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BRYAN D LEE DDS, MD
NPI 1790905495
Oral & Maxillofacial Surgery in Rexburg, ID

Active since April 26, 2007Opted out of Medicare · through Jul 1, 2028
360 E. MAIN ST., REXBURG, ID 83440(208) 356-5959(208) 356-5559 Get Directions Write a Review

NPPES record last updated: May 29, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bryan D Lee Dds, Md NPPES

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

BRYAN D LEE DDS, MD (NPI 1790905495) is an individual oral & maxillofacial surgery provider in Rexburg, Idaho, licensed in Idaho (M-11482) and active in the NPI registry since April 2007. He has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1790905495
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameBRYAN D LEECredential: DDS, MD
Location Address360 E. MAIN ST.Rexburg, ID 83440
Mailing Address360 E. Main St.Rexburg, ID 83440 · (208) 356-5959 · Fax (208) 356-5559
Phone(208) 356-5959
Fax(208) 356-5559
Sole ProprietorYes
Enumeration DateApril 26, 2007
Last NPPES UpdateMay 29, 2015
✔ NPI 1790905495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in ID · M-11482
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License D-3542 (ID)
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License D-3542-OS (ID)
360 E. MAIN ST., Rexburg, ID 83440
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Other Identifiers 1

Medicaid806068200ID

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Bryan D Lee Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Bryan Lee's NPI number?

The NPI number for Bryan Lee is 1790905495. It was assigned to this individual provider in the NPPES registry on April 26, 2007.

Where is Bryan Lee located?

Bryan Lee practices at 360 E. Main St., Rexburg, ID 83440. The listed phone number is (208) 356-5959.

What is Bryan Lee's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Bryan Lee enrolled in Medicare?

No. Bryan Lee has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Bryan Lee accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Bryan Lee 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 Bryan Lee was last updated on May 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.