MEDICARE: PLANKEN DENTAL INTEGRATIVE WELLNESS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1235097882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANKEN DENTAL INTEGRATIVE WELLNESS PC

Provider Business Mailing Address
First Line	:	3401 MERRICK RD
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-4343
Country	:	US
Telephone Number	:	516-783-4421
Fax Number	:	516-679-0855

Provider Business Practice Location Address
First Line	:	3401 MERRICK RD
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-4343
Country	:	US
Telephone Number	:	516-783-4421
Fax Number	:	516-679-0855

Authorized Official
Title or Position	:	OWNER
Name	:	MACARENA PLANKEN
Credential	:	DDS
Telephone Number	:	516-783-4421

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	05/22/2026

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