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

Jason Champagne Idaho 5, PLLC

Organization General Practice Dentistry · NPI 1114775640

Jason Champagne Idaho 5, 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.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5993 W State St Ste B
Boise, ID 83703-5058
Phone: (208) 939-1700
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1114775640
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Champagne — Owner · (775) 359-3934
Other names State Street Dental
NPI enumeratedMay 9, 2024
Last updated in NPPESMay 9, 2024
Certification dateMay 9, 2024
Mailing addressPo Box 2070, Sparks, NV 89432-2070

Other providers in Boise