DR. JORDAN P CROCKER DMD
NPI 1982952115
Dentist - General Practice in Vicksburg, MS

Q: What is Jordan Crocker's NPI number?

The NPI number for Jordan Crocker is 1982952115. It was assigned to this individual provider in the NPPES registry on August 20, 2012.

Q: What is Jordan Crocker's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jordan Crocker was last updated on December 7, 2018. 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.

Active since August 20, 2012

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

NPPES record last updated: December 7, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jordan P Crocker Dmd NPPES

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

DR. JORDAN P CROCKER DMD (NPI 1982952115) is an individual general practice provider in Vicksburg, Mississippi, licensed in Mississippi (3672-12) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1982952115

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JORDAN P CROCKERCredential: DMD

Location Address109 MONUMENT PLVicksburg, MS 39180-5161

Mailing Address109 Monument PlVicksburg, MS 39180-5161 · (601) 638-3661 · Fax (601) 631-0401

Phone(601) 638-3661

Fax(601) 631-0401

Sole ProprietorNo

Enumeration DateAugust 20, 2012

Last NPPES UpdateDecember 7, 2018

✔ NPI 1982952115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MS · 3672-12

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.

109 MONUMENT PL, Vicksburg, MS 39180

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Accepted Insurance

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

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 Crocker's NPI number?

The NPI number for Jordan Crocker is 1982952115. It was assigned to this individual provider in the NPPES registry on August 20, 2012.

Where is Jordan Crocker located?

Jordan Crocker practices at 109 Monument Pl, Vicksburg, MS 39180. The listed phone number is (601) 638-3661.

What is Jordan Crocker's specialty?

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

What insurance does Jordan Crocker accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Guardian and 4 other insurers list Jordan Crocker 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 Jordan Crocker was last updated on December 7, 2018. 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.