Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1982952115 Individual Practitioner Male Practitioner

Dr. Jordan P Crocker , DMD

Dentist - General Practice • Vicksburg, MS

Professional Overview & Biography Verified Profile Summary

Dr. Jordan Crocker, DMD is a registered healthcare professional specializing in Dentist - General Practice in Vicksburg, MS. Practice services are available at 109 MONUMENT PL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

109 Monument Pl

Vicksburg, MS 391805161

Telephone 6016383661
Fax 6016310401
Associated Practice Facility / Clinic
🏢 Robert A. Sadler Dds, Pa Facility NPI 1255473559

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vicksburg, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
16 Specialists

Practicing in Vicksburg, MS (895 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MS 3672-12

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Robert Sadler , DDS

Dentist - General Practice

NPI 1366582413

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location December 07, 2018

Registered at 109 MONUMENT PL, VICKSBURG, MS 391805161 (Tel: 6016383661)

📍
Updated Business Mailing Address December 07, 2018

Registered at 109 MONUMENT PL, VICKSBURG, MS 391805161 (Tel: 6016383661)

👤
Provider Name / Credentials Updated December 07, 2018

Recorded as JORDAN CROCKER, DMD

NPI Profile Active August 27, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location August 27, 2013

Registered at 1016 MISSION 66, VICKSBURG, MS 391832752 (Tel: 6016383661)

📍
Updated Business Mailing Address August 27, 2013

Registered at 1016 MISSION 66, VICKSBURG, MS 391832752 (Tel: 6016383661)

👤
Provider Name / Credentials Updated August 27, 2013

Recorded as JORDAN CROCKER, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2013

Dentist (License #3672-12 in MS)

🟢
Initial NPI Registration & Enumeration August 20, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982952115
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 20, 2012
Last Update: December 07, 2018
Sole Proprietor: No

Mailing Address

109 Monument Pl

Vicksburg, MS 391805161

Phone: 6016383661

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.