Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PRASAD B GONAVARUM D.D.S.
NPI 1174512339
Dentist - General Practice in Chicago, IL

Q: What is Prasad Gonavarum's NPI number?

The NPI number for Prasad Gonavarum is 1174512339. It was assigned to this individual provider in the NPPES registry on October 19, 2005.

Q: What is Prasad Gonavarum's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Prasad Gonavarum was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 19, 2005

2413 S STATE ST, IDEAL DENTAL CENTER, CHICAGO, IL 60616(312) 528-1800(312) 528-1881 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Prasad B Gonavarum D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRASAD B GONAVARUM D.D.S. (NPI 1174512339) is an individual general practice provider in Chicago, Illinois and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1174512339

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NamePRASAD B GONAVARUMCredential: D.D.S.

Location Address2413 S STATE ST, IDEAL DENTAL CENTERChicago, IL 60616-2311

Mailing Address7439 Pipers Way, Apt # 2Downers Grove, IL 60516-4050 · (630) 271-1687

Phone(312) 528-1800

Fax(312) 528-1881

Sole ProprietorNo

Enumeration DateOctober 19, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1174512339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

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.

2413 S STATE ST, Chicago, IL 60616

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. NATU J PATEL RPH

Pharmacist

2413 S STATE ST
CHICAGO, IL 60616

Cook County (312) 225-6803

DENTAL HEALTH CENTER LTD

Dentist

2413 S STATE ST
CHICAGO, IL 60616

Cook County (312) 949-9000

FTDC LTD

Dentist (General Practice)

2413 S STATE ST
CHICAGO, IL 60616

Cook County (312) 949-9000

IDEAL PHARMACY

Pharmacist

2413 S STATE ST
CHICAGO, IL 60616

Cook County (312) 225-6803

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prasad Gonavarum's NPI number?

The NPI number for Prasad Gonavarum is 1174512339. It was assigned to this individual provider in the NPPES registry on October 19, 2005.

Where is Prasad Gonavarum located?

Prasad Gonavarum practices at 2413 S State St Ideal Dental Center, Chicago, IL 60616. The listed phone number is (312) 528-1800.

What is Prasad Gonavarum's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Prasad Gonavarum accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Prasad Gonavarum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prasad Gonavarum was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.