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 & Maxillofacial Surgeons

Practice address

3135 16TH Street Rd
Suite 20
Huntington, WV 25701

Phone

(304) 399-1092

NPI assigned

Sep 30, 2008

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) 720-7819

Specialties & licenses 1

Addresses

Other names 1

• Mt State Oral & Maxillofacial Surgeons 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

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1053561779",
    "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": "304-345-1092",
            "fax_number": "304-345-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 16TH STREET RD",
            "address_2": "SUITE 20",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-399-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS BROCK, HENDERSON, DI PRISCO, RAVELO AND GREEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "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": "304-720-7819"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt State Oral & Maxillofacial Surgeons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mt State Oral & Maxillofacial Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Werner Dransfeld, MD
• Richard D Drennen, CRNA
• Anthony Eugene Driscoll
• Henry K Driscoll, MD
• Dawn Diane Drown
• DRS Samples and Adlington PLLC
• DRS. David M. Eller & Reginald S. Opimo, DDS Inc
• DRS. Martin Kirk & Holmes (Huntington Pediatric Dentistry & Orthodontics)
• Julie Denise Drummond
• Kobe Duckwyler

• Oral and Maxillofacial Surgery (Dentist) in Huntington, WV
• Providers in Huntington, WV by specialty
• Oral and Maxillofacial Surgery (Dentist) in West Virginia

• 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.