David Jerome Hagstrom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11449 Issued in MN

Practice address

2112 Viking Dr NW
Rochester, MN 55901-3522

Phone

(507) 288-1744

Fax

(507) 292-5776

NPI assigned

Nov 10, 2005

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 4

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David J. Hagstrom LLC

  • General Practice Dentistry
  • Rochester, MN
  • NPI 1225196363
  Authorized official Same address or phone

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639150006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 VIKING DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013522",
            "telephone_number": "507-288-1744",
            "fax_number": "507-292-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 VIKING DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559013522",
            "telephone_number": "507-288-1744",
            "fax_number": "507-292-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "DAVID",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39492MA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN ID",
            "identifier": "5242464",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BP",
            "identifier": "39492MA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "918158000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molissa M Hager, NP
• Sean Haggerty
• Sean Michael Haggerty Jr., MSW, L.I.C.S.W
• Donald J. Hagler Sr., M.D.
• Sharon D Hagler, LICSW
• Natalie Taylor Hagy, PHARMD
• Kathleen Mae Hahn
• Lewis D. Hahn, M.D.
• Sarah Judith Hahn, APRN, CNP, DNP
• Siu Han Jo Jo Hai, MBBS

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, 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 Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.