Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Jason Champagne Idaho 4, PLLC

Organization General Practice Dentistry · NPI 1508614033

Jason Champagne Idaho 4, PLLC provides General Practice Dentistry in Boise, Idaho. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

345 W Bobwhite Ct
Boise, ID 83706-3982
Phone: (208) 345-1383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1508614033
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Champagne — Owner · (775) 359-3934
Other names Blue Heron Dental
NPI enumeratedMay 9, 2024
Last updated in NPPESMay 9, 2024
Certification dateMay 9, 2024
Mailing addressPo Box 2070, Sparks, NV 89432-2070

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