Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan P. Crocker, DMD, PLLC

Organization Dental Clinic/Center · NPI 1962802710

Jordan P. Crocker, DMD, PLLC is a Dental Clinic/Center in Vicksburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2014.

Licensed in
MS
In the registry since
2014
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

109 Monument Pl
Vicksburg, MS 39180
Phone: (601) 638-3661
Fax: (601) 631-0401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 3672-12 (MS)

Record details

NPI number1962802710
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jordan Crocker — Owner · (601) 638-3661
Other names Crocker Family Dental
NPI enumeratedAugust 29, 2014
Last updated in NPPESJanuary 9, 2019
Mailing address109 Monument Place, Vicksburg, MS 39180

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