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DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
NPI 1073211637
Dentist - Oral and Maxillofacial Surgery in Charleston, WV

Active since February 22, 2023
869 OAKWOOD RD, CHARLESTON, WV 25314(304) 345-1092 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 29, 2025, Feb 22, 2023 (2 updates tracked since 2023).

About Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC (NPI 1073211637), doing business as Mt State Oral & Facial Surgery, is a healthcare organization registered as an oral and maxillofacial surgery in Charleston, West Virginia and active in the NPI registry since February 2023. The organization lists Lesley Marie Coyner, Accts Receivable Manager, as its authorized official.

NPPES Registry Identity

NPI1073211637
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameDRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
Location Address869 OAKWOOD RDCharleston, WV 25314-2057
Mailing Address103 Station Place WayHurricane, WV 25526-8747 · (304) 720-7819
Phone(304) 345-1092
Organization SubpartNo
Authorized OfficialLesley Marie CoynerAccts Receivable Manager · (304) 720-7819
Enumeration DateFebruary 22, 2023
Last NPPES UpdateMay 29, 20252 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1073211637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
869 OAKWOOD RD, Charleston, WV 25314
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Other Names 1

Doing Business AsMt State Oral & Facial Surgery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia, UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GORDON SCOTT WEAVER DDS
Dentist (Oral and Maxillofacial Surgery)
869 OAKWOOD RD
CHARLESTON, WV 25314
Kanawha County (304) 343-5161
SOKOLOSKY AND WEAVER DDS INC
Dentist (Oral and Maxillofacial Surgery)
869 OAKWOOD RD
CHARLESTON, WV 25314
Kanawha County (304) 343-5161
DR. JOSE GREGORIO RAVELO DDS
Dentist (Oral and Maxillofacial Surgery)
869 OAKWOOD RD
CHARLESTON, WV 25314
Kanawha County (304) 345-1092

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc's NPI number?

The NPI number for Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is 1073211637. It was assigned to this organization in the NPPES registry on February 22, 2023. The provider is doing business as Mt State Oral & Facial Surgery.

Where is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc located?

Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is located at 869 Oakwood Rd, Charleston, WV 25314. The listed phone number is (304) 345-1092.

What is Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia and UnitedHealthcare list Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.