Clove Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CLOVE DENTAL PLLC

Practice address

4207 N Prospect Rd
Peoria Heights, IL 61616-7754

Phone

(309) 323-8884

Fax

(309) 324-3336

NPI assigned

Mar 2, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sandeep Thota, DMD

Title

President

Phone

(314) 651-6550

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1588519904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 N PROSPECT RD",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167754",
            "telephone_number": "309-323-8884",
            "fax_number": "309-324-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 N PROSPECT RD",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167754",
            "telephone_number": "309-323-8884",
            "fax_number": "309-324-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "THOTA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-651-6550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosanna Cain, COTA
• Center of Excellence in Plastic, Aesthetic, and Reconstructive Surgery, Inc.
• Sandra Kay Chatwood, MA LMFT LCPC
• Carly Ann Cheatham
• Jonathon Ross Closen, PHARMD
• Kristin Kathryn Cochran, COTA/L
• Amanda M Crusen, LCSW
• Stephen C Doughty, MD
• Mary Ann Eichorn
• Shannon Jo Erdmann, MA, LPC, BA

• Dentist in Peoria Heights, IL
• Providers in Peoria Heights, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.