P Praxis·MD
● Active Type 2 · Organization

Wayne Mortensen DMD Pc

Clinic/Center·Boise, ID· NPI 1134885684 · Enumerated 2021 · 4 years on NPI
Wayne Mortensen DMD Pc is 1 of 202 clinic/center organizations in Idaho.
NPI age
4 years
Enumerated 2021-11-09
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Mortensen
Dr/owner
Last NPPES update
2023-07-06
Source: monthly bulk 2026-05

How this organization compares

Across 202 active clinic/center providers in Idaho.

NPI age
4 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2021 → 2026

2021-11Enumerated in NPPES
2021 2026

Where they practice

Primary practice location
9213 W State St
Boise, ID 837141737
📞 2088533300
Mailing address
9213 W State St
Boise, ID 837141737
📞 2088533300fax 2082583282

Authorized official

Wayne Mortensen, DMD
Dr/owner
📞 2088533300

Individual providers at this organization

1 individual provider on file at this primary practice address.

Specialties

  • Clinic/Center Primary
    Definition to come...
    taxonomy 261QD0000X

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Smiles on State Street
    Type code 3 recorded 2023-07-06

Practice context

Multi-provider organization. 1 individual provider on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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