Reggie Harris Broom is a Gulfport, Mississippi based Pediatric Dentist who is specialized in
Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Reggie Harris Broom is
200583 for Pediatric Dentistry in Mississippi. His current practice location is
1635 E Pass Road, Gulfport. Patients can reach him at
228-896-5197.
Reggie Harris Broom 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 Profile:
Reggie Harris Broom speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Reggie Harris Broom |
| Specialization: | Pediatric Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 1635 E Pass Road, Gulfport,
Mississippi, 39507 |
| Phone: | 228-896-5197 |
| Fax: | 228-896-5192 |
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 are as mentioned below.
| NPI Number: | 1063588788 |
| NPI Enumeration Date: | 27 Nov, 2006 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Reggie Harris Broom are as mentioned below.
| License Number | Specialization | State | Status | |
| 200583 | Pediatric Dentistry | Mississippi | Primary | |
| 11986 | Pediatric Dentistry | Mississippi | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Reggie Harris Broom such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| H66176 | Other | Mississippi | UNITED CONCORDIA |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1635 E Pass Road,
Gulfport, Mississippi |
| Zip: | 39507 |
| Phone Number: | 228-896-5197 |
| Fax Number: | 228-896-5192 |
Patients can reach Reggie Harris Broom at
1635 E Pass Road, Gulfport, Mississippi or can
call to book an appointment on 228-896-5197.
Comments/ Reviews:
Read all the reviews posted for Reggie Harris Broom below. You may also share your own experience with Reggie Harris Broom. Your feedback can help others make better decisions.
**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.