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

Dr. Jordan P Crocker, DMD

Individual provider General Practice Dentistry · NPI 1982952115

Dr. Jordan P Crocker, DMD is a General Practice Dentistry in Vicksburg, Mississippi. Licensed in Mississippi. Registered with an NPI since 2012.

Licensed in
MS
In the registry since
2012
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

109 Monument Pl
Vicksburg, MS 39180-5161
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

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3672-12 (MS)

Record details

NPI number1982952115
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedAugust 20, 2012
Last updated in NPPESDecember 7, 2018
Mailing address109 Monument Pl, Vicksburg, MS 39180-5161

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