Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1669303731 Individual Practitioner Female Practitioner

Jacey Melissa Thelen

Dentist - General Practice • Peoria, IL

Professional Overview & Biography Verified Profile Summary

Jacey Thelen is a registered healthcare professional specializing in Dentist - General Practice in Peoria, IL. Practice services are available at 838 W GLEN AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

838 W Glen Ave

Peoria, IL 616144882

Telephone 3092441655
Associated Practice Facility / Clinic
🏢 Pine Glen Dental Group, Ltd Facility NPI 1659589299

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
74 Specialists

Practicing in Peoria, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019.037106

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Lori Rice , DDS

Dentist - General Practice

NPI 1063620771

Doctor of Dental Surgery

NPI 1467759944

Doctor of Dental Medicine

Dr. Robert Pollard , DDS

Dentist - General Practice

NPI 1801004502

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 27, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location May 27, 2026

Registered at 838 W GLEN AVE, PEORIA, IL 616144882 (Tel: 3092441655)

📍
Updated Business Mailing Address May 27, 2026

Registered at 201 E NORTH LAKEVIEW DR, EAST PEORIA, IL 616111050 (Tel: 3099226720)

👤
Provider Name / Credentials Updated May 27, 2026

Recorded as JACEY THELEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 27, 2026

Dentist (License #019.037106 in IL)

🟢
Initial NPI Registration & Enumeration May 27, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669303731
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 27, 2026
Last Update: May 27, 2026
Sole Proprietor: No

Mailing Address

201 E North Lakeview Dr

East Peoria, IL 616111050

Phone: 3099226720

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.