Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Jordan P. Crocker, D.M.D., Pllc

Dental Clinic/Center in Vicksburg, MS · enumerated 2014 · authorized official Jordan Crocker, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1962802710

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Registry record

Entity type Organization (Type 2)

Legal business name Jordan P. Crocker, D.M.D., Pllc

Other name <Unavail>

Practice address 109 Monument Place, Vicksburg, MS, 39180

Phone (601) 638-3661

Fax (601) 631-0401

Enumeration date Aug 29, 2014

Last updated in NPPES Jan 9, 2019

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities · License 3672-12 (MS) Primary

Authorized official

Name Jordan Crocker

Title Owner

Phone (601) 638-3661

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

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

The practice location on file with NPPES is in Vicksburg, MS.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2019-01-09. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-01-09.