Sravanthi Ganne, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN19304 Issued in FL

Practice address

1728 Dunlawton Ave Ste 3
Apartment 2G
Port Orange, FL 32127-2923

Phone

(412) 913-8877

Fax

(844) 704-4268

NPI assigned

Jun 23, 2008

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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 Jan 1, 2026 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sai Oral Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Port Orange, FL
  • NPI 1477917706
  NPD (past) Authorized official
• Orlando Oral & Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Winter Park, FL
  • NPI 1205920204
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1972764967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 DUNLAWTON AVE STE 3",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272923",
            "telephone_number": "412-913-8877",
            "fax_number": "844-704-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 DUNLAWTON AVE STE 3",
            "address_2": "APARTMENT 2G",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272923",
            "telephone_number": "412-913-8877",
            "fax_number": "844-704-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W Granada Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748155",
            "country_code": "US",
            "telephone_number": "386-238-9380",
            "fax_number": "844-704-4268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 Colony Park Rd",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321680001",
            "country_code": "US",
            "telephone_number": "386-675-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNE",
        "first_name": "SRAVANTHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN19304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol M Gaines, DO
• Amanda Gaitan
• Jennifer Elizabeth Gaitan, D.C.
• Amanda Galena
• Kajal Gandhi
• Danny Garcia
• Dollyam Garcia, RBT
• Millan Miguel Garcia, DC
• Gabrielle Gardner
• Summer Gardner

• Oral and Maxillofacial Surgery (Dentist) in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.