DR. BRANDON COLT CLYBURN D.D.S. NPI 1619104759

NPI Information

  • NPI: 1619104759
  • Provider Name: DR. BRANDON COLT CLYBURN, D.D.S.
  • Classification: Oral & Maxillofacial Surgery - 204E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1505 EMERALD PLZ
    COLLEGE STATION, TX
    ZIP 77845
  • Phone: (979) 764-7101

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NPI Details

DR. Brandon Colt Clyburn, D.D.S. is an oral maxillofacial surgery in College Station, TX with 17 years of experience. The provider is 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. DR. Brandon Colt Clyburn, D.D.S. NPI is 1619104759. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: THE DENTAL SCHOOL AT UNIVERSITY OF TEXAS HSC AT SAN ANTONIO
Graduation Year:2009

The provider's business location address is:

1505 EMERALD PLZ
COLLEGE STATION, TX
ZIP 77845-501
Phone: (979) 764-7101

The NPI 1619104759 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • X-ray of lower jaws, upper jaws and teeth (HCPCS:70355)

The enumeration date for this NPI number is 6/16/2009 and was last updated on 4/30/2019.

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
1204E00000XOral & Maxillofacial Surgery24644TEXASYes

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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