Randal Wilson, DMD
NPI 1063846459 · Dentist · Burley, ID
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Randal Wilson, DMD is a Dentist provider in Burley, ID (NPI 1063846459).
Provider details
- NPI number
- 1063846459
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- D-4526 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-08-21
- Last updated
- 2021-03-17
- Certified
- 2021-03-17
Frequently asked questions
- What is Randal Wilson's NPI number?
- Randal Wilson's National Provider Identifier (NPI) is 1063846459, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Randal Wilson's specialty?
- Randal Wilson is listed in the NPPES registry with a primary specialty of Dentist (Dental Providers).
- Where is Randal Wilson located?
- Randal Wilson's practice location on file with NPPES is 1309 Bennett Ave, Burley, ID 83318-2676.
- What is Randal Wilson's phone number?
- The practice phone number listed in the NPPES registry for Randal Wilson is (208) 677-5198.
- Does Randal Wilson accept Medicare?
- Randal Wilson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Randal Wilson's NPI active?
- Yes — Randal Wilson's NPI (1063846459) is active in the NPPES registry as of the last update on 2021-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.