DR. MARY WHITAKER CROCKETT D.M.D.
NPI 1194805143
Dentist - Pediatric Dentistry in Greenville, SC

Active since October 16, 2006
102 S VENTURE DR, GREENVILLE, SC 29615(864) 234-9800(864) 234-9820 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mary Whitaker Crockett D.m.d. NPPES

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

DR. MARY WHITAKER CROCKETT D.M.D. (NPI 1194805143) is an individual pediatric dentistry provider in Greenville, South Carolina, licensed in South Carolina (SC3486) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1194805143
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameDR. MARY WHITAKER CROCKETTCredential: D.M.D.
Location Address102 S VENTURE DRGreenville, SC 29615-3571
Mailing Address102 S Venture DrGreenville, SC 29615-3571 · (864) 234-9800 · Fax (864) 234-9820
Fax(864) 234-9820
Sole ProprietorYes
Enumeration DateOctober 16, 2006
Last NPPES UpdateJuly 9, 2007
NPI 1194805143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License Licensed in SC · SC3486
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

102 S VENTURE DR, Greenville, SC 29615

Other Identifiers 2

Medicare UPINZX3486SC
MedicaidZA9507SC

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.

Dentist (Pediatric Dentistry)
102 S VENTURE DR
GREENVILLE, SC 29615
Dentist (Pediatric Dentistry)
102 S VENTURE DR
GREENVILLE, SC 29615

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 Mary Crockett's NPI number?

The NPI number for Mary Crockett is 1194805143. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Where is Mary Crockett located?

Mary Crockett practices at 102 S Venture Dr, Greenville, SC 29615. The listed phone number is (864) 234-9800.

What is Mary Crockett's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Mary Crockett was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.