DR. DEWAYNE LAVERNE BRISCOE DDS MD NPI 1003242769

NPI Information

  • NPI: 1003242769
  • Provider Name: DR. DEWAYNE LAVERNE BRISCOE, DDS MD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • Address: 404 FAIRWAY LOOP
    SUN VALLEY, ID
    ZIP 83353
  • Phone: (208) 720-9546

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NPI Details

DR. Dewayne Laverne Briscoe, DDS MD is an oral and maxillofacial surgery dentist in Sun Valley, ID. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Dewayne Laverne Briscoe, DDS MD NPI is 1003242769. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

404 FAIRWAY LOOP
SUN VALLEY, ID
ZIP 83353
Phone: (208) 720-9546

The enumeration date for this NPI number is 9/25/2013 and was last updated on 9/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryD-1661-OSIDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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