Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1336292952 Individual Practitioner Male Practitioner

Dr. Derrick Maurice Broadaway , DDS

Dentist - General Practice • Hampton, VA

Professional Overview & Biography Verified Profile Summary

Dr. Derrick Broadaway, DDS is a registered healthcare professional specializing in Dentist - General Practice in Hampton, VA. Practice services are available at 3709 KECOUGHTAN RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3709 Kecoughtan Rd

Hampton, VA 236694405

Telephone 7577228507
Fax 7576908765
Associated Practice Facility / Clinic
🏢 Hampton Roads Family Dental Facility NPI 1932735305

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Hampton, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.6 Yrs
Regional Practice Density
69 Specialists

Practicing in Hampton, VA (3535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-06-18
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License VA 0401007977

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
106546 (VI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Donald Robinson , DDS

Dentist - General Practice

NPI 1700987641

Doctor of Dental Surgery

NPI 1851495204

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 18, 2020

Dentist (License #0401007977 in VA)

📍
Updated Practice Location May 25, 2020

Registered at 3709 KECOUGHTAN RD, HAMPTON, VA 236694405 (Tel: 7577228507)

📍
Updated Business Mailing Address May 25, 2020

Registered at 3709 KECOUGHTAN RD, HAMPTON, VA 236694405 (Tel: 5772285077)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2020

Dentist (License #401007977 in VA)

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 3809 PRINCESS ANNE RD, SUITE 111, VIRGINIA BEACH, VA 234561900 (Tel: 7574716672)

📍
Updated Business Mailing Address July 09, 2007

Registered at 3809 PRINCESS ANNE RD, SUITE 111, VIRGINIA BEACH, VA 234561900 (Tel: 7574716672)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as DERRICK BROADAWAY, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dentist

🟢
Initial NPI Registration & Enumeration January 18, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Derrick Broadaway. Be the first to share your experience!

Sign in to leave a review for Dr. Derrick Broadaway

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1336292952
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 18, 2007
Last Update: November 27, 2023
Sole Proprietor: No

Mailing Address

3709 Kecoughtan Rd

Hampton, VA 236694405

Phone: 7577228507

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.