Individual provider Active NPI

Tristan Mauk, PHDHP

  • Dental Hygienist
  • Bedford, PA
National Provider Identifier
1043167760
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
PHDH001545 Issued in PA
Practice address
104 Railroad St
Bedford, PA 15522-1013
Phone
(814) 842-3206
Fax
(814) 310-2008
NPI assigned
Mar 12, 2026
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X PHDH001545 PA Primary

Addresses

Primary practice location

104 Railroad St
Bedford, PA 15522-1013

Mailing address

1 Corporate Dr Ste 107
Bedford, PA 15522-7941
Phone (814) 709-9803

Other practice location 1

144 5th Ave
Hyndman, PA 15545-7379
Phone (814) 842-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PHDH001545PAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1043167760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORPORATE DR STE 107",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155227941",
            "telephone_number": "814-709-9803",
            "fax_number": "814-310-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 RAILROAD ST",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155221013",
            "telephone_number": "814-842-3206",
            "fax_number": "814-310-2008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Hyndman",
            "state": "PA",
            "postal_code": "155457379",
            "country_code": "US",
            "telephone_number": "814-842-3206",
            "fax_number": "814-310-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUK",
        "first_name": "TRISTAN",
        "credential": "PHDHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "PA",
            "license": "PHDH001545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.