NPIMap

Individual provider Active NPI

Kathleen Judith Beache, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1154546489
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009653A Issued in IN
Practice address
7225 US 31 S Ste G
Indianapolis, IN 46227-8599
Phone
(317) 496-6652
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009653A IN Primary

Addresses

Primary practice location

7225 US 31 S Ste G
Indianapolis, IN 46227-8599

Mailing address

6510 Fall Creek Rd
Indianapolis, IN 46220-5087
Phone (317) 259-9426

Other practice location 1

4604 E 10th St
Indianapolis, IN 46201-2824
Phone (317) 353-8505

Other practice location 2

8060 N Shadeland Ave Ste B
Indianapolis, IN 46250-2690
Phone (317) 288-5023

Other practice location 3

508 Indiana Ave
Indianapolis, IN 46202-3106
Phone (317) 269-0402

Other identifiers 2

IdentifierTypeStateIssuer
200097410MedicaidIN
12009653AOtherININDIANA PROFESSIONAL LICENSING AGENCY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12009653AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Dentists LLC General Practice Past Accepting new patients
Emergency Dentist,LLC General Practice Past Accepting new patients
Midwest Periodontal and Oral Reconstruction, P.C. General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1154546489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 FALL CREEK RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462205087",
            "telephone_number": "317-259-9426",
            "fax_number": "317-259-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 US 31 S STE G",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278599",
            "telephone_number": "317-496-6652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4604 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462012824",
            "country_code": "US",
            "telephone_number": "317-353-8505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8060 N Shadeland Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502690",
            "country_code": "US",
            "telephone_number": "317-288-5023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "508 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462023106",
            "country_code": "US",
            "telephone_number": "317-269-0402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEACHE",
        "first_name": "KATHLEEN",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009653A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200097410",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA PROFESSIONAL LICENSING AGENCY",
            "identifier": "12009653A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.