DR. BENJAMIN KELLUM DDS
NPI 1225481930
Dentist in Pocatello, ID

Q: What is Benjamin Kellum's NPI number?

The NPI number for Benjamin Kellum is 1225481930. It was assigned to this individual provider in the NPPES registry on July 18, 2016.

Q: What is Benjamin Kellum's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Benjamin Kellum was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2016PECOS Enrolled

IDAHO STATE UNIVERSITY, POCATELLO, ID 83209(208) 282-3289 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Benjamin Kellum Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BENJAMIN KELLUM DDS (NPI 1225481930) is an individual dentist in Pocatello, Idaho, licensed in Idaho (D4772) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225481930

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. BENJAMIN KELLUMCredential: DDS

Location AddressIDAHO STATE UNIVERSITYPocatello, ID 83209-0001

Mailing AddressIdaho State UniversityPocatello, ID 83209-0001

Phone(208) 282-3289

Sole ProprietorYes

Enumeration DateJuly 18, 2016

✔ NPI 1225481930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in ID · D4772

Definition

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.

IDAHO STATE UNIVERSITY, Pocatello, ID 83209

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Benjamin Kellum Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83209 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEVEN RANDALL LAWYER PHD

Psychologist (Cognitive & Behavioral)

IDAHO STATE UNIVERSITY, DEPARTMENT OF PSYCHOLOGY, STOP 8112
POCATELLO, ID 83209

Bannock County (208) 282-2142

DR. JENNIFER HOLST AU.D.

Audiologist

IDAHO STATE UNIVERSITY, 921 S. 8TH STOP 8116
POCATELLO, ID 83209

Bannock County (208) 282-3747

MR. THEODORE WILLIAM PETERSON O.T.R.

Occupational Therapist

IDAHO STATE UNIVERSITY, CAMPUS BOX 8045
POCATELLO, ID 83209

Bannock County (208) 282-4631

DR. ALEXANDER G URFER PT

Physical Therapist

IDAHO STATE UNIVERSITY, MAIL STOP 8045
POCATELLO, ID 83209

Bannock County (208) 282-4095

DR. JAMES E CREELMAN III DPT

Physical Therapist

IDAHO STATE UNIVERSITY, CAMPUS BOX 8045
POCATELLO, ID 83209

Bannock County (208) 282-4566

MRS. LORIANN HELGESON OTRL

Occupational Therapist

IDAHO STATE UNIVERSITY, CAMPUS STOP 8045
POCATELLO, ID 83209

Bannock County (208) 282-2590

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Kellum's NPI number?

The NPI number for Benjamin Kellum is 1225481930. It was assigned to this individual provider in the NPPES registry on July 18, 2016.

Where is Benjamin Kellum located?

Benjamin Kellum practices at Idaho State University, Pocatello, ID 83209. The listed phone number is (208) 282-3289.

What is Benjamin Kellum's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Benjamin Kellum enrolled in Medicare?

Yes. Benjamin Kellum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Benjamin Kellum was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.