Healthcare Provider Details

I. General information

NPI: 1740104652
Provider Name (Legal Business Name): ALEXANDRA M. HEGERLE, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 ELDEN ST STE 2C2
HERNDON VA
20170-4850
US

IV. Provider business mailing address

2798 TIMBERLINE CT
OAKTON VA
22124-1129
US

V. Phone/Fax

Practice location:
  • Phone: 703-689-2697
  • Fax: 703-787-8271
Mailing address:
  • Phone: 703-861-4964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA HEGERLE
Title or Position: OWNER
Credential: DDS
Phone: 703-861-4964