Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Broadmoor Family Dentistry

Organization Dentist · NPI 1528359536

Broadmoor Family Dentistry is a Dentist in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2011.

Licensed in
LA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

230 Carroll St #4
Shreveport, LA 71105-4248
Phone: (318) 865-3311
Fax: (318) 865-3339
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 5424 (LA)
Dentist Taxonomy 122300000X · Licence 5859 (LA)

Record details

NPI number1528359536
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Cooper — Dentist · (318) 865-3311
NPI enumeratedApril 25, 2011
Last updated in NPPESApril 25, 2011
Mailing address230 Carroll St, 4, Shreveport, LA 71105-4248

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