Individual provider · Type 1 NPI

Prasad B. Gonavarum, DDS

General Practice Dentistry · Chicago, IL

NPI number 1174512339 Active

Practice location

2413 S State St, Ideal Dental Center
Chicago, IL 60616-2311

Call (312) 528-1800 Map

Fax (312) 528-1881

Mailing address

7439 Pipers Way, Apt # 2
Downers Grove, IL 60516-4050

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1174512339

Prasad B. Gonavarum, DDS's National Provider Identifier is 1174512339, issued on Oct 19, 2005. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Chicago, IL. The record was last updated on Jul 13, 2026.