Marc J. Tully, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

64401 Issued in CA

Practice address

901 N Pacific Coast Hwy Ste 200B
Redondo Beach, CA 90277-7702

Phone

(310) 379-6798

Fax

(310) 379-6501

NPI assigned

Sep 16, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Andrew C Sheng DMD Apc

  • General Practice Dentistry
  • San Pedro, CA
  • NPI 1518119486
  NPD (past)
• David Martin D.D.S., Inc.

  • Dental Clinic/Center
  • San Pedro, CA
  • NPI 1740495027
  NPD (past)
• Fred J Kim DDS Inc

  • Dentist
  • Redondo Beach, CA
  • NPI 1871628289
  NPD (past)

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1265714067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772162",
            "telephone_number": "310-379-6798",
            "fax_number": "310-379-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PACIFIC COAST HWY STE 200B",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902777702",
            "telephone_number": "310-379-6798",
            "fax_number": "310-379-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "MARC",
        "middle_name": "J.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02474000",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patsie Lee Trowbridge, PSYCHOLOGIST
• Erin A Trujillo
• Jimmy Truong, M.D.
• Ronald Tsao, M.D.
• Alexandra Marie Armas Tuck, LMFT
• Bejani Turley
• Laila Felica Turner
• Melinda Renae Turner, PT
• Antanissha Tyler
• Steven P Tyssee, DPT

• Dentist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.