Clayton Ray Wills, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

33067 Issued in TX

Practice address

20821 US Highway 281 N Ste 310
San Antonio, TX 78258-7597

Phone

(210) 494-4488

NPI assigned

Nov 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Clayton Ray Wills Other name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stone Oak Modern Dentistry, PC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1952602484
  NPD (past)

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1609389493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8406 DUDLEY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304521",
            "telephone_number": "210-920-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20821 US HIGHWAY 281 N STE 310",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587597",
            "telephone_number": "210-494-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "CLAYTON",
        "middle_name": "RAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "33067",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAYTON",
            "last_name": "WILLS",
            "middle_name": "RAY",
            "prefix": "DR.",
            "credential": "CLAY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Donald Eugene Willmann, D.D.S.
• Holly S Willmann, PA-C
• Christi Willome, NP
• Samantha Kathleen Willoughby, NP
• Shirley Ann Willrich, SOCIAL WORKER, LCDC
• Crystal D Wills, LCSW
• Thomas Joseph Willson, M.D.
• Laura Jean Wilner, MD
• Megan Wilsher, OTA
• Michelle Elaine Wilson-Lutz, LPN/LVN

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.