# JASON CHAMPAGNE II PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538835871
- **Authorized official:** DR. JASON CHAMPAGNE DDS (OWNER)
- **Authorized official phone:** (775) 636-9939

## Contact information

- **Practice address:** 601 W MOANA LN STE 6, RENO, NV 89509-4959
- **Practice address phone:** (775) 636-9939
- **Mailing address:** 601 W MOANA LN STE 6, RENO, NV 89509-4959
- **Mailing address phone:** (775) 583-7755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223X2210X | Orofacial Pain Dentistry | — | NULL | — |
| 1223X2210X | Orofacial Pain Dentistry | — | — | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 10/15/2021