Jason Len Champagne, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4050 Issued in NV

Practice address

925 Roberta LN
Sparks, NV 89431-1894

Phone

(775) 359-3934

Fax

(775) 359-8905

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 6, 2017 through Jun 6, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Champagne Family Dentistry, LLC

  • General Practice Dentistry
  • Sparks, NV
  • NPI 1952706012
  NPD Authorized official
• Jason Champagne II PLLC

  • Dentist
  • Reno, NV
  • NPI 1538835871
  NPD Authorized official
• Jason Champagne IX PLLC

  • Pediatric Dentistry
  • Reno, NV
  • NPI 1841021045
  NPD Authorized official
• Eric C Dean DDS LTD

  • Dentist
  • Sparks, NV
  • NPI 1881863116
  NPD (past)
• Heinen Family Dentistry

  • Dentist
  • Sparks, NV
  • NPI 1780065219
  NPD (past)
• Jason Champagne V, LLC

  • Pediatric Dentistry
  • Sparks, NV
  • NPI 1215332374
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1801979984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 ROBERTA LN",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894311894",
            "telephone_number": "775-359-3934",
            "fax_number": "775-359-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 ROBERTA LN",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894311894",
            "telephone_number": "775-359-3934",
            "fax_number": "775-359-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "JASON",
        "middle_name": "LEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Challacomb, PHARMD
• Alexander Chambers
• Champagne Family Dentistry, LLC
• Andrew Ryan Champagne, DMD
• Cariann Elaine Champagne, D.D.S.
• Larry L Champagne, DMD
• Fanny W Chan, O.D.
• Joseph Yaomin Chan, D.D.S.
• Zoey Chandler
• Alma A Chanes

• General Practice Dentistry in Sparks, NV
• Providers in Sparks, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.