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DR. DERRICK MAURICE BROADAWAY DDS
NPI 1336292952
Dentist - General Practice in Hampton, VA

Active since January 18, 2007
3709 KECOUGHTAN RD, HAMPTON, VA 23669(757) 722-8507(757) 690-8765 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 18, 2020, Jun 11, 2020, May 25, 2020 (3 updates tracked since 2020).

About Dr. Derrick Maurice Broadaway Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DERRICK MAURICE BROADAWAY DDS (NPI 1336292952) is an individual general practice provider in Hampton, Virginia, licensed in Virginia (0401007977) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1336292952
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. DERRICK MAURICE BROADAWAYCredential: DDS
Location Address3709 KECOUGHTAN RDHampton, VA 23669-4405
Mailing Address3709 Kecoughtan RdHampton, VA 23669-4405 · (757) 722-8507 · Fax (757) 690-8765
Phone(757) 722-8507
Fax(757) 690-8765
Sole ProprietorNo
Enumeration DateJanuary 18, 2007
Last NPPES UpdateNovember 27, 20233 updates tracked since enumeration
NPPES CertifiedJune 18, 2020
✔ NPI 1336292952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in VA · 0401007977
Definition
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.
3709 KECOUGHTAN RD, Hampton, VA 23669
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Other Identifiers 1

Medicaid106546VI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CECEIL CHRISTINE GALLOP DDS
Dentist
3709 KECOUGHTAN RD
HAMPTON, VA 23669
Hampton City (757) 722-8507
HAMPTON ROADS FAMILY DENTAL
Dentist (General Practice)
3709 KECOUGHTAN RD
HAMPTON, VA 23669
Hampton City (757) 722-8507

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Broadaway's NPI number?

The NPI number for Derrick Broadaway is 1336292952. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Derrick Broadaway located?

Derrick Broadaway practices at 3709 Kecoughtan Rd, Hampton, VA 23669. The listed phone number is (757) 722-8507.

What is Derrick Broadaway's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Derrick Broadaway accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Derrick Broadaway as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derrick Broadaway was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.