Individual provider Active NPI

William Blake Cluck, DDS

  • Dentist
  • Tyler, TX
National Provider Identifier
1689467383
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41430 Issued in TX
Practice address
7223 Crosswater
Tyler, TX 75703-0719
Phone
(903) 561-0533
NPI assigned
May 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41430 TX Primary

Addresses

Primary practice location

7223 Crosswater
Tyler, TX 75703-0719

Mailing address

2109 Commerce St Ste 200
Dallas, TX 75201-4350
Phone (972) 248-1221

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
41430TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oneal Family Dentistry PLLC CurrentSince Jun 3, 2025 Accepting new patients

Locations

2109 Commerce St
Ste 200
Dallas, TX 75201

7223 Crosswater
Tyler, TX 75703
Phone (903) 561-0533

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": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1689467383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 COMMERCE ST STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014350",
            "telephone_number": "972-248-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 CROSSWATER",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030719",
            "telephone_number": "903-561-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUCK",
        "first_name": "WILLIAM",
        "middle_name": "BLAKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.