Active NPI
Brendan William Tully, D.D.S.
- Dentist
- Camp Pendleton, CA
National Provider Identifier
1215920061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5806
- Practice address
- 1St Dental Battalion/NDC
Camp Pendleton, CA 92055 - Phone
- (760) 725-2569
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 5806 | AZ | Primary |
Addresses
Primary practice location
1St Dental Battalion/NDC
Camp Pendleton, CA 92055
Mailing address
2658 Del Mar Heights Rd
Del Mar, CA 92014-3100
Phone (760) 401-6881
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 |
|---|---|---|---|
| 5806 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1215920061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2658 DEL MAR HEIGHTS RD",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920143100",
"telephone_number": "760-401-6881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1ST DENTAL BATTALION/NDC",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "92055",
"telephone_number": "760-725-2569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "BRENDAN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "5806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.