Jacey Melissa Thelen

General Practice Dentistry · Peoria, IL

Individual Active NPI

NPI number 1669303731

Practice location

838 W Glen Ave
Peoria, IL 61614-4882
Phone
(309) 244-1655

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NPI record

NPI
1669303731
Entity type
Individual (Type 1)
Enumeration date
May 27, 2026
Last updated
May 27, 2026
Certified
May 27, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 019.037106 IL

Mailing address

201 E North Lakeview Dr
East Peoria, IL 61611-1050
Phone
(309) 922-6720

About Jacey Thelen

Jacey Melissa Thelen is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 838 W Glen Ave, Peoria, IL 61614-4882. The NPI number 1669303731 was assigned on May 27, 2026 and the record was last updated on May 27, 2026.

Jacey Thelen lists a license in the registry: #019.037106 (IL) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacey Melissa Thelen?

The NPI number is 1669303731.

What is the phone number of Jacey Thelen?

The phone number listed for the practice location is (309) 244-1655.

Where is Jacey Thelen located?

838 W Glen Ave, Peoria, IL 61614-4882.

What is the taxonomy code for Jacey Thelen?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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