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DRS. KRAJEKIANBROCKHENDERSON & DIPRISCO INC NPI 1356772677


NPI Information

NPI: 1356772677
Provider Name: DRS. KRAJEKIAN,BROCK,HENDERSON & DIPRISCO INC

Doing Business As: MT STATE ORAL & MAXILLOFACIAL SURGE

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 51D2088632

Address:
417 GRAND PARK DR
SUITE 103
PARKERSBURG, WV
ZIP 26105
Phone: (304) 699-5010
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DRS. KRAJEKIAN,BROCK,HENDERSON & DIPRISCO INC is an oral and maxillofacial surgery dentist in Parkersburg, WV. The provider is an oral and maxillofacial surgery dentist specialized in 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. DRS. KRAJEKIAN,BROCK,HENDERSON & DIPRISCO INC NPI is 1356772677. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mt State Oral & Maxillofacial Surge.

The provider's business location address is:

417 GRAND PARK DR
SUITE 103
PARKERSBURG, WV
ZIP 26105
Phone: (304) 699-5010
Fax: (304) 553-7268

The provider's authorized official is Lesley Marie Coyner .
The authorized official title is Credentialing and has the following contact phone number (304) 720-7819.

The CLIA number assigned to this NPI record is 51D2088632 - other - oral & maxillofacial surg with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2013 and was last updated on 12/3/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryWEST VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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