Provider Demographics
NPI:1881980258
Name:MOONEY, BRIGID BUCK (DDS)
Entity type:Individual
Prefix:
First Name:BRIGID
Middle Name:BUCK
Last Name:MOONEY
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 1:1301 N HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5017
Mailing Address - Country:US
Mailing Address - Phone:703-522-8894
Mailing Address - Fax:
Practice Address - Street 1:1301 N HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5017
Practice Address - Country:US
Practice Address - Phone:703-522-8894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014131931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice