Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

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

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1720734684

Drs Brock, Henderson, Di Prisco, Ravelo and Green Inc is an Oral and Maxillofacial Surgery (Dentist) in Vinton, Virginia. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

895 E Washington Ave
Vinton, VA 24179-2105
Phone: (304) 425-8220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1720734684
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDrs Krajekian, Brock, Henderson & Diprisco Inc
Authorized official Lesley Coyner — Credentialing · (304) 720-7819
Other names Mt State Oral & Facial Surgery; Mt State Oral & Facial Surgery
NPI enumeratedMarch 1, 2022
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025
Mailing address103 Station Place Way, Hurricane, WV 25526-8747

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