Roy Vernon Hakala, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8171 Issued in MN

Practice address

2550 University Ave W
Suite 143N
Saint Paul, MN 55114-1052

Phone

(651) 642-1013

Fax

(651) 642-0947

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 27, 2019 through Jun 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1497847354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 143N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-642-1013",
            "fax_number": "651-642-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 143N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-642-1013",
            "fax_number": "651-642-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKALA",
        "first_name": "ROY",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "8171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33662100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "1491470",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA DENTAL LICENSE",
            "identifier": "D8171",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sirak Assegie Hailu, D.C.
• Leah Autumn Haines, RN, BSN
• Cyrus Hair
• Fartun A Haji
• Umulkheir Ahmed Yussuf Haji
• Aila Dale Haku
• Jasmine Joelene Hal
• Amal Mohamed Halane
• Dennis William Halbe, M.D.
• Shelli N Halbersma, LPCC

• Dentist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.