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

Bradley John Hagen

Individual provider General Practice Dentistry · NPI 1316426752

Bradley John Hagen is a General Practice Dentistry in Mahtomedi, Minnesota. Licensed in Colorado, Minnesota and Virginia. Registered with an NPI since 2018.

Licensed in
CO, MN, VA
In the registry since
2018
Specialties on file
3

Practice location Address checks out

814 Mahtomedi Ave
Mahtomedi, MN 55115-1730
Phone: (651) 426-0011
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D15217 (MN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 0401417733 (VA)
General Practice Dentistry Taxonomy 1223G0001X · Licence DEN.00203682 (CO)

Record details

NPI number1316426752
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 7, 2018
Last updated in NPPESJuly 1, 2025
Certification dateJuly 1, 2025

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