Sam Reiser Caruso, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN123254 Issued in GA

Practice address

2230 Towne Lake Pkwy
BLDG 1000, Ste 110
Woodstock, GA 30189

Phone

(770) 672-5629

NPI assigned

Apr 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 5, 2024 through Nov 5, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1922627256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GOLF CREST DR STE 209",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012698",
            "telephone_number": "770-672-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BLDG 1000, STE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "770-672-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUSO",
        "first_name": "SAM",
        "middle_name": "REISER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN123254",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "DRP2199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Carr, PT, DPT, ATC
• Lindsey Carr
• Clayton O Carroll, PT, DPT, SCS
• Jacob Carson, CSFA
• Leroy Carswell I, CADC T
• Jennifer Nicole Case, DO
• Steven Castellanos, PHARMD
• Deidra Lynn Castillo, COTA/L
• Stephanie Castillo
• Alexis Catlett, MD

• Oral and Maxillofacial Surgery (Dentist) in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.