Individual provider Active NPI

Siqiang Rong, DMD

  • General Practice Dentistry
  • Queen Creek, AZ
National Provider Identifier
1467342188
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012514 Issued in AZ
Practice address
1714 W Hunt Hwy Ste 100
Queen Creek, AZ 85143-5245
Phone
(480) 882-3119
NPI assigned
Jul 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D012514 AZ Primary

Addresses

Primary practice location

1714 W Hunt Hwy Ste 100
Queen Creek, AZ 85143-5245

Mailing address

1727 E Pecos Rd Apt 3026
Gilbert, AZ 85295-1872
Phone (602) 815-3177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20251008003482 AZ Order and Referring Only - DentistPractitioner - Dentist 1153828850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Dental Group and Orthodontics, LLP General Practice PastSince Jul 9, 2025 Accepting new patients

Organizations & group practices 1

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": "1751587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1467342188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 E PECOS RD APT 3026",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951872",
            "telephone_number": "602-815-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 W HUNT HWY STE 100",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851435245",
            "telephone_number": "480-882-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONG",
        "first_name": "SIQIANG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.