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

Reggie Harris Broom, DMD

Individual provider Pediatric Dentistry · NPI 1063588788

Reggie Harris Broom, DMD is a Pediatric Dentistry in Gulfport, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1635 E Pass Rd
Gulfport, MS 39507
Phone: (228) 896-5197
Fax: (228) 896-5192
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 200583 (MS)
Pediatric Dentistry Taxonomy 1223P0221X · Licence 11986 (MS)

Record details

NPI number1063588788
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedNovember 27, 2006
Last updated in NPPESJuly 8, 2007

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