Reggie H. Broom, D.m.d., P.a.
Pediatric Dental Clinic
1635 E Pass Rd, Gulfport
Mississippi, 39507-3527
228-896-5197 228-896-5192
Maps & DirectionsReggie H. Broom, D.m.d., P.a. is a Pediatric Dental Clinic in Gulfport, Mississippi. It is located at 1635 E Pass Rd, Gulfport, MS and its contact number is 228-896-5197. The authorized person for Reggie H. Broom, D.m.d., P.a. is Dr. Reggie Harris Broom
who is Pediatric Dentist/owner of the clinic and their contact number is 228-896-5197. Other organizations associated with this clinic are Coastkids Pediatric Dentistry, Pllc, Reggie H. Broom, D.m.d., P.a., The primary license number for Reggie H. Broom, D.m.d., P.a. is 2005-83 (Pediatric Dentistry) in Mississippi.
Reggie H. Broom, D.m.d., P.a. Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Reggie H. Broom, D.m.d., P.a. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Reggie H. Broom, D.m.d., P.a. |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 1635 E Pass Rd, Gulfport,
Mississippi, 39507-3527 |
| Phone: | 228-896-5197 |
| Fax: | 228-896-5192 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Reggie Harris Broom |
| Position: | Pediatric Dentist/owner |
| Contact Number: | 228-896-5197 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Reggie H. Broom, D.m.d., P.a. clinic are as mentioned below.
| NPI Number: | 1215280672 |
| NPI Enumeration Date: | 23 Oct, 2012 |
| NPI Last Update On: | 23 Oct, 2012 |
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
| Name | Specialization | NPI Number |
| Coastkids Pediatric Dentistry, Pllc | Pediatric Dentistry | 1093262974 |
| Reggie H. Broom, D.m.d., P.a. | Pediatric Dentistry | 1215280672 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Reggie H. Broom, D.m.d., P.a. are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 2005-83 | Mississippi | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 09015230 | Medicaid | Mississippi | |
| 466176 | Other | Mississippi | United Concordia |
| 07734393 | Medicaid | Mississippi | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Reggie H. Broom, D.m.d., P.a.
1635 E Pass Rd,
Gulfport, Mississippi |
| Zip: | 39507-3527 |
| Phone Number: | 228-896-5197 |
| Fax Number: | 228-896-5192 |
Patients can reach Reggie H. Broom, D.m.d., P.a. at
1635 E Pass Rd, Gulfport, Mississippi or can
call to book an appointment on 228-896-5197.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.