Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jason Champagne Idaho 4, PLLC

Organization General Practice Dentistry · NPI 1508614033

Jason Champagne Idaho 4, PLLC is a 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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