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

Reggie H. Broom, DMD, PA

Organization Pediatric Dentistry · NPI 1215280672

Reggie H. Broom, DMD, PA is a Pediatric Dentistry in Gulfport, Mississippi. Licensed in Mississippi. Registered with an NPI since 2012.

Licensed in
MS
In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1635 E Pass Rd
Gulfport, MS 39507-3527
Phone: (228) 896-5197
Fax: (228) 896-5192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 2005-83 (MS)

Record details

NPI number1215280672
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Reggie Broom — Pediatric Dentist/Owner · (228) 896-5197
NPI enumeratedOctober 23, 2012
Last updated in NPPESOctober 23, 2012
Mailing address1635 E Pass Rd, Gulfport, MS 39507-3527

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