DRS KRAJEKIAN,BROCK & HENDERSON INC (NPI# 1447711858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447711858 |
| Entity Type | Organization |
| Organization Name | DRS KRAJEKIAN,BROCK & HENDERSON INC |
| Practice Address |
4307 Maccorkle Ave Se Charleston WV 25304-2500 |
| Mailing Address |
103 Station Place Way Hurricane WV 25526-8747 |
| Practice Telephone | 3043451092 |
| Mailing Telephone | 3047207819 |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | LESLEY MARIE COYNER (CREDENTIALING) |
| Authorized Official Telephone | 3043451092 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Mt State Oral & Facial Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053561779 | Drs Krajekian,brock & Henderson Inc | Dentist | 3135 16th Street Rd, Suite 20, Huntington, WV 25701 | 2008-09-30 |
| 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 |
| 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 |
4307 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023402476 | Cari Stover | Nurse Practitioner | 4307 Maccorkle Ave Se, Charleston, WV 25304-2500 | 2015-03-24 |
| 1124636576 | Stacie Bowen | Nurse Practitioner | 4307 Maccorkle Ave Se, Charleston, WV 25304-2500 | 2020-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| 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 | 25304 |
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.