Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jon Hallie, DDS

Individual provider Dentist · NPI 1063892313

Dr. Jon Hallie, DDS is a Dentist in Roseau, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2015
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

201 4th Ave NW
Roseau, MN 56751-1033
Phone: (218) 463-2553
Fax: (218) 463-9464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D13518 (MN)

Record details

NPI number1063892313
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 2, 2015
Last updated in NPPESJuly 21, 2022
Mailing address201 4th Ave Nw, Roseau, MN 56751-1033

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