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REGGIE H. BROOM, D.M.D., P.A.

REGGIE H. BROOM, D.M.D., P.A.

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Company Details

Name:	REGGIE H. BROOM, D.M.D., P.A.
Jurisdiction:	MISSISSIPPI
Business Type:	Profit Corporation
Status:	Dissolved
Effective Date:	01 Jan 1999 (27 years ago)
Business ID:	664148
ZIP code:	39507
County:	Harrison
State of Incorporation:	MISSISSIPPI
Principal Office Address:	1635 E PASS RDGULFPORT, MS 39507

Agent

Name	Role	Address
R BARRY VICKERY	Agent	771 BELHAVEN STREET, JACKSON, MS 39202-2411

Incorporator

Name	Role	Address
Reggie H Broom	Incorporator	1635 E Pass Rd, Gulfport, MS 39507

Director

Name	Role	Address
Reggie H Broom	Director	1635 E Pass Rd, Gulfport, MS 39507
Kathie E Broom	Director	1635 East Pass Rd, Gulfport, MS 39507

President

Name	Role	Address
Reggie H Broom	President	1635 E Pass Rd, Gulfport, MS 39507

Vice President

Name	Role	Address
Kathie E Broom	Vice President	1635 East Pass Rd, Gulfport, MS 39507

National Provider Identifier

NPI Number:

1215280672

Link:

View on NPI website

Authorized Person:

Name:

DR. REGGIE HARRIS BROOM

Role:

PEDIATRIC DENTIST/OWNER

Phone:

2288965197

Taxonomy:

Selected Taxonomy:

1223P0221X - Pediatric Dentist

Is Primary:

Yes

Contacts:

Phone:

+1 228-896-5197

Fax:

2288965192

Form 5500 Series

Employer Identification Number (EIN):

640902743

Plan Year:

2022

Number Of Participants:

12

Sponsors Telephone Number:

2288965197

File:

Plan Year:

2021

Number Of Participants:

13

Sponsors Telephone Number:

2288965197

File:

Plan Year:

2020

Number Of Participants:

15

Sponsors Telephone Number:

2282173042

File:

Plan Year:

2019

Number Of Participants:

13

Sponsors Telephone Number:

2282173042

File:

Plan Year:

2018

Number Of Participants:

11

Sponsors Telephone Number:

2282173042

File:

Filings

Type	Status	Filed Date	Description
Dissolution	Filed	2023-12-14	Dissolution For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2023-01-03	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2022-01-26	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2021-03-19	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2020-02-12	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2019-02-23	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2018-03-18	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2017-02-03	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2016-02-05	Annual Report For REGGIE H. BROOM, D.M.D., P.A.
Annual Report	Filed	2015-06-05	Annual Report For REGGIE H. BROOM, D.M.D., P.A.

Paycheck Protection Program

Jobs Reported:

2

Initial Approval Amount:

$23,292.5

Date Approved:

2021-01-20

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$23,292.5

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$23,427.73

Servicing Lender:

Hancock Whitney Bank

Use of Proceeds:

Payroll: $23,289.5
Utilities: $1

Jobs Reported:

2

Initial Approval Amount:

$23,292

Date Approved:

2020-05-01

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$23,292

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$23,419.46

Servicing Lender:

Hancock Whitney Bank

Use of Proceeds:

Payroll: $23,292

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Date of last update: 22 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website