DRS KRAJEKIAN,BROCK & HENDERSON INC (NPI# 1053561779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053561779 |
| Entity Type | Organization |
| Organization Name | DRS KRAJEKIAN,BROCK & HENDERSON INC |
| Other Organization Name | MT STATE ORAL & MAXILLOFACIAL SURGEONS |
| Practice Address |
3135 16th Street Rd Suite 20 Huntington WV 25701 |
| Mailing Address |
103 Station Place Way Hurricane WV 25526-8747 |
| Practice Telephone | 3043991092 |
| Mailing Telephone | 3043451092 |
| Mailing Fax Number | 3043455080 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2018-06-15 |
| Authorized Official Name | LESLEY MARIE COYNER (CREDENTIALING) |
| Authorized Official Telephone | 3047207819 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
WV | Dental Providers |
| Other Name | Type Code |
|---|---|
| Mt State Oral & Maxillofacial Surgeons | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992766737 | Drs Krajekian,brock & Henderson Inc | Dentist | 100a Prestige Park Dr, Hurricane, WV 25526 | 2006-03-31 |
| 1801435003 | Drs Krajekian,brock & Henderson Inc | Dentist | 220 Locust St, Princeton, WV 24740-3626 | 2020-01-06 |
| 1447711858 | Drs Krajekian,brock & Henderson Inc | Dentist | 4307 Maccorkle Ave Se, Charleston, WV 25304-2500 | 2019-03-28 |
| 1003388117 | Drs Krajekian,brock & Henderson Inc | Dentist | 2301 Lexington Ave Ste 120, Ashland, KY 41101-2807 | 2018-12-31 |
| 1235546813 | Drs Krajekian,brock & Henderson Inc | Dentist | 150 Brookshire Ln, Beckley, WV 25801 | 2014-07-16 |
| Street Address |
3135 16TH STREET RD SUITE 20 |
| City | HUNTINGTON |
| State | WV |
| Zip Code | 25701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144685348 | Frances Elvins | Speech-Language Pathologist | 3135 16th Street Rd, Suite 21, Huntington, WV 25701-5247 | 2015-12-15 |
| 1780082776 | Kristy Tackett | Occupational Therapist | 3135 16th Street Rd, Suite 21, Huntington, WV 25701-5247 | 2014-12-08 |
| 1740686708 | Brittany Ann Scheer | Physical Therapist | 3135 16th Street Rd, Huntington, WV 25701-5247 | 2014-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607803 | Sara Tonya Hicks | Technician | 742 4th Avenue, Huntington, WV 25701 | 2020-10-21 |
| 1316550791 | Ethan Scott Miller | Counselor | 1538 Charleston Ave., Huntington, WV 25701 | 2020-08-26 |
| 1336752674 | Brock Riley Hapney | Student in an Organized Health Care Education/Training Program | 1538 Charelston Avenue, Huntington, WV 25701 | 2020-08-26 |
| 1558972224 | Ardith Ruth Bartram | Technician | 4045 C 8th Street Road, Huntington, WV 25701 | 2020-08-14 |
| 1144839614 | Randall Edward Short | Behavior Technician | 10th Sixth Avenue West, Huntington, WV 25701 | 2020-07-30 |
| 1609495191 | Melanie Jean Howard | Pharmacist | 1538 Charleston Avenue, Huntington, WV 25701 | 2020-04-14 |
| 1205472016 | Kelly Kauffer | Technician | 1012 Johns Court, Huntington, WV 25701 | 2019-11-27 |
| 1265082648 | Matt France | Technician | 3650 Taymor Rd, Huntington, WV 25701 | 2019-09-17 |
| 1538649348 | Kathryn Markus | Pharmacist | 1500 Medical Center Drive, Huntington, WV 25701 | 2018-08-21 |
| 1487155636 | Heather Marie Rogers | Nurse Practitioner | 940 4th Ave, Huntington, WV 25701 | 2018-02-23 |
| Find all providers in zip 25701 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497096655 | Garrick James Alex | Dentist | 26 Fairview St, Huntington, NY 11743-3414 | 2013-03-12 |
| 1013087790 | Peter H Pruden | Dentist | 177 Main St Ste 102, Huntington, NY 11743-6917 | 2006-11-09 |
| 1871603779 | Joseph M. Nelson | Dentist | 820 8th St, Huntington, WV 25701-2802 | 2006-08-30 |
| 1992739734 | R. Scott Murphy | Dentist | 2828 1st Ave Ste 104, Huntington, WV 25702-1244 | 2006-07-10 |
| 1720023757 | Thomas Arcati | Dentist | 790 New York Ave, Suite 100, Huntington, NY 11743-4499 | 2006-06-16 |
| 1952699126 | David Sobarzo Jr. | Dentist | 790 New York Ave, Huntington, NY 11743-4499 | 2011-07-21 |
| 1760780621 | Long Island Oral Surgery Associates PC | Dentist | 61 E Main St, Huntington, NY 11743-2812 | 2011-03-02 |
| 1538303243 | Gregory Charles Bohle | Dentist | 790 New York Ave, Suite 100, Huntington, NY 11743-4499 | 2009-04-24 |
| 1114160207 | Peter H Pruden, D.d.s., P.c | Dentist | 124 Main St, Suite 2, Huntington, NY 11743-6922 | 2009-04-20 |
| 1396980512 | Huntington Oral & Maxillofacial Surgery | Dentist | 215 E Main St, Huntington, NY 11743-7904 | 2008-12-03 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 25701 |
Please comment or provide details below to improve the information on DRS KRAJEKIAN,BROCK & HENDERSON INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.