Dentsensus Peoria, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTSENSUS PEORIA, PLLC

Practice address

1320 W Northmoor Rd Ste a
Peoria, IL 61614-3425

Phone

(414) 841-2881

NPI assigned

Jun 13, 2025

Organization subpart

No

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

Authorized official

Name

Jack Kalloch, DMDNPI 1669215380

Title

Owner

Phone

(414) 841-2881

Specialties & licenses 1

Addresses

Other names 1

• Just Kidz Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Kalloch, DMD

  • Dentist
  • Edinburg, TX
  • NPI 1669215380
  NPD Authorized official

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1831085265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W NORTHMOOR RD STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143425",
            "telephone_number": "414-841-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W NORTHMOOR RD STE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143425",
            "telephone_number": "414-841-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTSENSUS PEORIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "KALLOCH",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-841-2881",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Just Kidz Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dental Professionals of Illinois, P.C.
• Dental Professionals of Illinois, P.C.
• Dental Sealants & More
• Heather L Dentino, APN
• Theresa Ann Denton, PTA
• Dentsensus, PLLC
• Marte Linn Deppermann, MD
• Danea Deppert
• Kristin M Derer, CRNA
• Tenzin Desa, M.D.

• Dental Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; 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.