Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Randal Todd Wilson, DMD

Individual provider Dentist · NPI 1063846459

Randal Todd Wilson, DMD is a Dentist in Burley, Idaho. Licensed in Idaho. Registered with an NPI since 2013.

Licensed in
ID
In the registry since
2013
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

1309 Bennett Ave
Burley, ID 83318-2676
Phone: (208) 677-5198
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D-4526 (ID)

Record details

NPI number1063846459
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedAugust 21, 2013
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021

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