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

NPI Status: Active since April 26, 2007

Contact Information

360 E. MAIN ST.
REXBURG, ID
ZIP 83440
Phone: (208) 356-5959
Fax: (208) 356-5559

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  • Individual
  • Male
  • Oral & Maxillofacial Surgery
  • Accepts Insurance

About BRYAN LEE

This page provides the complete NPI Profile along with additional information for Bryan Lee, a provider established in Rexburg, Idaho with a medical specialization in Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1790905495 assigned on April 2007. The practitioner's primary taxonomy code is 204E00000X with license number M-11482 (ID). The provider is registered as an individual and his NPI record was last updated 11 years ago.

NPI
1790905495
Provider Name
BRYAN D LEE DDS, MD
Gender
Male
Entity Type
Individual
Location Address
360 E. MAIN ST. REXBURG, ID 83440
Location Phone
(208) 356-5959
Location Fax
(208) 356-5559
Mailing Address
360 E. MAIN ST. REXBURG, ID 83440
Mailing Phone
(208) 356-5959
Mailing Fax
(208) 356-5559
Is Sole Proprietor?
Yes
Enumeration Date
04-26-2007
Last Update Date
05-29-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Oral & Maxillofacial Surgery

Taxonomy Code
204E00000X
Type
Allopathic & Osteopathic Physicians
License No.
M-11482
License State
ID
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223G0001XDental Providers

Dentist
General Practice

D-3542 (ID)
21223S0112XDental Providers

Dentist
Oral and Maxillofacial Surgery

D-3542-OS (ID)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
806068200MEDICAID (05)ID 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 15 times for 14 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 36 times for 36 patients

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1790905495, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
0
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 9 → 18 → 9 5 → 10 → 1 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 8 + 0 + 1 + 8 + 0 + 1 + 0 + 4 + 1 + 8 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1790905495.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790905495, enumerated as an "individual" on April 26, 2007.

The provider is located at 360 E. MAIN ST. REXBURG, ID 83440 and the phone number is (208) 356-5959.

Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.