Individual provider Active NPI

Qirong Huang

  • Dentist
  • Rochester, NY
National Provider Identifier
1336895630
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
063151 Issued in NY
Practice address
158 Orchard St
Rochester, NY 14611-1361
Phone
(585) 274-1630
NPI assigned
Feb 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 063151 NY Primary

Addresses

Primary practice location

158 Orchard St
Rochester, NY 14611-1361

Mailing address

347 Quinby Rd
Rochester, NY 14623-1225
Phone (585) 478-7575

Other practice location 1

25 Franklin St
Rochester, NY 14604-1002
Phone (585) 263-6599

Other practice location 2

625 Elmwood Ave
Rochester, NY 14620-2913
Phone (585) 275-5051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001367 NY Order and Referring Only - DentistPractitioner - Dentist 7416311196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063151NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester PastSince Aug 6, 2023 Accepting new patients
The Unity Hospital of Rochester PastSince Aug 6, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1336895630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 QUINBY RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231225",
            "telephone_number": "585-478-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 ORCHARD ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146111361",
            "telephone_number": "585-274-1630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146041002",
            "country_code": "US",
            "telephone_number": "585-263-6599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202913",
            "country_code": "US",
            "telephone_number": "585-275-5051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUANG",
        "first_name": "QIRONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2023-08-02",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.