Bradley Thomas Beauchene, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14189 Issued in MN

Practice address

4754 Washington SQ
White Bear Lake, MN 55110-3257

Phone

(651) 426-9499

Fax

(651) 429-6255

NPI assigned

May 14, 2019

Last updated

Jun 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Chanhassen Smiles Dentistry, PC

  dba Chanhassen Smiles Dentistry

  • General Practice Dentistry
  • Chanhassen, MN
  • NPI 1760852487
  NPD (past)

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1679139737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-426-9499",
            "fax_number": "651-429-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4754 WASHINGTON SQ",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103257",
            "telephone_number": "651-426-9499",
            "fax_number": "651-429-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHENE",
        "first_name": "BRADLEY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Elizabeth Bauer, M.D.
• Griffin Baumann
• Megan D Baumler, RDN, PHD
• Bear Town Chiropractic Clinic, P.a.
• Barbara Beasy, RPH
• Melissa Rose Beaudry
• Jane E Beer, LADC
• Diane Annette Beers, LMFT
• Beneficial Alcove Massage and Wellness Clinic
• Fernando Benitez

• Dentist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.