Provider Demographics
NPI:1407237001
Name:MOALA, ALLISON HOOSE (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:HOOSE
Last Name:MOALA
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:BARRETT
Other - Last Name:HOOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6677 RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-6647
Mailing Address - Country:US
Mailing Address - Phone:703-299-1794
Mailing Address - Fax:
Practice Address - Street 1:6677 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-6647
Practice Address - Country:US
Practice Address - Phone:540-362-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401415417OtherSTATE DENTAL LICENSE