NPI age
2 years
Enumerated 2024-05-09
● Active Type 2 · Organization
Jason Champagne Idaho 5, Pllc
Jason Champagne Idaho 5, Pllc is 1 of 1099 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Champagne
Owner
Last NPPES update
2024-05-09
Source: monthly bulk 2026-05
How this organization compares
Across 1099 active dentist providers in Idaho.
NPI age
2 years
↓ 16 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-05Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
5993 W State St Ste B
Boise, ID 837035058
Mailing address
Po Box 2070
Sparks, NV 894322070
Authorized official
Jason Champagne, DDS
Owner
📞 7753593934
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Brock Bohlman, D.D.S Dentist NPI 1891878484
Specialties
-
Dentist PrimaryA 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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
State Street Dental
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.