Provider Demographics
NPI:1467294389
Name:HEGERLE, ALEXANDRA MUSS (DDS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MUSS
Last Name:HEGERLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2798 TIMBERLINE CT
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1129
Mailing Address - Country:US
Mailing Address - Phone:703-861-4964
Mailing Address - Fax:
Practice Address - Street 1:131 ELDEN ST STE 2C2
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4850
Practice Address - Country:US
Practice Address - Phone:703-689-2697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014189501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice