KOENTJORO & LE DENTISTRY PLC NPI 1104494830

NPI Information

  • NPI: 1104494830
  • Provider Name: KOENTJORO & LE DENTISTRY PLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 3617 DENMARK DR STE 100
    COUNCIL BLUFFS, IA
    ZIP 51501
  • Phone: (712) 326-3205

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NPI Details

KOENTJORO & LE DENTISTRY PLC is a general practice dentist in Council Bluffs, IA. The provider is 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. KOENTJORO & LE DENTISTRY PLC NPI is 1104494830. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3617 DENMARK DR STE 100
COUNCIL BLUFFS, IA
ZIP 51501-756
Phone: (712) 326-3205

The provider's authorized official is Aldo Koentjoro .
The authorized official title is Owner and has the following contact phone number (712) 326-3205.

The enumeration date for this NPI number is 6/17/2021 and was last updated on 6/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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