J.M. Hallie Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

J.M. HALLIE INC.

Doing business as

Hallie Family Dentistry

Practice address

201 4TH Ave NW
Roseau, MN 56751-1033

Phone

(218) 463-2553

Fax

(218) 463-9464

NPI assigned

Mar 13, 2023

Last updated

Mar 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jon M Hallie, DDSNPI 1063892313

Title

Ceo

Phone

(218) 463-2553

Specialties & licenses 1

Addresses

Other names 1

• Hallie Family Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jon Hallie, D.D.S.

  • Dentist
  • Roseau, MN
  • NPI 1063892313
  NPD Authorized official
• Robert Frank Larson

  • General Practice Dentistry
  • Roseau, MN
  • NPI 1952478489
  NPD (past)

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1407557085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 4TH AVE NW",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511033",
            "telephone_number": "218-463-2553",
            "fax_number": "218-463-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 4TH AVE NW",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511033",
            "telephone_number": "218-463-2553",
            "fax_number": "218-463-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.M. HALLIE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-11",
        "status": "A",
        "authorized_official_last_name": "HALLIE",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-463-2553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hallie Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marsha Lee Hagen
• Jon Hallie, D.D.S.
• Ralph H Herseth, MD
• Andrew J Humes
• Aunica Isane, PA-C
• Jack V, Lundbohm Inc
• Luis G Jain, MD
• Marissa Johnson, LICSW
• Allyssa Jonsson, DO
• Blake Kalturnyk, M.D.

• General Practice Dentistry in Roseau, MN
• Providers in Roseau, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.