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KOENTJORO DENTISTRY DODGE LLC
NPI 1659013456
Dentist - General Practice in Omaha, NE

Active since April 12, 2022
7059 DODGE ST STE 102, OMAHA, NE 68132(402) 346-6800 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 15, 2023, Apr 12, 2022 (2 updates tracked since 2022).

About Koentjoro Dentistry Dodge Llc NPPES

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

KOENTJORO DENTISTRY DODGE LLC (NPI 1659013456) is a healthcare organization registered as a general practice in Omaha, Nebraska and active in the NPI registry since April 2022. The organization lists Aldo Koentjoro, Owner, as its authorized official.

NPPES Registry Identity

NPI1659013456
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameKOENTJORO DENTISTRY DODGE LLC
Location Address7059 DODGE ST STE 102Omaha, NE 68132-2703
Mailing AddressPo Box 70887Cleveland, OH 44190-0887
Phone(402) 346-6800
Organization SubpartNo
Authorized OfficialAldo KoentjoroOwner · (402) 346-6800
Enumeration DateApril 12, 2022
Last NPPES UpdateJune 15, 20232 updates tracked since enumeration
NPPES CertifiedJune 15, 2023
✔ NPI 1659013456 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.
7059 DODGE ST STE 102, Omaha, NE 68132
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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 Sunflower Health Plan, Ambetter Health 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.

GABRIEL PHILIP CROCKER DDS
Dentist (General Practice)
7059 DODGE ST STE 102
OMAHA, NE 68132
Douglas County (402) 200-3220
DR. ANDREW BRUCH DDS
Dentist (General Practice)
7059 DODGE ST STE 102
OMAHA, NE 68132
Douglas County (402) 346-6800

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 Dentistry Dodge LLC's NPI number?

The NPI number for Koentjoro Dentistry Dodge LLC is 1659013456. It was assigned to this organization in the NPPES registry on April 12, 2022.

Where is Koentjoro Dentistry Dodge LLC located?

Koentjoro Dentistry Dodge LLC is located at 7059 Dodge St Ste 102, Omaha, NE 68132. The listed phone number is (402) 346-6800.

What is Koentjoro Dentistry Dodge LLC's specialty?

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

What insurance does Koentjoro Dentistry Dodge LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 1 other insurer list Koentjoro Dentistry Dodge LLC 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 Dentistry Dodge LLC was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.