Provider Demographics
NPI:1912490285
Name:PLECKI, BROOKE ALIANA MENSAH (DMD)
Entity Type:Individual
Prefix:
First Name:BROOKE ALIANA
Middle Name:MENSAH
Last Name:PLECKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7949 WALNUT HILL LN STE 115
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5640
Mailing Address - Country:US
Mailing Address - Phone:469-897-4569
Mailing Address - Fax:
Practice Address - Street 1:7949 WALNUT HILL LN STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-5640
Practice Address - Country:US
Practice Address - Phone:469-897-4569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342221223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34222OtherTEXAS STATE BOARD OF DENTAL EXAMINERS