Active NPI
Astin Tan-Nam Lequang, DDS
- General Practice Dentistry
- Norfolk, VA
National Provider Identifier
1164314902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 14227683-9926
- Practice address
- 1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803 - Phone
- (757) 953-8635
- NPI assigned
- Jul 16, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14227683-9926 | UT | Primary |
Addresses
Primary practice location
1647 Admiral Taussig Blvd
Norfolk, VA 23511-2803
Mailing address
3100 De Forest Rd Unit 186
Marina, CA 93933-5308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14227683-9926 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1164314902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 DE FOREST RD UNIT 186",
"city": "MARINA",
"state": "CA",
"postal_code": "939335308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1647 ADMIRAL TAUSSIG BLVD",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235112803",
"telephone_number": "757-953-8635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEQUANG",
"first_name": "ASTIN",
"middle_name": "TAN-NAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-16",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "14227683-9926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.