Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Jacey Melissa Thelen

Dentist - General Practice β€’ Peoria, IL

Active NPI 1669303731 Individual Practitioner Female Practitioner
Practice location in NPPES

838 W Glen Ave
Peoria, IL 616144882

Call 3092441655 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

838 W Glen Ave

Peoria, IL 616144882

Telephone 3092441655
Organization at the Same NPPES Address or Phone
Pine Glen Dental Group, Ltd Facility NPI 1659589299

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2026

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Peoria and Illinois

68 active clinicians are listed under Dentist - General Practice with a practice address in Peoria, IL (5,281 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Peoria

0% of these 68 clinicians have the CMS telehealth indicator.

0% of these 68 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-05-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES 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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Dr. Robert Pollard , DDS

Dentist - General Practice

NPI 1801004502

Doctor of Dental Surgery

Dr. Lori Rice , DDS

Dentist - General Practice

NPI 1063620771

Doctor of Dental Surgery

NPI 1467759944

Doctor of Dental Medicine

Career & Practice History

NPI enumerated May 27, 2026.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from June 2026 to August 2026.

No reviews have been published yet. Leave a review.

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

Other Dentist - General Practices in Peoria

All Dentist - General Practices in Peoria

Mailing Address

201 E North Lakeview Dr

East Peoria, IL 616111050

Phone: 3099226720

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.