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DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
NPI 1346201183
Dentist - Oral and Maxillofacial Surgery in Charleston, WV

Active since March 31, 2006
1215 VIRGINIA ST E, CHARLESTON, WV 25301(304) 345-1092(304) 345-5080 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 29, 2025, Dec 3, 2020, Jun 15, 2018 and 1 more (4 updates tracked since 2016).

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 1346201183), doing business as Mt State Oral & Maxillofacial Surgeons, is a healthcare organization registered as an oral and maxillofacial surgery in Charleston, West Virginia and active in the NPI registry since March 2006. The organization lists Lesley Marie Coyner, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1346201183
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameDRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC
Location Address1215 VIRGINIA ST ECharleston, WV 25301
Mailing Address103 Station Place WayHurricane, WV 25526-8747 · (304) 720-7819 · Fax (304) 345-5080
Phone(304) 345-1092
Fax(304) 345-5080
Organization SubpartNo
Authorized OfficialLesley Marie CoynerCredentialing · (304) 720-7819
Enumeration DateMarch 31, 2006
Last NPPES UpdateMay 29, 20254 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1346201183 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.
1215 VIRGINIA ST E, Charleston, WV 25301
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Other Names 1

Doing Business AsMt State Oral & Maxillofacial Surgeons

Other Identifiers 2

Medicaid4500012000WV
Other000817140WV · Mt. State Bcbs

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.Insurance ›

Other Providers at the Same Location NPPES

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

DR. JACK ISSAC KRAJEKIAN D.M.D.
Dentist (Oral and Maxillofacial Surgery)
1215 VIRGINIA ST E
CHARLESTON, WV 25301
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 1346201183. It was assigned to this organization in the NPPES registry on March 31, 2006. The provider is doing business as Mt State Oral & Maxillofacial Surgeons.

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

Drs Brock, Henderson, Di Prisco, Ravelo And Green Inc is located at 1215 Virginia St E, Charleston, WV 25301. 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 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.