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

Broadmoor Family Dentistry

Organization Dentist · NPI 1528359536

Broadmoor Family Dentistry provides Dentist services in Shreveport, Louisiana. Licensed in Louisiana. Registered with an NPI since 2011.

Licensed in
LA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

230 Carroll St #4
Shreveport, LA 71105-4248 Not confirmed with CMS for 15 years — call before visiting
Phone: (318) 865-3311
Fax: (318) 865-3339
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 5424 (LA)
Dentist Taxonomy 122300000X · Licence 5859 (LA)

Record details

NPI number1528359536
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Cooper — Dentist · (318) 865-3311
NPI enumeratedApril 25, 2011
Last updated in NPPESApril 25, 2011
Mailing address230 Carroll St, 4, Shreveport, LA 71105-4248

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