Individual provider Active NPI

Nancyq Carol Motyka, DMD

  • General Practice Dentistry
  • Lackland Afb, TX
National Provider Identifier
1376522086
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14179 Issued in NJ
Practice address
2200 Bergquist Dr
Ste 1
Lackland Afb, TX 78236-9907
Phone
(210) 292-6707
NPI assigned
Jan 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14179 NJ Primary

Addresses

Primary practice location

2200 Bergquist Dr
Ste 1
Lackland Afb, TX 78236-9907

Mailing address

2200 Bergquist Dr Ste 1
Jbsa
Lackland Afb, TX 78236-9908
Phone (210) 292-6707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14179NJMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1376522086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR STE 1",
            "address_2": "JBSA",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTYKA",
        "first_name": "NANCYQ",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland Afb, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.