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

Wayne Mortensen DMD PC

Organization Dental Clinic/Center · NPI 1134885684

Wayne Mortensen DMD PC is a Dental Clinic/Center in Boise, Idaho. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9213 W State St
Boise, ID 83714-1737
Phone: (208) 853-3300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1134885684
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wayne Mortensen — Dr/Owner · (208) 853-3300
Other names Smiles On State Street
NPI enumeratedNovember 9, 2021
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023
Mailing address9213 W State St, Boise, ID 83714-1737

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