OrganizationActive
Crockett Pediatric Dentistry, P.A.
NPI 1124245626 · Pediatric Dentistry · Greenville, SC
Crockett Pediatric Dentistry, P.A. is a Pediatric Dentistry organization in Greenville, SC (NPI 1124245626).
Provider details
- NPI number
- 1124245626
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jerry Crockett, Business Manager(864) 234-9800
- License
- SC3486 (SC)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
102 S Venture Dr
Greenville, SC 29615-3571
Phone: (864) 234-9800
Fax: (864) 234-9820
Street-level locationGet directions
Mailing address
102 S Venture Dr
Greenville, SC 29615-3571
Registry dates
- Enumerated
- 2007-04-19
- Last updated
- 2020-08-22
Frequently asked questions
- What is Crockett Pediatric Dentistry, P.A.'s NPI number?
- Crockett Pediatric Dentistry, P.A.'s National Provider Identifier (NPI) is 1124245626, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crockett Pediatric Dentistry, P.A.?
- Crockett Pediatric Dentistry, P.A. is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Crockett Pediatric Dentistry, P.A. located?
- Crockett Pediatric Dentistry, P.A.'s practice location on file with NPPES is 102 S Venture Dr, Greenville, SC 29615-3571.
- What is Crockett Pediatric Dentistry, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Crockett Pediatric Dentistry, P.A. is (864) 234-9800.
- Who is the authorized official for Crockett Pediatric Dentistry, P.A.?
- The authorized official listed on Crockett Pediatric Dentistry, P.A.'s NPPES record is Jerry Crockett, Business Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crockett Pediatric Dentistry, P.A.'s NPI active?
- Yes — Crockett Pediatric Dentistry, P.A.'s NPI (1124245626) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.