SearchIllinoisGeneral Practice Dentistry

Prasad Gonavarum, D.D.S

NPI 1174512339 · on the registry since 2005

Practice

Address
2413 S State St
Ideal Dental Center
Chicago, IL 60616
Phone
(312) 528-1800
Fax
(312) 528-1881
Organisation at this address
Ftdc Ltd
Ideal Pharmacy
Dental Health Center Ltd
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
General Practice Dentistry
1223G0001X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-07-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois