DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC

Doing business as

Mt State Oral & Facial Surgery

Practice address

2301 Lexington Ave Ste 120
Ashland, KY 41101-2807

Phone

(304) 399-1092

NPI assigned

Dec 31, 2018

Last updated

May 29, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lesley Marie Coyner

Title

Credentialing

Phone

(304) 345-1092

Specialties & licenses 1

Addresses

Other names 1

• Mt State Oral & Facial Surgery Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

DRS Black Allen Krajekian3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc

  dba Mt State Oral & Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Charleston, WV
  • NPI 1073211637
  NPD tax ID
• DRS Brock, Henderson, Di Prisco, Ravelo and Green Inc

  dba Mt State Oral & Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Vinton, VA
  • NPI 1720734684
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Wayne Ledford Jr., DDS

  • Dentist
  • Ashland, KY
  • NPI 1639518574
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1003388117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 STATION PLACE WAY",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255268747",
            "telephone_number": "304-720-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE STE 120",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012807",
            "telephone_number": "304-399-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-31",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "COYNER",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "304-345-1092"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt State Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mt State Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn Christopher Doyle
• Dr. Melissa Davis, P.S.C.
• Daniel Drengacs
• Joseph M Dressel, CRNA
• William Dressel
• Drug Free Workplace Solutions LLC
• Brenda Rena Dudding
• Ashlee Nikole Dudley, SLP
• Amanda Hope Dunbar
• Jessica D Duncan, APRN

• Oral and Maxillofacial Surgery (Dentist) in Ashland, KY
• Providers in Ashland, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.