172✔ Licensed in CA · 52806

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

1425 S GREENFIELD RD STE 110, Mesa, AZ 85206

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Leonard Aaron Koltun D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Leonard Koltun reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gila River Health Care Corporation

13 mi

Critical Access

3042 W. QUEEN CREEK ROAD
Chandler, AZ 85286

Reassigned Medicare billing, Texas enrollment
482 clinicians in this Medicare group

NPI 1437664182 (602) 528-1200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85206 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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. JOHN ROBERT JOHNSTON D.D.S.

Dentist

1425 S GREENFIELD RD STE 110
MESA, AZ 85206

Maricopa County (480) 900-5545

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 Leonard Koltun's NPI number?

The NPI number for Leonard Koltun is 1619969276. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Where is Leonard Koltun located?

Leonard Koltun practices at 1425 S Greenfield Rd Ste 110, Mesa, AZ 85206. The listed phone number is (480) 854-3434.

What is Leonard Koltun's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Leonard Koltun enrolled in Medicare?

Yes. Leonard Koltun is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Leonard Koltun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leonard Koltun reassigns Medicare benefits to Gila River Health Care Corporation (Chandler, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Leonard Koltun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Leonard Koltun accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Leonard Koltun 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 Leonard Koltun was last updated on July 6, 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.