Siva Sai Kumar Gandham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6002016-15 Issued in WI

Practice address

843 W Broadway Ave
Medford, WI 54451-1307

Phone

(715) 785-8100

NPI assigned

Aug 21, 2024

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

Medicare fee-for-service enrollment

Enrolled in NC

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.

• Lane & Associates Xiii DDS PA

  • General Practice Dentistry
  • Greensboro, NC
  • NPI 1710031612
  NPD (past)

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1841023249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 N SAINT JOSEPH AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511307",
            "telephone_number": "715-785-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHAM",
        "first_name": "SIVA SAI KUMAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-21",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6002016-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrie C Flandermeyer, DO
• Linda Ruth Frahm, PT
• Alexandra Janota Gaines, AGACNP-BC
• Stuart Gall, MS, CRNA
• Odessa M Gallett, RDCD
• Gelhaus Dental Clinic S.C.
• Benjamin Ryan Gelhaus, DDS
• Frederick Charles Gelhaus, DDS
• Rebecca Elaine Gilbertson, DNP CNM FNP
• Steven J Goessl

• General Practice Dentistry in Medford, WI
• Providers in Medford, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.