Individual provider Active NPI

Anthony James Caruso Jr., D.D.S.

  • Dentist
  • Stow, OH
National Provider Identifier
1922046879
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-02-0590 Issued in OH
Practice address
4466 Darrow Rd
Suite 16
Stow, OH 44224-1866
Phone
(330) 688-3115
Fax
(330) 688-3304
NPI assigned
Jun 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-02-0590 OH Primary

Addresses

Primary practice location

4466 Darrow Rd
Suite 16
Stow, OH 44224-1866

Mailing address

3234 Hoagland Blackstub Rd
Cortland, OH 44410-9171
Phone (330) 637-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20150414000528 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537487046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1922046879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3234 HOAGLAND BLACKSTUB RD",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444109171",
            "telephone_number": "330-637-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4466 DARROW RD",
            "address_2": "SUITE 16",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241866",
            "telephone_number": "330-688-3115",
            "fax_number": "330-688-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "ANTHONY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-02-0590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

Verify at the official NPI Registry.