DRS. KRAJEKIAN,BROCK & HENDERSON INC (NPI# 1346201183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346201183 |
| Entity Type | Organization |
| Organization Name | DRS. KRAJEKIAN,BROCK & HENDERSON INC |
| Other Organization Name | MT STATE ORAL & MAXILLOFACIAL SURGEONS |
| Practice Address |
1215 Virginia St E Charleston WV 25301 |
| Mailing Address |
200 Prestige Park Hurricane WV 25526 |
| Practice Telephone | 3043451092 |
| Practice Fax Number | 3043455080 |
| Mailing Telephone | 3043451092 |
| Mailing Fax Number | 3043455080 |
| Enumeration Date | 2006-03-31 |
| 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 |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | MT. STATE BCBS | 000817140 | 01 |
| WV | 4500012000 | 05 |
| Other Name | Type Code |
|---|---|
| Mt State Oral & Maxillofacial Surgeons | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194364398 | Drs. Krajekian,brock & Henderson Inc | Dentist | 433 Carriage Dr, Beckley, WV 25801-2805 | 2020-01-06 |
| 1356772677 | Drs. Krajekian,brock & Henderson Inc | Dentist | 417 Grand Park Dr, Suite 103, Parkersburg, WV 26105 | 2013-12-12 |
| Street Address |
1215 VIRGINIA ST E |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790768562 | Jack Issac Krajekian | Dentist | 1215 Virginia St E, Charleston, WV 25301-2908 | 2005-11-25 |
| 1457693020 | Jose Gregorio Ravelo | Dentist | 1215 Virginia St E, Charleston, WV 25301-2908 | 2013-03-21 |
| 1871807875 | Italo Alejandro Di Prisco | Dentist | 1215 Virginia St E, Charleston, WV 25301-2908 | 2010-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| 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 |
|---|---|---|---|---|
| 1356963508 | Clements Ferry Dentistry LLC | Dentist | 1951 Clements Ferry Rd Ste 201, Charleston, SC 29492-8325 | 2020-05-11 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1205290764 | Sloan Rehder | Dentist | 2051 Sam Rittenberg Blvd, Charleston, SC 29407-4683 | 2016-04-11 |
| 1679954705 | Coafs Lab | Dentist | 125 Wappoo Creek Dr Ste C1, Charleston, SC 29412-2161 | 2015-06-15 |
| 1952798357 | Now Or Never 2011, LLC | Dentist | 2270 Ashley Crossing Dr Ste 175, Charleston, SC 29414-5863 | 2015-04-23 |
| 1124296470 | M. Stephen Brandon, Dds LLC | Dentist | 1051 Gardner Rd Ste B, Charleston, SC 29407-5747 | 2008-02-20 |
| 1043409063 | Charleston Oral and Facial Surgery, Inc. | Dentist | 125 Wappoo Creek Dr, Suite 1, Charleston, SC 29412-2163 | 2007-10-16 |
| 1659442309 | Edward Elias Howard | Dentist | 1321 Virginia St E, Charleston, WV 25301 | 2006-11-13 |
| 1376614024 | Richard Lee Howard | Dentist | 1321 Virginia St East, Charleston, WV 25301 | 2006-11-13 |
| 1568543619 | Francis Simons Hane Jr. | Dentist | 96 Jonathan Lucas, Charleston, SC 29425 | 2006-10-17 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25301 |
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.