DR. JON HALLIE D.D.S.
NPI 1063892313
Dentist in Roseau, MN

Q: What is Jon Hallie's NPI number?

The NPI number for Jon Hallie is 1063892313. It was assigned to this individual provider in the NPPES registry on June 2, 2015.

Q: What is Jon Hallie's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Jon Hallie was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 02, 2015PECOS Enrolled

201 4TH AVE NW, ROSEAU, MN 56751(218) 463-2553(218) 463-9464 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, May 22, 2017 (2 updates tracked since 2017).

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About Dr. Jon Hallie D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JON HALLIE D.D.S. (NPI 1063892313) is an individual dentist in Roseau, Minnesota, licensed in Minnesota (D13518) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063892313

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JON HALLIECredential: D.D.S.

Location Address201 4TH AVE NWRoseau, MN 56751-1033

Mailing Address201 4th Ave NwRoseau, MN 56751-1033 · (218) 463-2553 · Fax (218) 463-9464

Phone(218) 463-2553

Fax(218) 463-9464

Sole ProprietorYes

Enumeration DateJune 2, 2015

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1063892313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · D13518

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

201 4TH AVE NW, Roseau, MN 56751

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jon Hallie D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56751 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

J.M. HALLIE INC.

Dentist (General Practice)

201 4TH AVE NW
ROSEAU, MN 56751

Roseau County (218) 463-2553

DR. ROBERT FRANK LARSON

Dentist (General Practice)

201 4TH AVE NW
ROSEAU, MN 56751

Roseau County (218) 463-2553

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jon Hallie's NPI number?

The NPI number for Jon Hallie is 1063892313. It was assigned to this individual provider in the NPPES registry on June 2, 2015.

Where is Jon Hallie located?

Jon Hallie practices at 201 4th Ave NW, Roseau, MN 56751. The listed phone number is (218) 463-2553.

What is Jon Hallie's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jon Hallie enrolled in Medicare?

Yes. Jon Hallie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jon Hallie was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.