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RANDAL TODD WILSON DMD
NPI 1063846459
Dentist in Burley, ID

Active since August 21, 2013PECOS Enrolled
1309 BENNETT AVE, BURLEY, ID 83318(208) 677-5198 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Randal Todd Wilson Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDAL TODD WILSON DMD (NPI 1063846459) is an individual dentist in Burley, Idaho, licensed in Idaho (D-4526) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063846459
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameRANDAL TODD WILSONCredential: DMD
Location Address1309 BENNETT AVEBurley, ID 83318-2676
Mailing Address794 Eastland DrTwin Falls, ID 83301-6856 · (208) 734-3312
Phone(208) 677-5198
Sole ProprietorNo
Enumeration DateAugust 21, 2013
Last NPPES UpdateMarch 17, 2021
NPPES CertifiedMarch 17, 2021
✔ NPI 1063846459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in ID · D-4526
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1309 BENNETT AVE, Burley, ID 83318
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Other Names 1

Other Name (5)Todd Wilson Dmd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randal Todd Wilson Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83318 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAMILY HEALTH SERVICES CORPORATION
Clinic/Center (Federally Qualified Health Center (FQHC))
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-7796
DR. ALEXANDER ANTAR TORRES II DNP, ARNP, FNP-C
Nurse Practitioner (Family)
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-7796
MRS. KARRIE RAE KONDEL ARNP
Nurse Practitioner (Family)
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-7796
DAVID MILLER DO
Family Medicine
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-7796
MRS. RANDALYN BARROW LCSW
Social Worker (Clinical)
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 725-3145
JORDAN K. ROBINS LCSW
Social Worker (Clinical)
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-0101
MR. MATHEW G BOWDEN CSW
Social Worker (Clinical)
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 678-0101
LOGAN KAY DMD
Dentist
1309 BENNETT AVE
BURLEY, ID 83318
Cassia County (208) 732-7447

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randal Wilson's NPI number?

The NPI number for Randal Wilson is 1063846459. It was assigned to this individual provider in the NPPES registry on August 21, 2013. The provider is also known as Todd Wilson Dmd.

Where is Randal Wilson located?

Randal Wilson practices at 1309 Bennett Ave, Burley, ID 83318. The listed phone number is (208) 677-5198.

What is Randal Wilson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Randal Wilson enrolled in Medicare?

Yes. Randal Wilson is registered in the Medicare PECOS enrollment system.

What insurance does Randal Wilson accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 7 other insurers list Randal Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Randal Wilson was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.