Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1225481930 Individual Practitioner Male Practitioner

Dr. Benjamin Kellum , DDS

Dentist • Pocatello, ID

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Kellum, DDS is a registered healthcare professional specializing in Dentist in Pocatello, ID. Practice services are available at IDAHO STATE UNIVERSITY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

Idaho State University

Pocatello, ID 832090001

Telephone 2082823289

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Pocatello, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
34 Specialists

Practicing in Pocatello, ID (448 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License ID D4772

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1023422078

Doctor of Dental Surgery

NPI 1407261407

Doctor of Dental Surgery

Dr. Domenick Fuller , DDS

Dentist - General Practice

NPI 1649063850

Doctor of Dental Surgery

NPI 1700584794
Dr. Andrew Bohnsack , DDS

Dentist - General Practice

NPI 1811277742

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 18, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 18, 2016

Registered at IDAHO STATE UNIVERSITY, POCATELLO, ID 832090001 (Tel: 2082823289)

📍
Updated Business Mailing Address July 18, 2016

Registered at IDAHO STATE UNIVERSITY, POCATELLO, ID 832090001

👤
Provider Name / Credentials Updated July 18, 2016

Recorded as BENJAMIN KELLUM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 18, 2016

Dentist (License #D4772 in ID)

🟢
Initial NPI Registration & Enumeration July 18, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225481930
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 18, 2016
Last Update: July 18, 2016
Sole Proprietor: Yes

Mailing Address

Idaho State University

Pocatello, ID 832090001

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.