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JASON CHAMPAGNE IDAHO 5, PLLC
NPI 1114775640
Dentist - General Practice in Boise, ID

Active since May 09, 2024
5993 W STATE ST STE B, BOISE, ID 83703(208) 939-1700 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jason Champagne Idaho 5, Pllc NPPES

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

JASON CHAMPAGNE IDAHO 5, PLLC (NPI 1114775640), doing business as State Street Dental, is a healthcare organization registered as a general practice in Boise, Idaho and active in the NPI registry since May 2024. The organization lists Jason Champagne, Owner, as its authorized official.

NPPES Registry Identity

NPI1114775640
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameJASON CHAMPAGNE IDAHO 5, PLLC
Location Address5993 W STATE ST STE BBoise, ID 83703-5058
Mailing AddressPo Box 2070Sparks, NV 89432-2070
Phone(208) 939-1700
Organization SubpartNo
Authorized OfficialJason ChampagneOwner · (775) 359-3934
Enumeration DateMay 9, 2024
NPPES CertifiedMay 9, 2024
✔ NPI 1114775640 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.
5993 W STATE ST STE B, Boise, ID 83703
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Other Names 1

Doing Business AsState Street Dental

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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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. BROCK KEITH BOHLMAN D.D.S
Dentist (General Practice)
5993 W STATE ST STE B
BOISE, ID 83703
Ada County (208) 384-0577

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 Jason Champagne Idaho 5, PLLC's NPI number?

The NPI number for Jason Champagne Idaho 5, PLLC is 1114775640. It was assigned to this organization in the NPPES registry on May 9, 2024. The provider is doing business as State Street Dental.

Where is Jason Champagne Idaho 5, PLLC located?

Jason Champagne Idaho 5, PLLC is located at 5993 W State St Ste B, Boise, ID 83703. The listed phone number is (208) 939-1700.

What is Jason Champagne Idaho 5, PLLC's specialty?

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

What insurance does Jason Champagne Idaho 5, PLLC accept?

Health plans from UnitedHealthcare list Jason Champagne Idaho 5, PLLC 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 Jason Champagne Idaho 5, PLLC was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.