Robert Keith Broome Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9711 Issued in GA

Practice address

3875 Holcomb Bridge Rd
Suite 1
Norcross, GA 30092-5287

Phone

(770) 447-9808

Fax

(770) 447-6002

NPI assigned

Apr 25, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1093411910
  NPD (past)
• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1376929125
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1922366228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE ROAD",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 HOLCOMB BRIDGE RD",
            "address_2": "SUITE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300925287",
            "telephone_number": "770-447-9808",
            "fax_number": "770-447-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "ROBERT",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby J Britt, DC
• Diamond Brock
• Lenese Brock
• Darrin Samuel Bronfman, LCSW
• Dorothy Mae Brooks Thomas, LMT MMP
• Alexis Brown
• Kerene T Brown, LCSW
• Latasha Shaniel Brown, LPC
• Lavonia Rochelle Brown, RBT
• Leandra Roshell Brown

• General Practice Dentistry in Norcross, GA
• Providers in Norcross, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.