CROCKER FAMILY DENTAL
NPI 1962802710
Clinic/Center - Dental in Vicksburg, MS

Q: What is Jordan P. Crocker, D.M.D., PLLC's NPI number?

The NPI number for Jordan P. Crocker, D.M.D., PLLC is 1962802710. It was assigned to this organization in the NPPES registry on August 29, 2014. The provider is doing business as Crocker Family Dental.

Q: What is Jordan P. Crocker, D.M.D., PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since August 29, 2014

109 MONUMENT PLACE, VICKSBURG, MS 39180(601) 638-3661(601) 631-0401 Get Directions Write a Review

NPPES record last updated: January 9, 2019. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Crocker Family Dental NPPES

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

CROCKER FAMILY DENTAL (NPI 1962802710) is a healthcare organization registered as a dental in Vicksburg, Mississippi and active in the NPI registry since August 2014. The organization lists Jordan P Crocker, Owner, as its authorized official.

NPPES Registry Identity

NPI1962802710

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameJORDAN P. CROCKER, D.M.D., PLLC

Location Address109 MONUMENT PLACEVicksburg, MS 39180

Mailing Address109 Monument PlaceVicksburg, MS 39180 · (601) 638-3661 · Fax (601) 631-0401

Phone(601) 638-3661

Fax(601) 631-0401

Organization SubpartNo

Authorized OfficialJordan P CrockerOwner · (601) 638-3661

Enumeration DateAugust 29, 2014

Last NPPES UpdateJanuary 9, 2019

✔ NPI 1962802710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

License✔ Licensed in MS · 3672-12

109 MONUMENT PLACE, Vicksburg, MS 39180

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Other Names 1

Doing Business AsCrocker Family Dental

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 Jordan P. Crocker, D.M.D., PLLC's NPI number?

The NPI number for Jordan P. Crocker, D.M.D., PLLC is 1962802710. It was assigned to this organization in the NPPES registry on August 29, 2014. The provider is doing business as Crocker Family Dental.

Where is Jordan P. Crocker, D.M.D., PLLC located?

Jordan P. Crocker, D.M.D., PLLC is located at 109 Monument Place, Vicksburg, MS 39180. The listed phone number is (601) 638-3661.

What is Jordan P. Crocker, D.M.D., PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Jordan P. Crocker, D.M.D., PLLC was last updated on January 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.