DR. BRANDON S BEAUDOIN D.M.D.
NPI 1093079816
Dentist in Cambridge, MA

Q: What is Brandon Beaudoin's NPI number?

The NPI number for Brandon Beaudoin is 1093079816. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Q: What is Brandon Beaudoin's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Brandon Beaudoin enrolled in Medicare?

No. Brandon Beaudoin has opted out of Medicare through November 16, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Brandon Beaudoin was last updated on June 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 26, 2012Opted out of Medicare · through Nov 16, 2026

119 WINDSOR ST, CAMBRIDGE, MA 02139(617) 665-3990 Get Directions Write a Review

NPPES record last updated: June 26, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Brandon S Beaudoin D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRANDON S BEAUDOIN D.M.D. (NPI 1093079816) is an individual dentist in Cambridge, Massachusetts, licensed in Massachusetts (DL11582) and active in the NPI registry since June 2012. He has opted out of Medicare through November 16, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1093079816

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. BRANDON S BEAUDOINCredential: D.M.D.

Location Address119 WINDSOR STCambridge, MA 02139-3647

Mailing Address170 Brookline AveBoston, MA 02215-3937 · (978) 270-1848

Phone(617) 665-3990

Sole ProprietorNo

Enumeration DateJune 26, 2012

✔ NPI 1093079816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MA · DL11582

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

119 WINDSOR ST, Cambridge, MA 02139

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Northeast Delta Dental.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Brandon S Beaudoin D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 16, 2016 through November 16, 2026.

Opt-Out Effective DateNovember 16, 2016

Opt-Out In Effect ThroughNovember 16, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02139 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA SENEE

Licensed Practical Nurse