Healthcare Provider Details

I. General information

NPI: 1235097882
Provider Name (Legal Business Name): PLANKEN DENTAL INTEGRATIVE WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 MERRICK RD
WANTAGH NY
11793-4343
US

IV. Provider business mailing address

3401 MERRICK RD
WANTAGH NY
11793-4343
US

V. Phone/Fax

Practice location:
  • Phone: 516-783-4421
  • Fax: 516-679-0855
Mailing address:
  • Phone: 516-783-4421
  • Fax: 516-679-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MACARENA PLANKEN
Title or Position: OWNER
Credential: DDS
Phone: 516-783-4421