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

Dr. Jordan Broadwater, DDS

Individual provider Dentist · NPI 1164317020

Dr. Jordan Broadwater, DDS is a Dentist in Kingsport, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2025
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2701 Bloomingdale Rd
Kingsport, TN 37660-1854
Phone: (423) 288-8566
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 12846 (TN)

Record details

NPI number1164317020
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 11, 2025
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025
Mailing address1024 Forrest Ridge Dr, Kingsport, TN 37660-6628

Other providers in Kingsport