What is Reggie Broom's NPI number?

Reggie Broom's National Provider Identifier (NPI) is 1063588788, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Reggie Broom's specialty?

Reggie Broom is listed in the NPPES registry with a primary specialty of Pediatric Dentistry (Dental Providers).

Where is Reggie Broom located?

Reggie Broom's practice location on file with NPPES is 1635 E Pass Road, Gulfport, MS 39507.

What is Reggie Broom's phone number?

The practice phone number listed in the NPPES registry for Reggie Broom is (228) 896-5197.

Is Reggie Broom's NPI active?

Yes — Reggie Broom's NPI (1063588788) is active in the NPPES registry as of the last update on 2007-07-08.

IndividualActive

Reggie Broom, DMD

NPI 1063588788 · Pediatric Dentistry · Gulfport, MS

Reggie Broom, DMD is a Pediatric Dentistry provider in Gulfport, MS (NPI 1063588788).

Provider details

NPI number: 1063588788
Entity type: Individual
Primary specialty: Pediatric DentistryDental Providers
Credential: DMD
Sex: Male
Sole proprietor: No
License: 200583 (MS)

Specialties & taxonomies

Pediatric DentistryPrimary1223P0221XLicense 200583 (MS)
Dental Providers
Pediatric Dentistry1223P0221XLicense 11986 (MS)
Dental Providers

Profile Score

Detailed profile(90/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
19 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

1635 E Pass Road

Gulfport, MS 39507

Phone: (228) 896-5197

Fax: (228) 896-5192

Street-level locationGet directions

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Mailing address