Individual provider Active NPI

Alexis Rose Polczynski, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Antonio, TX
National Provider Identifier
1952903379
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
336964 Issued in TX
Practice address
23522 Wilderness Oak Ste 109
San Antonio, TX 78258-2409
Phone
(210) 774-4144
NPI assigned
Nov 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 336964 TX Primary

Addresses

Primary practice location

23522 Wilderness Oak Ste 109
San Antonio, TX 78258-2409

Mailing address

23522 Wilderness Oak Ste 109
San Antonio, TX 78258-2409

Other names 1

  • Alexis Rose Lintker Former name

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
336964TXMDLicensed Vocational Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Ortho, PLLC Orthodontics and Dentofacial Orthopedics CurrentSince May 11, 2025 Accepting new patients

Locations

23522 Wilderness Oak
Ste 109
San Antonio, TX 78258
Phone (210) 774-4144

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1952903379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23522 WILDERNESS OAK STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782582409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23522 WILDERNESS OAK STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782582409",
            "telephone_number": "210-774-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCZYNSKI",
        "first_name": "ALEXIS",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "336964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "LINTKER",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.